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Showing 66 results for لقاح

Maryam Eftekhar, Farnaz Mohammadian, Fariba Yousefnejad, Behnaz Molaei, Abbas Aflatoonian,
Volume 10, Issue 2 (7-2012)

Background: Conventional IVF and ICSI are two common techniques to achieve fertilization. IVF has long been used for treatment of infertility, although it is not an effective treatment in severe male infertility. The use of ICSI has been expanded in severe male factor and fertilization failure after IVF cycle. In spite of the widespread use of ICSI in patients with non-male factor infertility, there is still little evidence to confirm its effectiveness in this population. Objective: To evaluate assisted reproductive technology outcomes between IVF and ICSI cycles in non-male factor, normoresponder patients.
Materials and Methods: A total of 220 non-male factors, normoresponder patients who were indicated for ART were enrolled in this study. The patients received standard long GnRH agonist or GnRH antagonist protocols for ovarian stimulation and after oocytes retrieval, the patients were divided into two groups (IVF and ICSI groups). In IVF group (n=112), all of retrieved oocytes were treated by conventional IVF and in ICSI group (n=88), microinjection (ICSI) was done on all of retrieved oocytes.
Results: In IVF group, fertilization and implantation rates were significantly higher than ICSI group (66.22% and 16.67% in IVF group versus 57.46% and 11.17% in ICSI group, respectively). Chemical and clinical pregnancy rates were statistically higher in IVF group as compared with the ICSI group (42.9% vs. 27.3% and 35.7% vs. 21.5%, respectively).
Conclusion: According to our study, the routine use of ICSI is not improved fertilization, implantation and chemical pregnancy rates and is not recommended in non-male factor, normozoospermic patients.
Farokh Kafilzadeh, Hamed Karami Shabankareh, Leila Soltani,
Volume 10, Issue 2 (7-2012)

Background: Improvements in culture media formulations have led to an increase in the ability of sheep embryo in culture throughout the preimplantation period.
Objective: This study was carried out to evaluate the effects of various concentrations of MEM vitamins during in vitro maturation of sheep oocytes and subsequent embryo development.
Materials and Methods: Sheep ovaries were collected from a slaughterhouse and transported to the laboratory. Oocytes were matured in SOF medium supplemented with, eCG, hCG and EGF in various concentrations of MEM vitamins (control, 0.5, 1 and 1.5 ) for 24h. The cumulus oocyte compelex (COCs) were co-incubated with epididymal spermatozoa of post mortem rams in synthetic oviduct fluid fertilization (SOFF) medium with 10% heat inactivated estrous sheep serum for 18h. Embryos were cultured in synthetic oviduct fluid culture 1 (SOFC1) medium for 48h followed by cultured in synthetic oviduct fluid culture 2 (SOFC2) medium for six days.
Results: Addition of 0.5 and 1 MEM vitamins significantly increased (P< 0.05) overall blastocyst development (21.62% and 22.33%; respectively) compared with 1.5 MEM vitamins (15.59%), but there was no difference between control, 0.5 and 1 MEM vitamins in the percentage of embryos successfully developing to the blastocyst stage (19.50%, 21.62% and 22.33% respectively).
Conclusion: It seems that addition of 1.5 of MEM vitamins has detrimental effect on blastocyst rate.
Leili Safdarian, Zahra Khayatzadeh, Ebrahim Djavadi, Atossa Mahdavi, Marzieh Aghahosseini, Ashraf Aleyasin, Parvin Fallahi, Sima Khayatzadeh, Arash Ahmadzadeh, Mohhamad Bagher Larijani,
Volume 10, Issue 3 (7-2012)

