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Showing 27 results for Systematic Review

Tahereh Safarnavadeh, Mansoor Rastegarpanah,
Volume 9, Issue 2 (7-2011)

Background: The use of antioxidants in the treatment of infertility has been suggested and recent studies have indicated that oral administration of Satureja Khuzestanica essential oil (SKEO) to rats induces significant antioxidative effects.
Objective: This systematic review was conducted to evaluate the effectiveness of antioxidants in infertility and also to assess the effectiveness of Satureja Khuzestanica in infertility management.
Materials and Methods: Pubmed, Scopus, and Cochrane Library were searched for relevant trials published from respective database inception dates to August 2010. Study selection, and data extraction were performed by authors.
Results: Fifteen trials on evaluation of antioxidants in infertility and seven studies on the effectiveness of Satureja Khuzestanica were identified. Only 4 of the 15 trials were with application of allocation concealment and three studies were done in in-vitro environment. Despite the methodological and clinical heterogeneity of the trials, 14 of the 15 (93.33%) trials showed an improvement in either sperm quality or pregnancy rate after antioxidant therapy. The human and animal studies of Satureja Khuzestanica showed a significant antioxidative potential of the plant and its effectiveness for infertility improvement.
Conclusion: The use of oral antioxidants in infertility could improve sperm quality and pregnancy rates. Improved fertility observed by SKEO in rats might be due to its antioxidative effect. Further studies and clinical trials in humans are necessary to evaluate SKEO effectiveness in fertility disturbances.
Sedigheh Borna, Mamak Shariat, Mohaddese Fallahi, Leila Janani,
Volume 11, Issue 11 (12-2013)

Background: Our information regarding immunity to toxoplasmosis among reproductive age women is indeterminate and there is significant variation between reported results; it is necessary to perform a Meta-analysis study on subjects to obtain required findings and develop preventive measures accordingly.
Objective: Estimation level of immunity to toxoplasmosis in reproductive ages.
Materials and Methods: All published papers in main national and international databases were systematically searched for some specific keywords to find the related studies up to 2012. we selected only original articles that either reported percentage of positive anti Toxoplasma IgG or total anti toxoplasma antibody by using ELISA or IFAT method (provided that the titer ≥1.20 is considered positive for IFAT) in childbearing age women and the full text of papers were found too.
Results: Studies involved a total of 13480 participants. The maximum and minimum reported prevalence rates of anti-Toxoplasma IgG antibody using IFTA serological method were 21.8% and 54%; using ELISA serological method were 23% and 64%, respectively. The overall estimation for prevalence of anti-Toxoplasma IgG antibody using IFTA serological method was 34.5% (95% CI: 28.5-40.5); using ELISA method was 37.6% (95% CI: 30.4-44.9). The overall estimation for prevalence of anti-Toxoplasma total antibody was 39.9% (95% CI: 26.1-53.7).
Conclusion: In Iran, screening is not routinely performed yet. The incidence of toxoplasmosis is too high to justify routine screening. Prenatal screening can help to identify mothers susceptible to infection. Screening for the presence of antibodies allows primary prevention of toxoplasmosis infection where eating habits and hygiene practices have clearly been identified as risk factors.
Zahra Moazami Goudarzi, Hossein Fallahzadeh, Abbas Aflatoonian, Masoud Mirzaei,
Volume 12, Issue 8 (8-2014)

Background: Some trials have compared laparoscopic ovarian drilling (LOD) with gonadotropins but, because of variations in study design and small sample size, the results are inconsistent and definitive conclusions about the relative efficacy of LOD and gonadotropins cannot be extracted from the individual studies.
Objective: To evaluate the relative efficacy of LOD and gonadotropins for infertile women with clomiphene citrate- resistant poly cystic ovary syndrome (PCOS).
Materials and Methods: A complete electronic literature search in databases including EMBASE, MEDLINE, Cochrane Library and Google scholar for some specific keywords was accomplished. We contained randomized clinical trials comparing outcomes between LOD, without medical ovulation induction, and gonadotropins.
Results: Six trials, covering 499 women, reported on the primary outcome of pregnancy rate. There was no evidence of a difference in pregnancy rate when LOD compared with gonadotropins (OR: 0.534; 95% CI: 0.242-1.176, p=0.119, 6 trials, 499 women, I2=73.201%). There was evidence of significantly fewer live births following LOD compared with gonadotropin (OR: 0.446; 95% CI: 0.269-0.74, p=0.02, 3 trials, 318 women, I2=3.353%). The rate of multiple pregnancies was significantly lower in the LOD arm compared to the gonadotropins arm (OR: 0.127; 95% CI: 0.028-0.579, p=0.008, 3 trials, 307 women, I2=0%).
Conclusion: Our result revealed that there was no evidence of a significant difference in rates of clinical pregnancy and miscarriage in women with clomiphene citrate-resistant PCOS undergoing LOD compared to the gonadotropin arm. The decrease in multiple pregnancies rate in women undergoing LOD makes this option attractive. The increase in live birth rate in the gonadotropin group may be because of the higher rate of multiple pregnancies in these women. However, more focus on the long-term effects of LOD on ovarian function is suggested.
Leila Amini, Najmeh Tehranian, Mansoureh Movahedin, Fahimeh Ramezani Tehrani, Saeideh Ziaei,
Volume 13, Issue 1 (1-2015)

