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Monjurul Hoque, Ehsanul Hoque, Suriya B Kader,
Volume 6, Issue 2 (7-2008)

Background: Intrapartam complications such as foetal malpresentation, placental abruption, dysfunctional labour, and postpartum haemorrhage are associated with grandmultiparity. In developing countries and many parts of Africa and sub-Saharan Africa, there is limited access to medical care. There is a need in these areas to identify women whose pregnancies are at risk of complication and it is an important part of antenatal screening and care during delivery to reduce adverse outcomes.
Objective: The objectives of this study were to evaluate the complications during pregnancy and delivery of grandmultiparity and to compare it with other parity groups.
Materials and Methods: A retrospective case control study was conducted targeting women delivered at Empangeni Hospital during April to December 2004. Among all women who delivered at the hospital, 352 grandmultimaras, 3326 nulliparas and 3772 who had parity 1 to 5, were taken as cases and controls respectively for the study.
Results: Significantly higher rates of ante partum (1%) and post partum (2%) haemorrhages, post term delivery (3%), and intrauterine foetal deaths (4.5%) were observed in grandpultiparas compared to nulliparous women but there was no difference with parity group 1-5. Assisted vaginal delivery rates were significantly lower in grandpultiparas women (2%) compared to nulliparous (5%) group (p < 0.05) but there was no difference with parity group 1-5. There were no significant differences in anaemia (14%), hypertension (10%), eclampsia (0.5%) and diabetes (3%), elective and emergency caesarean delivery (14.2%) and low-birth-weight delivery rates (13.2%) among different parity groups.
Conclusion: Grandmultiparity was not safer compared to other lower parity groups. Thus strategies are needed to guide women to seek proper care during pregnancy and if possible to avoid pregnancy if they had higher parity.
Zahra Kiasalari, Mohsen Khalili, Mahbobeh Aghaei,
Volume 7, Issue 5 (7-2009)

Background: There are evidences regarding the prevalence of dysfunction in sexual function and behavior in diabetic people. Experimental studies revealed a positive effect of withania somnifera on sexual function and behaviors.
Objective: In this research, the effect of withania somnifera on sexual function in diabetic male Wistar rats was assessed by measuring the serum levels of testosterone, progesterone, estrogen, FSH and LH.
Materials and Methods: Experimental diabetes mellitus type I was induced by intraperitoneal injection of a single dose (60 mg/kg) of streptozotocin (STZ) in Wistar male rats. Oral withania somnifera root was given in pelleted food at ratio of 6.25% for 4 weeks. The levels of gonadadotropic hormones (LH, FSH), progesterone, estrogen and testosterone in animals’ serum were determined after 4 weeks in all groups.
Results: Withania somnifera root was effective in lowering FSH serum level in somnifera-treated animals compared to controls (p<0.05) in both diabetic and non-diabetic groups, whereas progesterone (p<0.05), testosterone (p<0.05) and LH levels (p<0.001) were significantly higher in non-diabetic treated animals. Oral somnifera root was also able to reverse the reductive effect of diabetes on the progesterone. The estrogen level did not show any significant difference in any of the groups.
Conclusion: It is suggested that withania somnifera may have a regulatory effect on diabetes-induced change of the levels of gonadal-hormones, especially progesterone, in male rats. Nevertheless, somnifera is apparently only able to diminish FSH serum level in intact animals.  
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.
Marzieh Nojomi, Ladan Haghighi, Bita Bijari, Layla Rezvani, Seyede Khadije Tabatabaee,
Volume 8, Issue 3 (7-2010)