Background: Detection of best predictor of ovarian reserve in patients with temporarily or consistently elevated early follicular phase serum levels of FSH is one of the most important goals in assisted reproductive technique (ART).
Objective: To evaluate whether high level of anti-mullerian hormone level is related to success of ART in patients with temporarily or consistently elevated early follicular phase serum levels of FSH.  
Materials and Methods: Sixty three women underwent intracytoplasmic sperm injection (ICSI) with GnRH-agonist long protocol or intrauterine insemination (IUI) in a prospective cohort study. FSH, inhibin B and anti-Mullerian hormone (AMH) levels were measured in these women whom were divided to three groups (persistently elevated FSH, variably elevated FSH and, normal FSH level). Basal characteristics, stimulation parameters, and pregnancy occurrence were evaluated.
Results: AMH was significantly higher in women with persistently elevated early follicular phase FSH achieving pregnancy. Women with normal FSH did not have significant difference in AMH level between conceived and non conceived cycles. Women with only one elevated early follicular phase FSH achieving pregnancy did not have significant difference in AMH level with non pregnant women. Response to gonadotropin stimulation, recommendation to oocyte donation significantly differed between the groups.
Conclusion: This study has demonstrated that relatively young women with persistently or intermittently elevated day 3 FSH levels have diminished ovarian reserve and lower ART success. However, in women whose FSH levels were constantly elevated, AMH (not inhibin B) concentrations were significantly higher in ART cycles resulting in pregnancy. Therefore, AMH level is a good predictor of ART outcome in patients with elevated early follicular phase serum levels of FSH.

Mehri Makki, Elham Saboori, Mohammad Ali Sabbaghi, Raheleh Aram, Mohammad Hasan Fallahian, Fatemeh Peyghambari, Hessam Roustaei, Abbas Ahmadi,
Volume 10, Issue 4 (8-2012)

Background: In vitro maturation (IVM) of human oocytes is an emerging procedure quickly incorporated into the world of assisted reproductive technologies. As an effective method of in vitro maturation, several studies have reported the critical role of differentions on activating the complex process involved in both gamete maturation and fertilization.
Objective: In this study, we supplemented a chemically defined medium with different combinations of selenium, calcium and calcium ionophore concentrations to obtain the best rate of human oocytes maturation, survival, and fertilization.
Materials and Methods: As an experimental study, Three combinations of [selenium (5 μg/ml), calcium (5 μg/ml) and calcium ionophore (1 μg/ml)], [selenium (10 μg/ml), calcium (7 μg/ml) and calcium ionophore (2 μg/ml)] and [selenium (15 μg/ml), calcium (10 μg/ml) and calcium ionophore (5 μg/ml)] added to the chemically defined medium and the morphology of oocytes assessed after 22-24 hours in vitro maturation of the oocytes.
Results: The highest percentage of MII (meiosis II) oocytes (68%), developing beyond the morula (20.1%) and the blastocyst formation (11.1%) observed in oocytes treated with 15µg/ml selenium, 10µg/ml calcium and 5µg/ml calcium ionophore. Moreover, we showed the significant rate of survival in each three combinations after 36, 72 and 96 hours.
Conclusion: Maturation and activation of oocytes may be triggered by changes in intracellular ion concentrations as second messengers in signal transduction pathways. Here, we received the highest percentage of in vitro maturation and fertilization among three combinations of selenium, calcium and calcium ionophore treatments. Using this combination of ions beside other factors might be useful for the enrichment of the human oocytes IVM medium.

Maryam Asgharnia, Roya Faraji, Fariba Mirblouk, Zahra Atrkar Roshan , Ayda Parvizi,
Volume 10, Issue 4 (8-2012)

Background: Vaginal sonograghy and serial -hCG are the most common diagnostic methods for ectopic pregnancy but about 50% of cases are initially misdiagnosed. In tubal pregnancy the zygote lies next to the muscular layer, and this invasion causes an increase in creatine phosphokinase (CPK) in blood.
Objective: assessment of CPK and its isoenzyme CPK-MB as a diagnostic marker for tubal pregnancy.
Materials and Methods: In this case-control study, 111 women between 16-40 years in first-trimester pregnancy admitted to emergency ward of Rasht Alzahra hospital with abdominal pain or vaginal bleeding were included and according to sonography and βhCG divided into 3 groups (N=37): tubal pregnancy (1), threatened abortion (2) and normal pregnancy (3). Blood samples were taken for totalCPK and CPK-MB before any invasive procedure. Results: Mean total CPK level were 96.27±63.9 u/lit (group 1), 55.37±14.1 u/lit (group 2) and 48.94±19.2 u/lit (group 3) and was significantly higher in tubal pregnancy compared to other groups. Mean CPK-MB levels in 3 groups were 15.62±5.2 u/lit, 17.32±6.9 u/lit, and 15.1±4.7 u/lit, respectively which was not significant.
Conclusion: It seems that determination of total CPK can enhance the diagnostic value of tubal pregnancy.
Razieh Dehghani Firouzabadi, Farnaz Mohammadian, Mehri Mashayekhy, Robab Davar, Maryam Eftekhar,
Volume 10, Issue 5 (10-2012)

