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Showing 6 results for Female Infertility

Mona Zvâncă, Radu Vlădăreanu, Asim Kurjak, Awatif Juma Al Bahar,
Volume 6, Issue 4 (7-2008)

Background: With the technical development, ultrasound tends to overpass its limits and to become the main investigation tool even for situations when it was traditionally considered second best. It is more convenient both for patient and doctor, less expensive and has real diagnostic value.
Objective: The present paper, and its graphic back-up, are intended as a visual testimony of the fact that the newer three dimensional (3D) ultrasound technique is much more than a simple generator of nice, commercial, images. Moreover, its use may be extended from obstetrics to gynecological pathology, especially in cases related to infertility.
Materials and Methods: We performed a review of the main local infertility causes and their perception by the 3D ultrasound, as compared to the conventional methods. General literature citations were completed with personal cases and images. In our research, we used a Kretz Voluson Expert 730 ultrasound machine with a full logistic equipment. Our database was completed over a period of 18 months and included various pathology, such as uterine anomalies, fibroids, polyps, ovarian cysts and many others.
Results: Three dimensional ultrasound represents the best tool in evaluating the uterine cavity, the endometrium, assessing its volume and vascularity pattern. It also offers a very good image of the uterine structure, the adnexal morphology and their relationship. It performs a thorough pelvic assessment by a single examination. Moreover, it may realize a histerosalpingography, which is as efficient as the radiological method, but easier and with fewer side effects.
Conclusion: Even though it is technically more difficult and time consuming, a good practice and high quality ultrasound equipment offer a series of benefits over any other kind of investigation.
Seema Bibi, Mohammad Ali Pir, Roshan Ara Qazi, Misbah Bibi Qureshi,
Volume 8, Issue 2 (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.
Hossein Pashaiefar, Mohammad Hasan Sheikhha, Seyyed Mehdi Kalantar, Tahereh Jahaninejad, Mohammad Ali Zaimy, Nasrin Ghasemi,
Volume 11, Issue 1 (4-2013)

Background: Meiotic genes are very important candidates for genes contributing to female and male infertility. Mammalian MutL homologues have dual roles in DNA mismatch repair (MMR) after replication errors and meiotic reciprocal recombination. The MutL homologs, MLH1 and MLH3 , are crucial for meiotic reciprocal recombination and human fertility. In this study the functional polymorphisms of MLH3 C2531T was investigated in Iranian women with unexplained infertility.
Objective: Investigating the association between a common SNP (single nucleotide polymorphism) C2531T in the MLH3 gene and female infertility.
Materials and Methods: In total, 105 women with unexplained infertility as case group and 100 women with at least one child and no history of infertility or abortion as controls were recruited for this association study. The MLH3 C2531T polymorphism was tested by tetra-amplification refractory mutation system-PCR (4P-ARMS-PCR) method.
Results: The MLH3 2531C and T alleles frequencies were 43.33% and 56.67% among infertile patients, and 61.5% and 38.5% among normal controls, respectively. In the patient and control subjects the CC (Pro 844 Pro) genotype frequency of MLH3 C2531T was 4.76% and 25%, the CT (Pro 844 Leu) genotype was 77.15% and 73%, and the TT (Leu 844 Leu) genotype was 19% and 2%, respectively (p=0.0001).
Conclusion: The presence of the polymorphic allele T leads to an increased risk of 2.09 times (OR=2.09, 95% CI=1.38-3.16; p=0.0001) for developing infertility in relation to the control group. Therefore, our data suggest that the MLH3 C2531T polymorphism can be associated with the risk of unexplained infertility in Iranian women.
Seyedeh Zahra Masoumi, Parisa Parsa, Nooshin Darvish, Sahar Mokhtari, Mahnaz Yavangi, Ghodratollah Roshanaei,
Volume 13, Issue 8 (9-2015)

Background: Infertility is considered as a major health care problem of different communities. The high prevalence of this issue doubled its importance. A significant proportion of infertility have been related to environmental conditions and also acquired risk factors. Different environmental conditions emphasized the need to study the different causes of infertility in each area.
Objective: The aim of this study was to determine the frequency causes of infertility in infertile couples.
Materials and Methods: In this cross sectional descriptive study 1200 infertile men and women that were referred to infertility clinic of Fatemieh Hospital during 2010 to 2011, were examined. This center is the only governmental center for infertility in Hamadan. Sampling was based on census method. Information about the patients was obtained from medical examinations and laboratory findings. To analyze the data, descriptive statistics such as frequencies and the mean were used.
Results: The prevalence of primary and secondary infertility was 69.5% and 30.5% respectively. Among the various causes of infertility women factors (88.6%) had the highest regard. In the causes of female infertility, menstrual disorders, diseases (obesity, thyroid diseases, and diabetes), ovulation dysfunction, uterine factor, fallopian tubes and cervical factor had the highest prevalence respectively. The causes of male infertility based on their frequency included semen fluid abnormalities, genetic factors, vascular abnormalities, and anti-spermatogenesis factors, respectively.
Conclusion: Etiology pattern of infertility in our study is similar with the many other patterns that have been reported by the World Health Organization. However, frequency of menstrual disorders is much higher than other studies that require further consideration.
Seyed Kazem Kazemeini, Majid Emtiazy, Fatemeh Owlia, Parisa Khani,
Volume 15, Issue 4 (6-2017)