Background: Women 35-39 years old have a 2–3 fold higher risk of pregnancy-related death than women in their twenties and the risk is even more dramatic for women 40 years and older.
Objective: The aim of this study was to investigate the association of maternal age with risk of adverse pregnancy and mother outcomes in our setting Tehran Iran.
Materials and Methods: In this retrospective observational hospital-based study 538 nulliparous women were assessed. The association between maternal age and various pregnancy and neonatal outcomes were reported. Data were extracted from the database of Akbar Abadi hospital in Tehran from 2001-2006 records. Univariate and multiple logistic regression analyses were preformed to investigate the association between maternal age and various relevant outcomes.
Results: Women aged 35 years or older had an increased percentages of gestational hypertension (18.8% vs 9.6%; p=0.02) and diabetes in pregnancy (3.7% vs 1.4%; p=0.08) compared with women younger than 35 years. There were no differences between the two age groups in Apgar score at 1 min antepartum hemorrhage preterm labor PROM fetal distress perinatal death and postpartum hemorrhage.
Conclusion: Advanced maternal age was shown to be independently associated with low birth weight preterm labor and rate of cesarean delivery.
Sedigheh Amooee, Alamtaj Samsami, Jamileh Jahanbakhsh, Mehran Karimi,
Volume 9, Issue 1 (7-2011)

Background: β-thalassemia is the most common hereditary disease in Iran and more than 2 million carriers of the β-thalassemia mutant gene are living in this country.
Objective: To determine pregnancy outcome of women with β-thalassemia minor.
Materials and Methods: In this retrospective, case-control study in two universities affiliated hospitals in Shiraz, all pregnancies occurred between 2006 and 2008 were included. Patients were divided in two groups regarding the presence of β-thalassemia minor. Patients in case and control groups were matched according to maternal age, gestational age and number of previous pregnancies. Cesarean delivery, hypertensive disorders, gestational diabetes mellitus, premature rupture of membranes and preterm labor were recorded in each group and were compared using the χ2 or Fisher exact tests. 
Results: Overall 510 β-thalassemia minor subjects and 512 healthy controls were studied. Cases with β-thalassemia minor had significantly higher prevalence of oligohydramnios (p<0.001) and cesarean section delivery (p=0.001). There was no significant difference regarding Apgar score in 1st (p=0.65) and 5th minute (p=0.25), IUGR (p=0.073), gestational diabetes mellitus (DM) (p=0.443) and preeclampsia (p=0.116) between two study groups.    
Conclusion: β-thalassemia minor does not significantly influence the pregnancy outcome in the negative way.
Akram Ahangarpour, Ali Akbar Oroojan, Ashraf Amirzargar, Maryam Ghanavati,
Volume 9, Issue 4 (7-2011)

Background: Citrus aurantium is a small citrus tree, with scented white flowers. The C. aurantium is used in Asian herbal medicine primarily to treat digestive problems.
Objective: The goal of this study is to investigate the effect of C. aurantium flower's aqueous extract on uterine contraction in presence of some known uterus stimulants.
Materials and Methods: In experimental study 30 virgin Wistar rats 200-300gr were obtained. After laparatomy, a piece of Uterus was dissected out and mounted in an organ bath (10ml) containing De Jalon (29°C) and contracted by KCl (60mM), oxytocin (10mU/ml) and barium chloride (4mM) then  the effect of C. aurantium flower's aqueous extract (1-8 mg/ml) on the uterine contractions was investigated. Uterus was separately incubated with propranolol (1mM), naloxone (1mM) and the role of β-adrenoceptors, opioid receptors were evaluated.
Results: Cumulative concentrations of the extract (1-8 mg/ml) decreased KCl, oxytocin and barium chloride induced uterine contractions, dose-dependently (p<0.001). C. aurantium flower's aqueous extract was unaffected on incubation the tissue with propranolol and naloxone.
Conclusion: It seems that the extract induced antispasmodic effect mainly via calcium influx blockade. However, neither β-adrenoceptors nor opioid receptors were involved. Since the extract has antispasmodic effect on uterus contraction therefore we can suggest that more study will be necessary to relief dysmenorrheal.
Lii-Shung Huang, Chi-Hwa Yen, Shu-Hsin Lee, Bih-Ching Shu, For-Wey Lung, Ching-Pyng Kuo, Wei-Ya Wu, Angel Yen-Chiao Lu, Yen-Ju Lin, Hui-Sheng Lin, Ming-Chih Chou, Meng-Chih Lee,
Volume 9, Issue 4 (7-2011)

