International Journal of Fertility and Sterility

182-190

Authors: Jenniffer Puerta Suárez, Stefan du Plessis, Walter D. Cardona-Maya

The 100,000th scientific article on the subject of spermatozoa was recently published. Numerous studies evaluated the characteristics of this important cell that led to tremendous discoveries. Since its first observation and description in 1677, many important characteristics have been described regarding this highly fascinating gamete. In this review, we intend to provide a historical account of the numerous milestones and breakthroughs achieved related to sperma- tozoa. We conducted a review of the literature by selecting the most important subjects with regards to spermatozoa. Since their discovery by van Leeuwenhoek, spermatozoa have been studied by scientists to better understand their physiology and process of interaction with their female counterpart, the oocyte, in order to treat and resolve infertility problems. Three centuries after van Leeuwenhoek’s discovery, the 100,000th article about these cells was published. It is encouraging that sperm research reached this landmark, but at the same time it is clear that further research on male reproductive physiology and spermatozoa is required to shed more light on their function and pathology in order to reduce the number of unexplained infertility cases.

200-206

Authors: Shahideh Jahanian Sadatmahalleh, Saeideh Ziaei, Anoshirvan Kazemnejad, Eesa Mohamadi

Background The aim of this study is to evaluate the menstrual pattern, sexual function, and anxiety, and depression in women with poststerilization regret, and potential influencing factors for regret following tubal ligation (TL) in Iranian women. Materials and Methods In this cross-sectional study, 166 women with TL were subdivided into two groups including women with poststerilization regret (n=41) and women without poststerilization regret (n=125). They were selected from a health care center in Guilan province (Iran) during 2015-2016. Menstrual blood loss was measured using the Pictorial Blood Loss Assessment Chart (PBLAC) and through a self-administered questionnaire. In addition, sexual function was assessed by the Female Sexual Function Index (FSFI), and psychological distress was measured by employing the Hospital Anxiety and Depression Scale (HADS). Student’s t test and Chi-square test were used to reveal the statistical differences between the two groups. We used logistic regression to determine the influencing factors associated with regretting sterilization. Results Women with poststerilization regret had more menorrhagia (78 vs. 57.6%, P=0.03) than those who did not regret sterilization. A significant difference was found in sexual dysfunction in orgasm (P=0.02), satisfaction (P=0.004), pain (P=0.02), and total FSFI scores (P=0.007) between the two groups. Also, there was a significant difference between the two groups in anxiety, depression and total scores HADS (P=0.01). In the logistic regression model, age of sterilization [odds ratio (OR=2.67), confidence interval (CI): 1.03-7.81, P=0.04)], pre-sterilization counseling (OR=19.92, CI: 6.61-59.99, P<0.001), score of PBLAC (OR=1.01, CI: 1.004-1.01, P=0.001), the number of days of bleeding (OR=1.37, CI: 1.01-1.99, P=0.04), and the length of menstrual cycles (OR=0.91, CI: 0.84-0.99, P=0.03) were significantly associated with regretting sterilization. Conclusion Complications due to sterilization are the main causes of regret; therefore, it is necessary to pay due attention to mentioning the probable complications of the procedures such as menstruation disorders, sexual dysfunction, and anxiety and depression in women during pre-sterilization counseling.

213-217

Authors: Farideh malekzadeh, Ashraf Moini, Elham Amirchaghmaghi, Leila Daliri, Mohammad Reza Akhoond, Mehrak Talebi, Rihaneh Hosseini

Background Endometriosis is a common gynaecological disease that affects quality of life for women. Several studies have revealed that both environmental and genetic factors contribute to the development of endometriosis. The aim of this study was to investigate the distribution of ABO and Rh blood groups in Iranian women with endometriosis who presented to two referral infertility centers in Tehran, Iran. Materials and Methods In this case-control study, women who referred to Royan Institute and Arash Women’s Hospital for diagnostic laparoscopy between 2013 and 2014 were assessed. Based on the laparoscopy findings, we categorized the women into two groups: endometriosis and control (women without endometriosis and normal pelvis). Chi-square and logistic regression tests were used for data analysis. Results In this study, we assessed 433 women, of which 213 patients were assigned to the endometriosis group while the remaining 220 subjects comprised the control group. The most frequent ABO blood group was O (40.6%). The least frequent blood group was AB (4.8%). In terms of Rh blood group, Rh+ (90.1%) was more frequent than Rh- (9.9%). There was no significant correlation between ABO (P=0.091) and Rh (P=0.55) blood groups and risk of endometriosis. Also, there was no significant difference between the two groups with regards to the stage of endometriosis and distribution of ABO and Rh blood groups (P>0.05). Conclusion Although the O blood group was less dominant in Iranian women with endometriosis, we observed no significant correlation between the risk of endometriosis and the ABO and Rh blood groups. Endometriosis severity was not correlated to any of these blood groups.