Background: Recently there is a focus on the antioxidants as adjuvant treatment of polycystic ovary syndrome (PCOS), the most endocrinopathy in reproductive age women.
Objective: The aim of this review is answer to the question whether antioxidants are effective for managing of hormonal and metabolic problems in women with PCOS based on first degree evidences from Iran.
Materials and Methods: A systematic review of clinical trials was done in Persian and international databases including PubMed, Scientific Information Database, Google Scholar, Iran Medex, and Magiran up to 2013. Keywords were including polycystic ovary syndrome, Iran, vitamin, antioxidant. From 440 potential studies found electronically, 11 studies; including 444 women in intervention and 390 women in control groups. Intervention in three studies was Calcium-vitamin D or calcitriol; in three studies was ω-3 fatty acids; in two studies was N-acetyl cysteine; in one study was folic acid; in one study was Zinc; and in one study was Soy.
Results: Finally, 11 studies that were relevant and met the inclusion criteria reviewed. There were 7 studies in English and 4 studies in Persian. We couldn’t include all studies because all full texts were not accessible.
Conclusion: The results showed that antioxidants and vitamins have positive effects on management of PCOS women. Although it seems more studies is necessary in this field.
Fatemeh Bazarganipour, Seyed Abdolvahab Taghavi, Ali Montazeri, Fazlollah Ahmadi, Reza Chaman, Ahmad Khosravi,
Volume 13, Issue 2 (2-2015)

Background: Polycystic ovary syndrome (PCOS) has been shown to cause a reduction in health-related quality of life (HRQOL). However, the relative degree of impairment in each domain differed among samples, and it was not clear which aspect of disease-specific HRQOL (modified polycystic ovary syndrome health-related quality of life questionnaire) was most negatively affected.
Objective: To systematically review the effects of PCOS on specific domains of HRQOL.
Materials and Methods: Literature search using search engine of database (PubMed, PsychInfo, CINAHL, CENTRAL, and Scopus) between 1998 to December 2013 yields 6 relevant publications. Pairs of raters used structural tools to analyze these articles, through critical appraisal and data extraction. The scores of each domain of polycystic ovarian syndrome questionnaire (PCOSQ) or modified version (MPCOSQ) of 1140 women with PCOS were used in meta-analysis.
Results: The combine mean of emotional (4.40; 95% CI 3.77-5.04), infertility (4.13; 95% CI 3.81-4.45) and weight (3.88; 95% CI 2.33-5.42) dimensions were better, but menstruation (3.84; 95% CI 3.63-4.04) and hirsutism (3.81; 95% CI 3.26-4.35) domains were lower than the mean score of PCOSQ/MPCOSQ in related dimension.
Conclusion: The meta-analysis showed that the most affected domains in specific HRQOL were hirsutism and menstruation. Based on these findings, we recommend healthcare providers to be made aware that HRQOL impairment of PCOS is mainly caused by their hirsutism and menstruation, which requires appropriate management.
Arash Khaki,
Volume 13, Issue 3 (3-2015)