Background: Determination of oocyte fertilization and embryo quality are one of the most important purposes in ART cycles. Follicular fluid provides an important microenvironment for development of oocytes and some biochemical characteristics of the follicular fluid, such as pregnancy-associated plasma protein-A (PAPP-A), may play an important role in prediction of success rate of ART.
Objective: This study was performed to evaluate whether there was any difference in follicular fluid PAPP-A, fertilization, and embryo quality between GnRH agonist long protocol and flexible GnRH antagonist multiple-dose protocol in ART cycles.
Materials and Methods: A total of 100 women who were candidates for ART were enrolled the study and were divided into two groups, GnRH agonist (GnRHa) long protocol (n=51) and flexible GnRH antagonist (GnRHant) multiple-dose protocol (n=49). Follicular fluid sample was obtained from a single mature follicle and follicular fluid PAPP-A level, fertilization and embryo quality of the same oocyte were evaluated in both groups.
Results: There was no significant difference in the mean levels of follicular fluid PAPP-A between the GnRHa protocol and GnRHant protocol (3.5±1.4 vs. 3.8±1.9, respectively). The mean levels of follicular fluid PAPP-A in fertilized oocyte and good quality embryo were comparable in GnRHa and GnRHant protocols.
Conclusion: Our data indicated that no differences of follicular fluid PAPP-A levels were observed between cycles using GnRHa long protocol and those of using flexible GnRHant multiple-dose protocol.
Reza Mahmoudi, Farzad Rajaei, Iraj Ragardi Kashani, Mehdi Abbasi, Fardin Amidi, Aligholi Sobhani, Iraj Amiri,
Volume 10, Issue 5 (10-2012)

Background: Cryopreservation and in vitro maturation (IVM) of oocyte is becoming an important technique in infertility treatment and fertility preservation. Also it has been proposed to establish a genetic resource bank for endangered or commercially important animal species.
Objective: The aim of this study was to evaluate viability, maturation and fertilization rate of mouse immature oocytes after single and stepwise vitrification procedure.
Materials and Methods: Oocytes were obtained from 4 weeks old female mice 48h after intraperitoneal injection of 7.5 IU pregnant mare serum gonadotropin (PMSG). Collected oocytes before vitrification were exposed to cryoprotectant, which was composed of 30% (v/v) ethylene glycol, 18% (w/v) Ficoll-70, and 0.3 M sucrose, either by single step or in a step-wise way. After vitrification and storage in liquid nitrogen, the oocytes were warmed and washed two times in medium TCM199 and then subjected to IVM, fertilization and subsequent development to blastocysts.
Results: The oocytes survival rates after vitrifying-warming (88.96%), maturation rate (73.23%), the capacity of fertilization (57.80%) and embryonic development to blastocyst (16.41%) in the step-wise exposure were significantly higher (p<0.001) compared with corresponding rate in the single step procedure.
Conclusion: The results suggest that vitrification with step-wise procedure has positive effects on maturation and developmental capacity of mice germinal vesicle oocytes in compare with single step vitrification procedure.
Leila Soltani, Farokh Kafilzadeh, Hamed Karami Shabankareh,
Volume 10, Issue 5 (10-2012)