Background: There is an upward trend for parents to resort to assisted reproductive technology (ART) treatment due to delayed childbirth or birth difficulties.
Objective: This study investigates the pregnancy health and birth outcomes of women who underwent ART and analyzes the factors that influence birth weight to become<10 percentile when undergoing ART.
Materials and Methods: This study analyzed results of the first wave of the Taiwan Birth Cohort study. Through stratified systematic sampling, 24,200 mother-and-child sampling pairs were obtained from a total of 206,741 live births in Taiwan in 2005; 366 of the babies were born with the use of ART.
Results: During pregnancy, mothers who used ART suffered from higher risks of complication than the natural conception counterparts, including gestational diabetes mellitus (GDM), pregnancy induced hypertension (PIH), and placenta previa. Additionally, babies born through ART had poorer outcomes than the natural conception groups: the low birth weight (<2500g) was 33.1% compared to 6.4% for babies born naturally.
Conclusion: Pregnancy health and birth outcomes of women who underwent ART were worse than those who got natural conception. Types of maternal complication among ART women included GDM, PIH, and placenta previa. Having multiple births was the most important factor that causes low birth weight in babies. The results of this study can be used as a reference for the health and care of mothers and babies who use ART.
Ashraf Jamal, Forozan Milani, Ashraf Al-Yasin,
Volume 10, Issue 3 (7-2012)

Background: Women with polycystic ovary syndrome (PCOS) often are infertile and even if they become pregnant, there are complications with some adverse outcomes. It has been reported that aspirin and metformin improve uteroplacental circulation and reduce pregnancy complications.
Objective: To determine and compare uteroplacental circulation and obstetrics complications in pregnant women with PCOS treated with metformin, aspirin and control group.
Materials and Methods: 105 pregnant women with PCOS were enrolled in this study after assessing uterine artery pulsatility index (PI) with Doppler ultrasonography at 12 weeks of gestation. The patients were divided into three groups and received metformin 2000 mg or aspirin 80 mg daily, or no intervention until the end of pregnancy. PI was assessed for the patients at 20 week of gestation and groups were followed up till delivery. PI and obstetrics complications such as gestational diabetes, preterm labor, preeclampsia and IUGR were compared among groups.
Results: All groups had significant reduction in the mean uterine artery PI at 20 weeks measurement (p<0.05), but this reduction was more in metformin and aspirin groups than control group (p=0.002). There was a significant difference in mean uterine artery PI 20 week of gestation in three groups (p=0.005). Adverse outcomes have seen 4 out of 35 in metformin group, 7 out of 35 in aspirin group and 11 out of 35 in control group. There weren’t significant differences among groups (p=0.12).
Conclusion: Metformin and low dose aspirin reduced uterine artery impedance but there was not associated with reduced obstetrics complication in women with PCOS.

Samira Behboudi Gandevani, Ahia Garshasbi, Sara Shahpari Niri, Mohammad Mehdi Naghizade,
Volume 10, Issue 3 (7-2012)