Background: Antibiotic therapies used in treatment of many diseases have adverse effects on fertility. This review analyzes previous comparative studies that surveyed the effects of two common groups of antibiotics on male fertility.
Objective: To evaluate histo-pathological effects of fluoroquinolones and aminoglycosides on sperm parameters and male reproductive tissue.
Materials and Methods: Articles about the effects of aminoglycosides and fluoroquinolones on male infertility, sperm parameters, male reproductive tissue, and spermatogenesis in English and Persian languages published on Google Scholar and PubMed databases from January 2000 to December 2013 were assessed. Randomized controlled trials (RCTs) assessing the effects of aminoglycosides or fluoroquinolones on sperm parameters, artificial insemination, and male reproductive tract or RCTs comparing aminoglycosides vs. fluoroquinolones were eligible for inclusion. For ascertaining the reliability of study, data were extracted independently and in duplicate by two investigators.
Results: Sperm viability was decreased significantly with streptomycin, gentamicin, and neomycin (p<0.001). Sperm motility was decreased significantly with gentamicin and neomycin (p<0.05). Total sperm count was significantly decreased with ofloxacin, gentamicin, streptomycin, and neomycin (p<0.022). There was significant decrease in post-thawing motility with low dose and high dose of ciprofloxacin. Testis weight was decreased with gentamicin and ofloxacin significantly (p<0.011). There was significant decrease in seminal vesicle weight with gentamicin, neomycin, and ofloxacin (p<0.022). Furthermore, changes in epididymis weight, percentage of total apoptotic cells, and diameter of seminiferous tubule were significant with all drugs including streptomycin, gentamicin, neomycin, and ofloxacin (p<0.05).
Conclusion: Streptomycin has less negative effects on cell’s apoptosis and sperm parameters as compared to other drugs. Gentamicin has more detrimental effects so lesser dosage and duration is recommended. Fluoroquinolones showed negative effects on testis tissue and sperm parameters. Ciprofloxacin has less adverse effects than gentamicin in artificial insemination.
Marcelo Borges Cavalcante, Fabrício da Silva Costa, Ricardo Barini, Edward Araujo Júnior,
Volume 13, Issue 4 (5-2015)

Background: Recently, the use of granulocyte colony-stimulating factor (G-CSF) has been proposed to improve pregnancy outcomes in reproductive medicine.
Objective: A systematic review of the current use of G-CSF in patients who have difficulty conceiving and maintaining pregnancy was performed.
Materials and Methods: Two electronic databases (PubMed/ Medline and Scopus) were searched. Study selection, data extraction and quality assessment were performed in duplicate. The subject codes used were granulocyte colony-stimulating factor, G-CSF, recurrent miscarriage, IVF failure, and endometrium.
Results: The search of electronic databases resulted in 215 citations (PubMed/ Medline: 139 and Scopus: 76), of which 38 were present in both databases. Of the remaining 177 publications, seven studies were included in the present review.
Conclusion: Treatment with G-CSF is a novel proposal for immune therapy in patients with recurrent miscarriage and implantation failure following cycles of IVF. However, a larger number of well-designed studies are required for this treatment to be established.
Seyed Abdolvahab Taghavi, Fatemeh Bazarganipour, Ali Montazeri, Anoshirvan Kazemnejad, Reza Chaman, Ahmad Khosravi,
Volume 13, Issue 8 (9-2015)

Background: Increasing attention to the concept of polycystic ovary syndrome (PCOS) health-related quality of life has led to the development of tool that aims to measure this concept.
Objective: The purpose of this study was to conduct a systematic review of psychometric properties of the PCOS health-related quality of life questionnaire.
Materials and Methods: A search of database (Pubmed, PsychInfo, CINAHL, CENTRAL, Scopus and SID) from January1998 to December 2013 yielded 6152 references of which 27 papers remained after review of the titles and abstracts. The reviewers used structural tools to analyze the articles, critically appraise papers, and extract the data. Finally, eight papers met the full inclusion criteria.
Results: Studies suggested that the PCOS health-related quality of life questionnaire (PCOSQ)/or its modified version (MPCOSQ) have partial known groups validity. The convergent/divergent validity of the questionnaire also was found to be relatively acceptable. The PCOSQ/MPCOSQ reached acceptable benchmarks for its reliability coefficients. Regarding structural validity, some studies suggested that the PCOSQ/MPCOSQ have an extra dimension (related to menstruation) in addition to its existing dimensions for original or modified versions.
Conclusion: The PCOSQ/MPCOSQ showed acceptable content and construct validity, reliability and internal consistency. However, some other properties, particularly those related to factor and longitudinal validity, absolute error of measurement, minimal clinically important difference and responsiveness still need to be evaluated.
Katayon Vakilian, Mehdi Ranjbaran, Mahboobeh Khorsandi, Naser Sharafkhani, Mahmoud Khodadost,
Volume 13, Issue 12 (1-2015)