Background: Progress achieved in culture media formulations have resulted led to an improvement in maintaining the mammalian embryo in culture throughout the preimplantation and pre-attachment period.
Objective: The objective of this study was to evaluate the effect of various concentrations of myo-inositol during in vitro fertilization of bovine oocytes on subsequent embryo development.
Materials and Methods: Bovine cumulus oocytes complexes (COCs) were matured in vitro at 39oC, in humidified 5% CO2 atmosphere for 22-24 h. The COCs were coincubated with epididymal spermatozoa of post mortem bulls in modified TALP medium for 22-24hr. The fertilization medium used was: 1) TALP medium without myo-inositol (control); 2) control+0.02 g/l myo-inositol; 3) control+0.03 g/l myoinositol; 4) control+0.04 g/l myo-inositol. Zygotes were cultured in vitro for 8 days when the ratios of in vitro embryo development of the hatched blastocysts were assessed and compared with the control group (p<0.05).
Results: The presence of 0.04 g/l myo-inpsitol significantly improved overall morula and blastocyst rates (46.94%) compared to control (32.19%), but there was no difference in the percentage of embryos successfully developed to the morula and blastocyst stage when different levels of myo-inositol were used (46.94, 36.36 and 37.33% respectively). The mean percentage of cleavage rate was not significantly affected by treatments.
Conclusion: These results suggest that, addition of 0.04 g/l myo-inositol in TALP medium is more beneficial for subsequent bovine embryonic development.
Mohammad Hadi Bahadori, Fatemeh Ghasemian, Mina Ramezani, Zakieh Asgari,
Volume 11, Issue 1 (4-2013)

Background: It is important to protect oocytes and embryos from oxidative stress in the culture medium. Melatonin has been shown to be a direct free radical scavenger.
Objective: Effect of melatonin during in vitro oocyte maturation, fertilization and embryo development of mouse oocytes was evaluated.
Materials and Methods: Oocytes from supper-ovulated mouse were divided to two groups: cumulus oocyte complexes (COCs, group I) and denuded COC (d-COCs, group II). The oocytes were cultured in maturation medium with different doses of melatonin (1×101-105 nM). The cumulus expansion and nuclear status were evaluated after 24 h of in-vitro maturation. The oocytes were used for in-vitro fertilization. The fertilized oocytes were cultured in medium supplemented with different doses of melatonin.
Results: The expansion (86.79%) and maturation (80.55%) rate of COCs increased in supplemented medium with 10 nM of melatonin vs. control group (73.33%), p=0.006 and p=0.026 respectively), but oocytes without cumulus cells indicated higher maturation rate at higher melatonin doses (10 and 100 M, 84.34% and 79.5% respectively( vs. 69.33% in control group (p=0.002). Fertilization rate was higher in treated medium with 1 μM of melatonin (93.75%, p=0.007). The rate of cleavage and blastocyst formation was promoted in medium supplemented with 10 and 100 nM of melatonin (92.37% and 89.36% vs. 81.25% in control group, p=0.002). We observed a dose dependent response to melatonin treatment in this experiment.
Conclusion: Exogenous melatonin can promote cumulus cell expansion, in vitro oocyte maturation, and embryo development. However we investigated a dose-dependent response in different stages of maturation and development. It may reflect sensitive rate of oocytes and embryos to culture conditions.
Maryam Eftekhar, Elham Rahmani, Farnaz Mohammadian,
Volume 11, Issue 2 (4-2013)

Background: Gonadotrophin-releasing hormone (GnRH) agonist is used for controlling ovarian stimulation in assisted reproductive technology (ART) cycles which has some benefits.
Objective: To compare the efficacy of two different formulations of GnRH agonist: short-acting and long-acting, for ART protocols.
Materials and Methods: In a prospective randomized study, one hundred women who underwent ART cycles were randomly divided into two groups. In group I, the patients received one single injection of 1.87 mg Triptorelin in previous mid-luteal phase. In group II, Decapeptyl 0.1 mg per day started from previous mid-luteal phase. Pregnancy outcome in in vitro fertilization (IVF) cycle was compared between two groups.
Results: There were no statistically significant differences in the number of retrieved oocyte (p=0.545), fertilization (p=0.876), implantation (p=0.716) and pregnancy rate (p=0.727) between the two groups.
Conclusion: There were not any advantages in IVF outcome between half-dose long-acting and short-acting GnRH agonist groups in ART cycle.
Abass Aflatoonian, Elham Rahmani, Mozhgan Rahsepar,
Volume 11, Issue 3 (5-2013)