Background: Gestational diabetes mellitus (GDM) is common problem during pregnancy. Diagnostic criteria of this problem are based on foreign population. Because of differences in racial, cultural, and nutritional characteristics, we need to determine these criteria are suitable for Iranian population.
Objective: To determine whether different diagnostic criteria of gestational diabetes mellitus (GDM) are suitable for Iranian population.
Materials and Methods: Prospective study was performed on 617 pregnant women. 1804 subjects referred for 50 g glucose challenge test (GCT) between 24th and 28th weeks of gestation. 617 women with abnormal GCT (blood glucose ≥130 mg/dl) underwent 100-g 3-h oral glucose tolerance test (OGTT). The results were classified by three diagnostic criteria: new “Iranian” diagnostic criteria based on the results from the 100-g 3-h OGTT performed in healthy participating women; the Carpenter and Coustan (CC) criteria; and the National Diabetes Data Group (NDDG) criteria. Obstetric and neonatal outcomes were recorded.
Results: With 89% as the statistical cutoff value for the 100-g 3-h OGTT, the new diagnostic criteria were 92, 179, 153, and 121 mg/dL at 0, 60, 120, and 180 min. The K value was 0.945 for the new criteria vs. the CC criteria and 0.657 for the new criteria vs. the NDDG criteria (p<0.001). In women with GDM, the incidence rates of adverse outcomes by the new and CC criteria were similar, but higher than NDDG criteria (p<0.05).
Conclusion: Carpenter and Coustan criteria are applicable to Iranian pregnant women for diagnosis of GDM. 
Fakhrolmolouk Yassaee, Roghieh Eskandari, Zohreh Amiri,
Volume 10, Issue 5 (10-2012)

Background: Idiopathic thrombocytopenic purpura (ITP) is a disease that commonly affects women of reproductive age and is associated with maternal and fetal complications.
Objective: The aim of the present study was to report the perinatal outcome in pregnant women with ITP. Materials and Methods: Twenty one pregnant women with ITP admitted in a teaching hospital in Tehran, from October 2008 to February 2010, were enrolled in this prospective historical cohort study; course and perinatal outcome of pregnancies were studied.
Results: Seven (33.3%) cases had been diagnosed before pregnancy, while the other fourteen (66.7%) were diagnosed during pregnancy. During hospitalization, thirteen (62%) patients required treatment, eight (61.5%) of them with steroids, two (15.3%) received intravenous immunoglobulin (IVIG), and three (23%) were treated with steroids and IVIG. Three babies were delivered vaginally (14.3%), seventeen (81%) through cesarean section and one patient aborted her fetus. Nine mothers (42.9%) had platelet counts &lt;50000/ml at the time of delivery; but postpartum hemorrhage occurred in 4 (19%) women and one women received platelet transfusion during cesarean section. Six (28.6%) women developed gestational diabetes. Pregnancy was complicated by preeclampsia in one woman and by abruptio placenta in another. One pregnancy terminated in intrauterine fetal death. Seventeen infants (89.5%) had normal platelet counts, and two (10.5%) had moderate thrombocytopenia. No infant showed signs of hemorrhage, but 2 neonates (10.5%) were diagnosed with intrauterine growth restriction.
Conclusion: Rate of gestational diabetes in pregnant women with ITP is higher than the general population. Rate of gestinational diabetes is 3-5% and postpartum hemorrhage is 5-7% in general. Postpartum hemorrhage is common in these women. Severe thrombocytopenia and bleeding in the newborns are uncommon.
Esmat Mangoli, Ali Reza Talebi, Morteza Anvari, Majid Pourentezari,
Volume 11, Issue 1 (4-2013)

Background: Diabetes mellitus (DM), primary or idiopathic is a chronic disorder of the carbohydrate, lipid and protein metabolism. DM may impact male reproductive function at several levels. It is shown that DM has detrimental effects on sperm parameters in human and experimental animals.
Objective: The aim of this study was to observe the effects of diabetes on sperm parameters (viability, count, morphology and motility) and evaluation of sperm chromatin quality in mice.
Materials and Methods: Totally twenty adult male Syrian mice were divided randomly into 2 groups (n=10). The animals of group A were considered as controls while group B mice were diabetic that received a single dose (200 mg/kg) streptozotocin (STZ) intra peritoneally. After 35 days, the cauda epididymis of each diabetic mouse was dissected and placed in culture medium for 30 min. The swim-out spermatozoa were analyzed for count, motility, morphology and viability. The sperm chromatin quality and DNA integrity, was evaluated with Aniline Blue (AB), Toluidine blue (TB), Acridine orange (AO) and Chromomycin A3 (CMA3) staining.
Results: In sperm analysis, the diabetic mice had poor parameters in comparison with control animals (p=0.000). Regarding sperm chromatin quality, the results of TB and AO tests showed statically significant differences between two groups, but in AB and CMA3 staining, we didn’t see any differences between them.
Conclusion: The results showed that STZ-induced diabetes mellitus may influence the male fertility potential via affecting sperm parameters and DNA integrity in mice. However, according to our data, the diabetes doesn’t have any detrimental effects on histone-protamines replacement during the testicular phase of sperm chromatin packaging.
Laleh Eslamian, Soheila Akbari, Vajihe Marsoosi, Ashraf Jamal,
Volume 11, Issue 4 (6-2013)