Infertility is one of the most important reproductive health concerns in the conventional medicine. Iranian traditional medicine presents different viewpoints in this regard which they could be of benefit and a good guide for the society of medicine. This study sought to provide the comprehensive investigation on the causes of infertility according to Iranian traditional medicine for understanding of old sageschr('39') ideas and categorizing of the causes of infertility. In this narrative review, we searched causes of infertility in traditional medicine books and available articles in this field. Iranian traditional physicians have investigated the causes of infertility in couples and attributed them to male and female causes. They have divided the main causes of infertility in both sexes into structural and functional abnormalities, that both traditional medicine and conventional medicine have a lot of participations, but the traditional medicine believes holistic approach in the treatment of diseases and the involvement of all parts of the body particularly specialty board members (heart, liver, brain, ovary, and testicles) in the proper conduct activities in different parts of the body such as reproduction system. There is also special attention to temperament Mizaj disorders. Given the numerous commonalities existing between traditional and conventional medicine in categorizing the causes of infertility, Iranian traditional medicine methods can be applied as a complementary solution in infertility. It could be also subject to further research and investigation due to its opposition to modern medicine in some regards.
Firouzeh Ghaffari, Arezoo Arabipoo,
Volume 16, Issue 5 (5-2018)

Uniform and definitive terminology in reproductive medicine is important for appropriate timing in starting an infertility workup to avoid over- and under-treatment, their related financial burden and psychological pressures (1, 2) and comparison of different treatments. Despite surveys and definitions provided by the World Health Organization (WHO), it seems that some terms are still confusing and misleading and therefore further discussion in this area is essential (2). The objective of the current letter is, to discuss critically a number of issues including the definitions of infertility, especially the role of assisted reproductive treatments. In the most recent definition proposed by WHO and the International Committee for Monitoring Assisted Reproductive Technology ICMART (3), clinical infertility was considered as "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse". However, it appears that in couples with sterility and no chance of spontaneous pregnancy (such as some men with azoospermia, primary hypothalamic amenorrhea, bilateral tubal ligation, some type of premature ovarian failure, etc.), this definition is illogical and the duration of the infertility should be considered equal to the time that the couple has tried to achieve a pregnancy. A broad spectrum of patients with different histories is observed among infertile couples who are referred to treatment centers. On the one hand there are couples who have not experienced any clinical pregnancy, on the other hand there are those who have a child and are trying to have another child, and there are some women who have experienced abortion and after that never have conceived again. On the basis of WHO and International Committee for Monitoring Assisted Reproductive Technology definitions (3), the role of infertility treatment, specially assisted reproduction treatment, is not considered. Achieving clinical pregnancy in couples who have had a previous spontaneous pregnancy is very different in comparison with those who have not ever conceived and this gives them a much better prognosis (4). It seems that for evaluation of the efficacy of different infertility treatments, particularly assisted reproduction treatments, it is more appropriate that the primary infertility be defined as "inability to achieve a spontaneous clinical pregnancy". By this definition, patients who achieve the clinical pregnancy by using different infertility treatments for example: medical, intrauterine insemination and assisted reproduction technology or surgery, have not achieved a natural clinical pregnancy; the same would be true of primary infertility. So, it is more appropriate that secondary infertility be defined as "the inability to achieve a spontaneous clinical pregnancy following a previous spontaneous pregnancy". However, the main question is which type of treatment should be considered in this definition; only assisted reproduction technology cycles or any infertility treatment? In all infertility treatments, the focus is to have a live child which will survive; however, in most infertility research one of the main outcomes is the capacity to achieve a clinical pregnancy. By this new definition, the efficacy of different infertility treatments for the broad spectrum of infertile patients with different obstetrical histories could be better compared with each other. Despite successful conception, several factors are involved to reach a clinical pregnancy to live birth at term. It seems that the WHO classifications are not sufficiently detailed for these situations which have been described and require revision. The type of conception should be considered in the definition of primary and secondary infertility. Three important factors should be considered before starting an infertility workup: the most important factors are the age of the woman, followed by the time attempting pregnancy, and the cause of infertility. Immediate infertility treatment should be suggested for the couple who are sterile (e.g. azoospermia, primary hypothalamic amenorrhea and bilateral tubal ligation etc...). More time could be allowed for couples with a good prognosis (e.g. women under 35 yr old, unexplained infertility etc…) to achieve a spontaneous pregnancy.

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