Background: Endometriosis is a common hormone-dependent gynecologic disease with a high recurrence. Laparotomy or laparoscopy is the standard surgery for the large endometrioma. Also, sclerotherapy is basically used to treat different diseases one of which is endometrioma.
Objective: The study was designed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma.
Materials and Methods: In a randomized clinical trial, an interventional group of 20 patients underwent transvaginal ethanol sclerotherapy for recurrent ovarian endometrioma. The patients were followed up first after one and two weeks and then after one, two, and three months. If the patients had no endometrioma, they were treated with in vitro fertilization (IVF) (standard long protocol). A control group of 20 patients with endometrioma were enrolled for an IVF protocol. They had no treatment by ethanol sclerotherapy. IVF parameters, pregnancy rates, and implantation rates were compared in both groups.
Results: The demographic data showed no difference between the two groups. The initial mean endometria size was 41.45±15.9 cm, the recurrence rate after 6 months was 4 (20%), FSH before and after sclerotherapy was 6.97±2.25 IU/L and 6.78±1.88 IU/L (p=0.343). The clinical pregnancy rate was 6 (33.3%) vs. 3 (15%), (p=0.616). The fertilization rate emerged 63.06% in study group vs. 60.38%, (p=0.57). The implantation rate turned out 12.9% in study group vs. 7.5%, (p=0.52). None of these results were significant. However, the data pointed to a better trend toward the ethanol sclerotherapy group.
Conclusion: Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF.
Maged Mohammed Yassin, Fadel Akram Sharif, Mohammed Marwan Laqqan,
Volume 11, Issue 4 (6-2013)

Background: Careful evaluation of patients and proper treatment with right techniques are essential for successful outcome of assisted reproduction. To obtain satisfactory results, it is necessary to assess ovarian reserve before planning treatment.
Objective: To evaluate anti-mullerian hormone as a predictor of fertility potential in terms of ovarian reserve and ovarian response reflected by antral follicles and mature oocyte counts in response to menotrophin stimulation in in vitro fertilization (IVF) women from Gaza Strip.
Materials and Methods: This prospective cohort study consisted of 81 women (mean age 28.7 years) attending IVF at Al-Basma Fertility Center in Gaza City. Blood withdrawal for antimullerian hormone measurement was performed in all the patients and the number of oocytes and embryos were recorded.
Results: The total number of retrieved oocytes was inversely associated with age (12.5±4.5, 11.0±5.4 and 6.9±4.7 at age ≤25, 26-35 and >35 years, respectively (F=4.793 and p=0.011). The ovarian response to Menotrophin (FSH 75IU, LH 75 IU) stimulation was better for younger age. There was a significant positive association between ovarian response in terms of total number of oocytes and antimullerian hormone levels. The maximum level of antimullerian hormone was observed in females who achieved positive pregnancies (4.5±2.5 ng/mL) followed by negative pregnancies (2.9±1.8 ng/mL) with significant differences (F=6.862 and p=0.002). Correlation coefficient revealed that the number of mature oocytes showed strong positive correlation with the antimullerian hormone levels (r=0.469, p=0.001).
Conclusion: Anti-mullerian hormone can be used in IVF programs as a good predictor of ovarian reserve and ovarian response.
Sahar Moghbelinejad, Hossein Mozdarani, Zahra Rezaeian,
Volume 11, Issue 5 (7-2013)