Background: Fetal growth in diabetic pregnancies is a complex process and probably abnormalities in other metabolic pathways such as protein and lipid, as well as carbohydrate are responsible for delivering of macrosomic newborn.
Objective: The purpose of this study was to investigate the association between fetal growth and different maternal metabolic parameters in women with gestational diabetes mellitus (GDM) in comparison to control group.
Materials and Methods: This was a prospective cohort study conducted between March 2011 and May 2012, on 112 pregnant women with GDM and 159 healthy pregnant women. In order to determine of lipids or lipoproteins changes during pregnancy and to investigate any possible effects on fetal growth, lipid components, glucose and insulin levels were obtained in maternal serum three times in third trimester.
Results: Maternal serum glucose, total cholesterol (TC), low and high density lipoprotein (LDL-c, HDL-c) levels did not show any significant difference between two groups. While insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride (TG) values were detected to be significantly higher in the GDM cases especially after 32 weeks of gestation (p<0.001). After adjustment for confounding variables, maternal hypertriglyceridemia remained as a significant risk factor for delivering large for gestational age (LGA) newborns (p=0.04); and according to spearman test the increase of TG level was correlated with increase of insulin resistance and HOMA-IR (p<0.001, CI: 0.312).
Conclusion: Due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight, it is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels.
Zhongyu Qu, Yanhui Zhu, Jingjing Jiang, Yuhua Shi, Zijiang Chen,
Volume 11, Issue 9 (12-2013)

Background: Polycystic ovary syndrome (PCOS) is highly associated with non-alcoholic fatty liver disease (NAFLD). There are extensive ethnic differences in the clinical manifestations, pathological changes, and ovarian changes in women with PCOS.
Objective: To investigate the prevalence and clinical characteristics of NAFLD in Chinese women with PCOS.
Materials and Methods: Non-pregnant women with PCOS (N= 602) and matched controls without PCOS (N=588) were recruited. Basal endocrine, oral glucose tolerance test, insulin release level, lipid level, blood pressure, and body mass index (BMI) were measured. Liver biochemical and B-hepatitis and C-hepatitis indices were determined.
Results: NAFLD was significantly more prevalent in women with PCOS than controls (32.9% vs. 18.5%) and included 113 (57.1%) mild, 75 (37.8%) moderate and 10 (5.1%) severe cases. Luteinizing hormone was significantly lower in PCOS women with NAFLD than without NAFLD. In the PCOS group, NAFLD prevalence and severity increased with BMI. The liver index was significantly higher (p<0.001), and the quantitative insulin sensitivity check index and high density lipoprotein cholesterol were significantly lower (p<0.001) in the PCOS group than controls. Insulin resistance, abdominal obesity, diabetes mellitus, abnormal glucose tolerance, liver dysfunction, dyslipidemia, hypertension, and metabolic syndrome were significantly more prevalent in the NAFLD group than controls.
Conclusion: Chinese women with PCOS have a high prevalence of mostly mild and moderate NAFLD, not significantly associated with hyperandrogenism that increased significantly with BMI. Insulin resistance and metabolic abnormalities are important factors associated with NAFLD. Chinese women with BMI ≥24 kg/mP2P should be screened for NAFLD.
Maryam Asgharnia, Roya Faraji, Fatemeh Salamat, Babak Ashrafkhani, Seyedeh Fatemeh Dalil Heirati, Samira Naimian,
Volume 11, Issue 9 (12-2013)