Objective Background: Preterm labor, which defines as live-birth delivery before 37 weeks of gestation is a main determinant of neonatal morbidity and mortality around the world. : The aim of this study was to determine the prevalence of preterm labor in Iran by a meta-analysis study, to be as a final measure for policy makers in this field. Materials and Methods: In this meta-analysis, the databases of Thomson database (Web of Knowledge), PubMed/Medline, Science Direct, Scopus, Google Scholar, Iranmedex, Scientific Information Database (SID), Magiran, and Medlib were searched for articles in English and Persian language published between 1995 and 2014. Among the studies with regard to the inclusion and exclusion criteria, 14 studies (out of 1370 publications) were selected. Data were analyzed by using Stata software version 11. The heterogeneity of reported prevalence among studies was evaluated by the Chi-square based Q test and I2 statistics. Results: The results of Chi-square based on Q test and I2 statistics revealed severe heterogeneity (Q=2505.12, p-value < 0.001 and I2= 99.5%) and consequently, the random effect model was used for the meta-analysis. Based on the random effect model, the overall estimated prevalence of preterm in Iran was 9.2% (95% CI: 7.6 – 10.7). Conclusion: Present study summarized the results of previous studies and provided a comprehensive view about the preterm delivery in Iran. In order to achieve a more desirable level and its reduction in the coming years, identifying affecting factor and interventional and preventive actions seem necessary.
Masumeh Ghazanfarpour, Ramin Sadeghi, Somayeh Abdolahian, Robab Latifnejad Roudsari,
Volume 14, Issue 3 (3-2016)

Background: Hot flashes are the most common symptoms experienced by women around the time of menopause. Many women are interested in herbal medicines because of fear of side effects of hormone therapy.
Objective: The aim of this systematic review was to assess the effectiveness of Iranian herbal medicines in alleviating hot flashes.
Materials and Methods: MEDLINE (1966 to January 2015), Scopus (1996 to January 2015), and Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 1, 2015) were searched along with, SID, Iran Medex, Magiran, Medlib and Irandoc. Nineteen randomized controlled trials met the inclusion criteria.
Results: Overall, studies showed that Anise (Pimpinella anisum), licorice (Glycyrrhizaglabra), Soy, Black cohosh, Red clover, Evening primrose, Flaxseed, Salvia officinalis, Passiflora، itex Agnus Castus, Piascledine (Avacado plus soybean oil), St. John's wort (Hypericum perforatum), and valerian can alleviate the side effects of hot flashes.
Conclusion: This research demonstrated the efficacy of herbal medicines in alleviating hot flashes, which are embraced both with people and health providers of Iran Therefore, herbal medicine can be seen as an alternative treatment for women experiencing hot flashes.
Farzad Roshanzamir, Seyyed Morteza Safavi,
Volume 15, Issue 1 (1-2017)

Background: D-Aspartic acid (D-Asp) is in invertebrate and vertebrate neuroendocrine tissues, where it carries out important physiological functions. Recently, it has been reported that D-Asp is involved in the synthesis and release of testosterone and is assumed can be used as a testosterone booster for infertile men, and by athletes to increase muscle mass and strength.
Objective: The aim of this review is to summarize available evidence related to the effects of D-Asp on serum testosterone levels.
Materials and Methods: We conducted a systematic review of all type studies, which evaluated the effect of the D-Asp on blood testosterone including published papers until October 2015, using PubMed, ISI Web of Science, ProQuest and Scopus database.
Results: With 396 retrieved records, 23 animal studies and 4 human studies were included. In vivo and in vitro animal studies revealed the effect of D-Asp depending on species, sex and organ-specific. Our results showed that exogenous D-Asp enhances testosterone levels in male animal’s studies, whereas studies in human yielded inconsistent results. The evidence for this association in man is still sparse, mostly because of limited number and poor quality studies.
Conclusion: There is an urgent need for more and well-designed human clinical trials with larger sample sizes and longer duration to investigate putative effects of D-Asp on testosterone concentrations.
Shoboo Rahmati, Ali Delpishe, Milad Azami, Mohammed Reza Hafezi Ahmadi, Kurosh Sayehmiri,
Volume 15, Issue 3 (5-2017)