Background: Irradiation is one of the major causes of induced sperm DNA damage. Various studies suggested a relation between sperm DNA damage and fertilization rate after intra-cytoplasmic sperm injection (ICSI).
Objective: In this study, fertilization rate and premature chromosome condensation (PCC) formation after ICSI of hamster oocytes with irradiated sperms from normal and oligosperm individuals was investigated.
Materials and Methods: Human sperms were classified according to counts to normal and oligosperm. Ten samples were used for each group. Golden hamster oocytes were retrieved after super ovulation by PMSG and HCG injection. From retrieved oocytes, 468 were in metaphase II. Control and 4 Gy gamma irradiated sperms were then injected into oocytes. After pronuclei formation in injected oocytes and formation of 8 cells embryos, slides were prepared using Tarkowskie's standard air-drying technique. The frequency of embryos and PCC were analyzed using 1000× microscope after staining in 5% Giemsa.
Results: The extent of embryo development in oocytes injected by irradiated sperms was lower than those injected by non-irradiated sperms (p=0.0001). The frequency of PCC in failed fertilized oocytes was significantly higher in oligosperms (46%) compared with normal ones (0%), but there was no significant difference between irradiated and non-irradiated samples in each group (p=0.12).
Conclusion: The results showed that irradiation of sperms might influence the fertilization outcome possibly due to sperm DNA damage. One possible cause of precluding oocytes from fertilization in oligosperm individuals might be the formation of PCC.
Fatemeh Ghasemian, Roya Faraji, Maryam Asgharnia, Ziba Zahiri, Mohammad Hadi Bahadori,
Volume 11, Issue 7 (10-2013)

Background: Abnormal oocyte morphology has been associated with the hormonal environment to which the gametes are exposed.
Objective: In this study, we evaluated the oocytes morphology, fertilization rate, embryos quality, and implantation rate resulted of retrieved oocytes in different times after human chorionic gonadotrophin (HCG) administration.
Materials and Methods: A total of 985 metaphase II oocytes were retrieved 35, 36, 37 and 38 h after the injection of HCG as groups 1, 2, 3, and 4 respectively. Oocyte morphology was divided into (I) normal morphology, (II) extracytoplasmic abnormalities, (III) cytoplasmic abnormalities and (IV) intracytoplasmic vacuoles and in each group, oocytes were evaluated according to this classification.
Results: Extracytoplasmic abnormalities were encountered in 17.76% and 31.1% of these oocytes (groups 3 and 4 respectively, p=0.007) in comparison with 12.23% group 2. Cytoplasmic abnormalities in group 4 were higher than other groups. 23.88% (p=0.039) and 43.25% (p=0.089) of resulted 2PN (two pronucleus) from groups 3 and 4 showed grade Z3 respectively in comparison to group 2 (16.44%). Normal and various categories of abnormal oocytes did not differ regarding fertilization and cleavage rates (p=0.061). However, group 4 showed significant difference in the rate of embryos fragmentation (grade III and IV embryo) in comparison with group 2 (40.96% vs. 24.93%, p=0.078). The pregnancy rate was higher in G2 and G3 groups (28.5 and 24.13% respectively).
Conclusion: Oocyte retrieval time following HCG priming affected on oocyte morphology, 2PN pattern and embryos qualities subsequently. Both good quality embryo formation and pregnancy outcomes were noticeably higher when oocytes were retrieved 36 h after HCG priming in ART program.
Bárbara Romero, Laura Aibar, Luis Martínez Navarro, Juan Fontes, Maria-Angeles Calderón, Juan Mozas,
Volume 11, Issue 8 (11-2013)

Background: Pelvic inflammatory disease with progression to pelvic abscess is a rare complication after oocyte retrieval during in vitro fertilization cycles. However, in patients with endometriosis the risk appears to be increased. Many authors agree on the need for antibiotic prophylaxis during the oocyte retrieval in these patients, but there is no consensus regarding the best antibiotic.
Case: We discuss 3 clinical cases of tubo-ovarian abscess in women with endometriosis after oocyte retrieval despite antibiotic prophylaxis between 2004 and 2011 at our center, and discuss our experience in the context of earlier reports.
Conclusion: It is unclear whether antibiotic prophylaxis is necessary in these women, and which antibiotic is best. Only douching with povidone-iodine appears to decrease the rate of pelvic infection.
Narges Nabavi, Fatemeh Todehdehghan, Abdollhossein Shiravi,
Volume 11, Issue 9 (12-2013)