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.
Abbas Aflatoonian, Hoora Amouzegar, Razieh Dehghani Firouzabadi,
Volume 11, Issue 10 (12-2013)

Background: Preterm labor (PTL) is one of the most important causes in neonatal mortality and morbidity. Late preterm labor (34-36w) includes 75% of such birth. Assisted reproductive technology (ART) pregnant women are at increased risk of PTL.
Objective: The study has been undertaken to determine whether beginning and continuing 17-α hydroxy progesterone caproate can reduce risk of PTL or change neonatal mortality.
Materials and Methods: In a double-blind clinical randomized control trial, 106 women were treated by ART technique for their infertility and in gestational age at 16 weeks entered in our study. In one group, 17-α hydroxy progesterone caproate (Femolife) was injected intramuscularly every week until 36 weeks of gestation and in another group; placebo was injected from 16 until 36 weeks of gestetion. Data collected from pregnancy outcomes, infancy, and subsidiary problems were statistically analyzed by a questionnaire.
Results: The risk of PTL in placebo group was 2.48 higher than control group that was not significant (Cl: 0.81-9.94). Femolife side effect in case group was gestational diabetes and local complication was not frequent. NICU admission was not significantly different between groups.
Conclusion: Although it seems that 17-α hydroxy progesterone caproate does not cause significantly decrease in PTL in singleton ART gestations but any reduction of PTL in such high risk pregnancies may improve final gestational outcome. There is critical need for larger clinical trials to better understanding causes of PTL, specifically late preterm labor, to prevent mortality and morbidity in ART gestation.
Ozra Nasrolahi, Fereshteh Khaneshi, Fatemeh Rahmani, Mazdak Razi,
Volume 11, Issue 12 (1-2013)

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.
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.
Akram Ahangarpour, Ali Akbar Oroojan, Maryam Radan,
Volume 12, Issue 1 (2-2014)

Background: One of the considerable uses of lettuce (Lactuca sativa) seed in traditional medicine has been to reduce semen, sperm and sexuality.
Objective: The aim of this study was to investigate the effects of aqueous and hydro-alcoholic extracts of lettuce seed on testosterone level and spermatogenesis.
Materials and Methods: In this experimental study 24 adult male NMRI mice weighing 20-25gr were purchased. Animals were randomly divided into 4 groups: controls, hydro-alcoholic (200 mg/kg) and aqueous extracts (50, 100mg/kg). The extracts were injected intraperitoneally once a day for 10 consecutive days. 2 weeks after the last injection, the mice were anaesthetized by ether and after laparatomy blood was collected from the heart to determine testosterone by ELISA assay kit. Then testis and cauda epididymis of all animals were removed for analyzing testis morphology and sperm count and viability.
Results: Testis weight in hydro-alcoholic and aqueous extracts 100 mg/kg (p=0.001) and aqueous extract 50 mg/kg (p=0.008) groups was increased .Sperm viability in hydro-alcoholic (p=0.001) and aqueous extracts 50 (p=0.026), 100 mg/kg (p=0.045) groups was decreased, Also the results showed a significant decrease in sperm count in hydro-alcoholic (p=0.035) and aqueous extracts 50 mg/kg (p=0.006) groups in comparison with control group. Also there was a significant increase in serum level of testosterone in aqueous extract 50 mg/kg group in comparison with control (p=0.002) hydro-alcoholic (p=0.001) and aqueous extracts 100 mg/kg (p=0.003) groups.
Conclusion: Present results demonstrated that hydro-alcoholic and aqueous 50 mg/kg extracts of lettuce seed have antispermatogenic effects, also aqueous extract 50 mg/kg increased serum level of testosterone in mice. Therefore we can suggest that lettuce seed could be a potential contraceptive agent.
Anahita Khodabakhshi Koolaee, Edalat Asadi, Ladan Mansoor, Leili Mosalanejad, Ali Fathabadi,
Volume 12, Issue 3 (4-2014)