Background: Infant low birth weight is one of the major problems in differentsocieties. Different reports have provided different results regarding the relationshipbetween maternal anemia and infant low birth weight in different months ofpregnancy.
Objective: The aim of this study was to determine the relationship betweenmaternal anemia during pregnancy and infant low birth weight.
Materials and Methods: This systematic review was conducted using relatedkeywords in national (Sid, Iran.doc, Iran medex and Magiran) and international(PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer,Embase, Google scholar) databases. Relative risks and confidence intervals wereextracted from each study. The results were combined using random-effects modelfor meta-analysis. The I2 index was also used to measure heterogeneity between thestudies.
Results: Overall, 17 studies with a total sample size of 245407 entered the finalmeta-analysis and demonstrated that the relative risk for maternal anemia in the first,second and third trimester of pregnancy were 1.26 (95% CI: 1.03-1.55), 0.97 (95%CI: 0.57-1.65), and 1.21 (95% CI: 0.84-1.76), respectively. The relationship betweenmaternal anemia and infant low birth weight in the first trimester of pregnancy wassignificant.
Conclusion: Maternal anemia, especially during the first trimester of pregnancy, canbe considered as a risk factor for pregnancy outcomes. Therefore, one needs to takethe necessary steps to cure this disease in order to reduce the incidence of infant lowbirth weight.
Nahid Maleki-Saghooni, Malihe Amirian, Ramin Sadeghi, Robab Latifnejad Roudsari,
Volume 15, Issue 7 (8-2017)

Background: Psychological interventions such as counseling for infertile patients seem to increase pregnancy rate.
Objective: The aim of this systematic review and meta-analysis was to examine if counseling improves pregnancy rate among infertile patients. Thus, randomized controlled trials investigating the effect of counseling on pregnancy rate in infertile patients undergoing ART were pooled in a meta-analysis.
Materials and Methods: The databases of PubMed, Scopus, Cochrane, Google Scholar, and Persian databases including SID, Iran Medex, and Magiran were searched from 1997 to July 2016 to identify relevant articles. Included studies were trials on infertile patients (women or couples) receiving counseling independent of actual medical treatment. The outcome measure was pregnancy rate. Out of 620 relevant published trials, a total of nine RCTs were ultimately reviewed systematically and included in a meta-analysis to measure the efficacy of counseling on pregnancy rate. Odds ratio and Risk difference were calculated for pregnancy rate. All statistical analyses were done by Comprehensive Meta-analysis Version 2.
Results: Nine RCTs involving 1079 infertile women/couples were included in the study. The findings from RCTs indicated significant effect of counseling on pregnancy rate so that there was a positive impact of counseling on pregnancy rate (OR= 3.852; 95% CI: 2.492-5.956; p=0.00) and (RD= 0.282; 95%; CI: 0.208-0.355; p=0.00).
Conclusion: Counseling was found to improve patients’ chances of becoming pregnant. So counseling represents an attractive treatment option, in particular, for infertile patients who are not receiving medical treatments.
Marzieh Parizad Nasirkandy, Gholamreza Badfar, Masoumeh Shohani, Shoboo Rahmati, Mohammad Hossein Yektakooshali, Shamsi Abbasalizadeh, Ali Soleymani, Milad Azami,
Volume 15, Issue 9 (9-2017)

Background: The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear.
Objective: The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth.
Materials and Methods: In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the 83Tcohort studies83T were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and IP2P index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2.
Results: Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1.30 (95% CI: 1.05-1.61, p=0.013, involving 20079 cases and 2452817 controls), 1.36 (95% CI: 1.09-1.68, p=0.005, involving 3580 cases and 64885 controls) and 1.31 (95% CI: 1.04-1.66, p=0.020, involving 1078 cases and 44377 controls), respectively.
Conclusion: The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83Tgynecologists and endocrinologists83T should manage these patients to control the incidence of 83Tadverse pregnancy outcomes83T such as preterm birth.
Maryam Asgharnia, Fariba Mirblouk, Soudabeh Kazemi, Davood Pourmarzi, Mina Mahdipour Keivani, Seyedeh Fatemeh Dalil Heirati,
Volume 15, Issue 9 (9-2017)