Background: Caffeine increases the CAMP production that stimulates spermatozoa movement. Caffeine is also used for induction of in vitro acrosome reaction in mammalian spermatozoa, an important step in achieving fertilization.
Objective: The aim of this study was to assess the effect of caffeine on sperm's motility, vitality and laboratory fertilization rates in mouse in two T6 and M16 media.
Materials and Methods: Epididymal mouse sperms were collected and treated by caffine in T6 and M16 media and their motility and vitality rates were evaluated. The pretreated sperms were added to oocytes in T6 and M16 media with and without caffeine and fertilization rates were recorded after 24 hours incubation.
Results: Sperm's motility (81.7±1.67%) and vitality (88.7±1.33%) rates and percentage of fertilized oocytes (67.52±8.16%) in T6 medium plus caffeine compare to control group have increased and shown significant differences at p≤0.01. While the percentages of these parameters in M16 medium supplemented with caffeine were 68.3±6.01%, 78±6.11%, and 42.6±12.96 respectively and in comparison to control group (M16 without caffeine) have not shown significant differences.
Conclusion: Addition of caffeine to T6 medium promotes the sperm's motility and vitality and enhances fertilization and early in vitro development of mouse embryos.
Rehana Rehman, Zahir Hussain, Syeda Sadia Fatima,
Volume 11, Issue 9 (12-2013)

Background: There has been an increase in number of obese infertile females booked for advanced infertility treatment procedures like in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI). The knowledge of impact of body mass index (BMI) on reproductive outcome can help to counsel these patients.
Objective: To compare reproductive outcome in females of different BMI after ICSI.
Materials and Methods: Cross-sectional study of 323 females was conducted from June 2010 till August 2011. Females were grouped on the basis of BMI; underweight, (BMI <18 kg/m2), normal weight, (BMI 18-22.9 kg/m2) overweight (BMI 23-25.9 kg/m2) and obese (BMI ≥26 kg/m2). The procedure involved down regulation of ovaries, controlled ovarian stimulation, ovulation induction by hCG, oocyte pickup, in vitro fertilization and embryo transfer of blastocysts. The oocyte yield and embryological data of all BMI groups was compared by ANOVA (analysis of variance). Pregnancy outcome of these was categorized as; no conception βhCG <5 m IU/ml, preclinical abortion with βhCG >5 m IU/ml, no cardiac activity on trans vaginal scan (TVS) and clinical pregnancy with βhCG >5mIU/ml and cardiac activity on trans vaginal scan.
Results: Females with BMI 23-25.99 kg/m2 had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI ≥26 kg/m2.
Conclusion: A BMI cut off value of above 26 kg/m2 in our study population is associated with a negative impact on pregnancy outcome.
Afsaneh Niakani, Farah Farrokhi, Shapour Hasanzadeh,
Volume 11, Issue 10 (12-2013)

Background: Gonadotropin-releasing hormone (GnRH) is a reproductive key hormone. The GnRH analogues are widely used in in vitro fertilization and treatment of sex hormone-depended cancers induced by the materials used in chemotherapeutic agents.
Objective: The aim of this study is to evaluate the effects of cyclophosphamide and decapeptyl (analogues of GnRH) on histomorphometry and stereology of testicular tissue as well as gonadotropic and gonadal hormones indices in mice.
Materials and Methods: For this study, 24 adult male Balb/C strain mice were divided in four groups; first, cyclophosphamide (65 mg/kg/body weight (BW)), second, decapeptyl (0.05 mg/kg/BW), third, decapeptyl at first, and after 10 days of cyclophosphamide injection, and control group was received same volume of sterile saline. In order to evaluate the tissue changes in testes of the mice, sections were prepared and stained with Hematoxylin-Eosine, Periodic Acid Schief's (PAS) and Oil-Red-O staining techniques.
Results: The cyclophosphamide causes histomorphologic changes in the testicular tissue; whereas such changes by decapeptyl were comparatively mild. The morphometric results revealed significant reduction in diameters of seminiferous tubules (p=0.02), and the stereological results confirmed significant differences in spermatogenesis (SI) as well as rate of tubal differentiation (TDI) indices between experimental and control groups (p=0.001). In addition, the morphometric findings proved that, there are significant decrease (p=0.001) in thicknesses of epithelia and stereologic result revealed reduction in number of cell layers in both decapeptyl and chemotherapy groups, but the decrements of these parameters were significant (p=0.02) in later group. In groups that had received cyclophosphamide, and decapeptyl alone, the LH and testosterone levels were decreased significantly (p=0.03), whereas in those that had received decapeptyl along with cyclophosphamide, the LH and FSH levels showed a decline but the level of testosterone increased.
Conclusion: These results demonstrated that, analogue of GnRH i.e., decapeptyl protect morphologic, morphometric, and stereologic alterations of the testes tissue, as well as gonadotropic and gonadal hormonal changes preceding cyclophosphamide treatment in male mice.
Maryam Eftekhar, Sima Janati, Mozhgan Rahsepar, Abbas Aflatoonian,
Volume 11, Issue 11 (12-2013)