Background: One of negative and influential factor to chronic diseases is creation of sexual problems in the couple's sexual relationship. Sexual health is one of the most important factor in Sexual and marital satisfaction.
Objective: This study aims to compare the relationship between couple burnout, sexual assertiveness, and sexual dysfunctional beliefs in women with diabetic and non-diabetic husbands.
Materials and Methods: This cross sectional descriptive study was a causal comparative one. The research plan was derived from the master’s dissertation for family counseling in Shahid Beheshti University which was done during 2011-2012 in Tehran, Iran. Totally 200 participants were included in this study; 100 participants were women with diabetic husbands and the others were women with non-diabetic husbands. These participants were selected by purposeful sampling method. Data were collected using personality traits and demographic characteristics’ questionnaire, couple burnout Measure, Hulbert index of sexual assertiveness and sexual dysfunctional beliefs Questionnaire.
Results: Results of the multi-variable analysis of variance indicated that there was a significant difference between couple burnout, sexual assertiveness, and sexual dysfunctional beliefs in women with diabetic and non-diabetic husbands. Women with non-diabetic husbands had a higher mean score in sexual assertiveness factor compared to women with diabetic husbands, whereas in couple burnout and sexual dysfunctional beliefs factors, women with diabetic husbands had a higher mean score.
Conclusion: It seems that one of the most important factors which influences and increases couple burnout, increases wrong sexual beliefs regarding sexual function, and decreases sexual assertiveness in women is their husbands’ sexual dysfunction. In fact, women whose husbands suffer from chronic diseases such as diabetes (which results in sexual dysfunction) have lower sexual assertiveness and higher couple burnout and sexual dysfunctional beliefs compared with other women.

Zhang Jie, Ding Yiling, Yu Ling,
Volume 13, Issue 3 (3-2015)

Background: More and more infertile patients have accepted the assisted reproductive technique (ART) therapy. Concerns have been raised over an increased risk of adverse maternal outcomes in ART populations as compared with natural conception (NC).
Objective: The aim was to improve the ART in clinicial work and to reduce the incidence of pregnancy complications in ART group according to analyzing the reasons of high incidence of pregnancy complications in ART group, comparing the incidence of pregnancy complications in different controlled ovarian hyperstimulation (COH) programs and evaluating the effects of ART which attribute to adverse pregnancy outcomes.
Materials and Methods: In this prospective population-based cohort study,3216 pregnant women with gestational age ≤12 weeks, regular antenatal examination,and ultrasound identification of intrauterine pregnancy were enrolled from January 2010 to June 2013. According to having ART history, the participantswere divided into two groups: ART group (contains fresh embryo transfer group or frozen-thawed embryo transfer group) and NC group. We compared the incidence of pregnancy complications between different groups and evaluated the factors which could affect the occurrence of these complications.
Results: When compared to NC group, significantly increased rates of gestational diabetes mellitus (GDM) (p<0.01), preeclampsia (PE) (p<0.01) and intrahepatic cholestasis of pregnancy (ICP) (p˂0.01) were observed in ART group. There was no significant difference in the incidence of birth defect between the two groups (p=0.07). Multiple pregnancies and Gonadotropin (Gn) were risk factors in GDM, PE, and ICP. The exogenous progesterone treatment had no effect on GDM, PE or ICP.
Conclusion: ART increases the risk of adverse maternal complications such as GDM, PE and ICP. The dosages of Gn should be reduced to an extent and the number of embryo implantation should be controlled. Exogenous progesterone treatment is safe.

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