Background: Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia.
Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia.
Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included. Hemoglobin, hematocrit, platelet count, liver and uric acid tests, and maternal and neonatal complications were assessed. The severity of preeclampsia, placental abruption, preterm labor, thrombocytopenia, elevated alanine aminotransferase and aspartate aminotransferase (ALT and AST), HELLP syndrome, eclampsia and required hospitalization in the ICU was considered as the maternal complication. Fetal complications were: small for gestational age (SGA), intrauterine fetal death, hospitalization in the neonatal intensive care unit, and Apgar score <7 at five minutes.
Results: Of our participants, 38 women had severe preeclampsia (23.8%). The mean level of uric acid in women with severe preeclampsia was significantly higher than non-severe preeclampsia (p=0.031), also in those with an abnormal liver test (p=0.009). The mean level of uric acid in women with preterm delivery was significantly higher than women with term delivery (p=0.0001). Also, the level of uric acid had no effect on neonatal hospitalization in neonate invasive care unit. Based on logistic regression, the incidence of severe preeclampsia not affected by decreased or increased serum levels of uric acid.
Conclusion: With higher level of uric acid in server preeclampsia we can expected more complications such as hepatic dysfunction and preterm delivery. Thus serum uric acid measurement can be helpful marker for severe preeclampsia.
Sara Darbandi, Mahsa Darbandi, Hamid Reza Khorram Khorshid, Abolfaz Shirazi, Mohammad Reza Sadeghi, Ashok Agarwal, Safaa Al-Hasani, Mohammad Mehdi Naderi, Ahmet Ayaz, Mohammad Mehdi Akhondi,
Volume 15, Issue 10 (12-2017)

Nuclear transfer procedures have been recently applied for clinical and research targets as a novel assisted reproductive technique and were used for increasing the oocyte activity during its growth and maturation. In this review, we summarized the nuclear transfer technique for germinal vesicle stage oocytes to reconstruct the maturation of them. Our study covered publications between 1966 and August 2017. In result utilized germinal vesicle transfer techniques, fusion, and fertilization survival rate on five different mammalian species are discussed, regarding their potential clinical application. It seems that with a study on this method, there is real hope for effective treatments of old oocytes or oocytes containing mitochondrial problems in the near future.
Mehdi Ranjbaran, Reza Omani Samani, Amir Almasi-Hashiani, Pegah Matourypour, Ashraf Moini,
Volume 15, Issue 11 (11-2017)

Background: Premenstrual syndrome (PMS) is a common disorder characterized by physical, mental and behavioral changes in the luteal phase of the menstrual cycle in the reproductive age women.
Objective: The present study aimed to determine the overall prevalence of PMS in Iran by a systematic review and meta-analysis study.
Materials and Methods: In this systematic review and meta-analysis, we searched international databases included ISI Web of Knowledge, PubMed/Medline, Scopus, Google Scholar, and also local databases including Iranmedex, Scientific Information Database, and Magiran for articles in English and Persian language published up to September 2016. We carried out data analysis with Stata version 11. We examined heterogeneity in the results of studies through I2 statistics and Chi-square based Q test. Also, we investigated the effects of potential heterogeneity factors in the prevalence of PMS by meta-regression.
Results: We studied a total of 9147 reproductive-age women from 24 articles which entered to meta-analysis. Based on the result of random effect model, we estimated the overall prevalence of PMS 70.8% [95% CI: 63.8-77.7]. The results of subgroup analysis revealed that prevalence of PMS was 80.4% (95% CI; 66.9-93.9) among high school students, 68.9% (95% CI; 59.2-78.6) among university students, and 54.9% (95% CI; 51.6-58.2) in general population. Univariate meta-regression model showed that prevalence of PMS was decreased by increasing the age of subjects but this was not statistically significant (p=0.155).
Conclusion: Our finding showed that PMS was prevalent in Iranian reproductive age women especially among high school students. More epidemiological research for determining factors that affect PMS prevalence seems essential.
Nafiseh Saghafi, Leila Pourali, Vahid Ghavami Ghanbarabadi, Fatemeh Mirzamarjani, Masoumeh Mirteimouri,
Volume 16, Issue 1 (2-2018)