Background: Chemical activation is the most frequently used method for artificial oocyte activation (AOA), results in high fertilization rate.
Objective: This prospective, randomized, unblinded, clinical study aimed to evaluate the efficiency of oocyte activation with calcium ionophore on fertilization  and pregnancy rate after intracytoplasmic sperm injection (ICSI) in infertile men suffer from teratoospermia.
Materials and Methods: Thirty eight women with teratoospermic partner underwent ICSI with antagonist protocol. A total of 313 metaphase II (MII) oocytes were randomly divided into two groups: In the oocytes of the control group (n=145), routine ICSI was applied. Oocytes in the AOA group (n=168) immediately after ICSI, were entered in culture medium supplemented with 5 μΜ calcium ionophore (A23187) for 5 minutes and then washed at least five times with MOPS solution. In both groups, the fertilization was evaluated 16-18 hours after ICSI.
Results: The number of fertilized oocytes and embryos obtained were significantly different between two groups (p=0.04). There was no significant difference between the two studied groups regarding the fertilization and cleavage rate (95.33% vs. 84.4%, p=0.11; and 89.56% vs. 87.74%, p=0.76, respectively). Implantation rate was higher in AOA group than in control group, but the difference was not significant (17.64% vs. 7.4%, p=0.14). No significant differences were observed in chemical and clinical pregnancy rate between groups (47.1% vs. 16.7%, p=0.07; and 41.2% vs. 16.7%; p=0.14, respectively).
Conclusion: We didn’t find significant difference in the implantation, fertilization, cleavage and pregnancy rates between the two groups but could significantly increase the number of fertilized oocytes and embryos obtained. Finally oocyte activation with calcium ionophore may improve ICSI outcomes in infertile men suffer from teratoospermia. Further study with more cases can provide greater value.
Ashraf Kazemi, Fatemeh Ramezanzadeh, Mohammad Hosein Nasr-Esfahani, Ali Akbar Saboor Yaraghi, Mehdi Ahmadi,
Volume 11, Issue 12 (1-2013)

Background: Fat-rich diet may alter oocyte development and maturation and embryonic development by inducing oxidative stress (OS) in follicular environment.
Objective: To investigate the relationship between fat intake and oxidative stress with oocyte competence and embryo quality.
Materials and Methods: In observational study follicular fluid was collected from 236 women undergoing assisted reproduction program. Malon-di-aldehyde (MDA) levels and total antioxidant capacity (TAC) levels of follicular fluid were assessed as oxidative stress biomarkers. In assisted reproduction treatment cycle fat consumption and its component were assessed. A percentage of metaphase ΙΙ stage oocytes, fertilization rate were considered as markers of oocyte competence and non-fragmented embryo rate, mean of blastomer and good cleavage (embryos with more than 5 cells on 3 days post insemination) rate were considered as markers of embryo quality.
Results: The MDA level in follicular fluid was positively related to polyunsaturated fatty acids intake level (p=0.02) and negatively associated with good cleavage rate (p=0.045). Also good cleavage rate (p=0.005) and mean of blastomer (p=0.006) was negatively associated with polyunsaturated fatty acids intake levels. The percentage of metaphase ΙΙ stage oocyte was positively related to the TAC levels in follicular fluid (p=0.046). The relationship between the OS biomarkers in FF and the fertilization rate was not significant.
Conclusion: These findings revealed that fat rich diet may induce the OS in oocyte environment and negatively influence embryonic development. This effect can partially be accounted by polyunsaturated fatty acids uptake while oocyte maturation is related to TAC and oocytes with low total antioxidant capacity have lower chance for fertilization and further development.

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