Background: Preeclampsia, a severe complication of human pregnancy is one of the main causes of maternal, fetal, and neonatal morbidity and mortality with unclear pathogenesis. Heat shock protein 70 (HSP70) is one of the factors that can mediate cytoprotective, antiapoptotic, and immune regulatory effects.
Objective: This meta-analysis was performed with aim to evaluate HSP70 in preeclampsia and normal pregnancy.
Materials and Methods: The original publications reporting the serum HSP70 levels in preeclampsia and normal pregnancies published before November 2015 were identified by searching PubMed Central, Scopus, and ISI Web of Knowledge databases by two researchers, separately. The keywords were” preeclampsia” and “HSP70” or “Heat shock protein 70” Statistical analyses were performed using STATA software (version 11).
Results: Out of 127 studies, seven eligible case-control studies were identified which consists of 350 preeclampsia and 429 normal pregnancies. Our pooled analysis of data from 7 studies which met the inclusion criteria, provides evidence that there is a significant association between HSP70 and preeclampsia. Cochran's test results showed the heterogeneity of the studies (p<0.001) and the I2 index was 91%. The standardized mean differences (SMD) based on a random effect model with trim and fill method was 0.92 (95% CI: 0.33-1.51); also there was a significant association between HSP70 and preeclampsia (Z=3.07, p=0.002).
Conclusion: The results showed that serum HSP70 concentration was significantly higher in preeclamptic patients than the control group. Therefore HSP70 may be identified as a diagnostic factor.

Mohammad Rafiei, Marzieh Saei Ghare Naz, Malihe Akbari, Faezeh Kiani, Fatemeh Sayehmiri, Koroush Sayehmiri, Reza Vafaee,
Volume 16, Issue 4 (4-2018)

Background: Uncontrolled increase of C-section is one of the major problems in Iranian health system, such that C-section is the most common surgical procedure in the entire country’s hospitals in Obstetrics and Gynecology sections. A variety of complications also come along with cesarean.
Objective: The aim of this study was to evaluate the prevalence, causes, and complications of cesarean in Iran.
Materials and Methods: forty-one articles were considered with respect to certain criteria and were included in a systematic review to perform a meta-analysis study. The systematic review’s search was conducted on SID, Iranmedx, Magiran, Medlib, PubMed, and Science Direct databases published between1999-2016. The weight of each included study was calculated according to its sample size and the reported prevalence of binomial distribution. A random-effects model using R and STATA (Version 11.2) software was utilized for analyzing data
Results: The total number of the sample was 197514 pregnant women with a mean age of 26.72 yr. The prevalence of cesarean in Iran was estimated at 48%. The main reasons for the prevalence of cesarean in this study were mothers’ higher education, previous cesarean, and doctor recommendation. The most frequent complication in women undergoing cesarean was the muscular pain, and the most common fetal complications in newborns by caesarean delivery was transient tachypnea.
Conclusion: The prevalence of C-section in Iran is much higher than what WHO recommends. It is essential, to decrease such a phenomenon, making the mothers aware of the risks of cesarean delivery, and establishing counselling sessions as well to eliminate the mothers’ fear of vaginal delivery.
Reza Omani Samani , Amir Almasi Hashiani, Maryam Razavi, Samira Vesali, Mahroo Rezaeinejad, Saman Maroufizadeh, Mahdi Sepidarkish,
Volume 16, Issue 11 (11-2018)

Background: Understanding the prevalence of menstrual disorders has important implications for both health service planning and risk factor epidemiology.
Objective: The aim of this review is to identify and collate studies describing the prevalence of menstrual disorders in Iran.
Materials and Methods: Studies with original data related to the prevalence of menstrual disorders were identified via searching six electronic databases and reviewing citations. All abstracts or titles found by the electronic searches were independently scrutinized by two reviewers. The Meta-analysis was performed with a random effects model, considering the remarkable heterogeneity among studies. A total of 35 eligible epidemiological studies were included in this review.
Results: Overall, the pooled prevalence of primary dysmenorrhea was 73.27% (95% CI=65.12-81.42). The mean proportion of women with oligomenorrhea was 13.11% (95.5%, 95% CI: 10.04-16.19). We identified 16 studies that reported polymenorrhoea with a random effect of pooled prevalence estimate of 9.94% (95% CI 7.33%-12.56%). The prevalence estimate of hypermenorrhea was 12.94% (95% CI 9.31%-16.57%). Overall prevalence of hypomenorrhea was 5.25% (95% CI 3.20%-7.30%), ranging from 0.9- 12.90%. Pooling six studies that reported estimates for menorrhagia, the overall prevalence was 19.24% (95% CI 12.78-25.69). Overall, 6.04% (95% CI: 1.99-10.08) of the women were shown to have metrorrhagia.
Conclusion: This systematic review suggests that the average prevalence of menstrual disorders in Iran is substantial. It has been neglected as a fundamental problem of women's reproductive health. Diagnosis and treatment of these disorders should be included in the primary health care system of reproductive health.

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