223-228

Authors: Homayoun Khazali, Fariba Mahmoudi, Mahyar Janahmadi

Background: The inhibitory effects of morphine and the stimulatory influence of kisspeptin signaling have been demonstrated on gonadotropin releasing hormone (GnRH)/luteinizing hormone (LH) release. Hypothalamic kisspeptin is involved in relaying the environmental and metabolic information to reproductive axis. In the present study, the role of kisspeptin/ GPR54 signaling system was investigated on relaying the inhibitory influences of morphine on LH hormone secretion. Materials and Methods: In this experimental study, 55 wistar male rats weighing 230-250 g were sub-grouped in 11 groups (in each group n=5) receiving saline, kisspeptin (1 nmol), peptide234 (P234, 1 nmol), morphine (5 mg/kg), naloxone (2 mg/kg), kisspeptin/P234, morphine/naloxone, kisspeptin/morphine, kisspeptin/naloxone, P234/morphine or P234/naloxone respectively. Blood samples were collected via tail vein. Mean plasma (LH) concentrations and mean relative KiSS1 or GPR54 mRNA levels were determined by radioimmunoassay (RIA) and real time reverse transcriptase-polymerase chain reaction (RT-PCR), respectivwely. Results: Morphine significantly decreased mean plasma LH concentration and mean relative KiSS1 gene expression compared to saline; while it did not significantly decrease mean relative GPR54 gene expression compared to saline. Naloxone significant increased mean LH level and mean relative KiSS1 gene expression compared to saline; while it did not significantly increase mean relative GPR54 gene expression compared to saline. Injections of kisspeptin plus morphine significantly increased mean LH concentration compared to saline or morphine, while simultaneous infusions of them significantly declined mean plasma LH level compared to kisspeptin. In kisspeptin/naloxone group mean plasma LH level was significantly increased compared to saline or naloxone. Co-administration of P234/morphine significantly decreased mean LH concentration compared to saline. Conclusion: Down regulation of KiSS1 gene expression may be partly involved in the mediating the inhibitory effects of morphine on reproductive axis.

235-241

Authors: Mahnaz Poorhassan, Fatemeh Navaee, Simin Mahakizadeh, Mahshid Bazrafkan, Banafsheh Nikmehr, Farid Abolhassani, Sahar Ijaz, Nazila Yamini, Nasrin Dashti, Kobra Mehrannia, Gholamreza Hassanzadeh, Mohammad Akbari

Background Hypoxia causes detrimental effects on the structure and function of tissues through increased production of reactive oxygen species that are generated during the re-oxygenation phase of intermittent and continuous hypobaric hypoxia. This study was carried out to evaluate the effects of flaxseed (Fx) in reducing the incidence of hypoxia in rat testes. Materials and Methods In this experimental study, 24 adult Wistar rats were randomly divided into four groups: i. Control group (Co) that received normal levels of oxygen and food, ii. Sham group (Sh) that were placed in hypoxia chamber but received normal oxygen and food, iii. Hypoxia induction group (Hx) that were placed in hypoxia chamber and treated with normal food, iv. Hypoxia induction group (Hx+Fx) that were placed in hypoxia chamber and treated with 10% flaxseed food. Both the Hx and Hx+Fx groups were kept in a hypoxic chamber for 30 days; during this period rats were exposed to reduced pressure (oxygen 8% and nitrogen 92%) for 4 hours/day. Then, all animal were sacrificed and their testes were removed. Malondialdehyde (MDA) and total antioxidant capacity (TAC) levels were evaluated in the testis tissue. Tubular damages were examined using histological studies. Blood samples and sperm were collected to assess IL-18 level and measure sperms parameters, respectively. All data were analyzed using SPPSS-22 software. One way-ANOVA or Kruskal-Wallis tests were performed for statistical analysis. Results A significant difference was recorded in the testicular mass/body weight ratio in Hx and Hx+Fx groups in comparison to the control (P=0.003 and 0.027, respectively) and Sh (P=0.001 and 0.009, respectively) groups. The sperm count and motility in Hx+Fx group were significantly different from those of the Hx group (P=0.0001 and 0.028, respectively) .Also sperm viability (P=0.0001) and abnormality (P=0.0001) in Hx+Fx group were significantly different from Hx group. Conclusion This study therefore suggests that the oral administration of flaxseed can be useful for prevention from the detrimental effects of hypoxia on rat testes structure and sperm parameters.

249-256

Authors: Amir M. Bassam Elnagar, Abdelnasser Ibrahim, Amro Mohamed Soliman

Background Titanium dioxide (TiO2) is a white pigment which is used in paints, plastics, etc. It is reported that TiO2 induces oxidative stress and DNA damage. N-acetylcysteine (NAC) has been used to fight oxidative stress-induced damage in different tissues. The objective of this study was to evaluate the toxic effects of orally administered TiO2 nanoparticles and the possible protective effect of NAC on the testes of adult male albino rats. Materials and Methods In this experimental study, 50 adult male albino rats were classified into five groups. Group I was the negative control, group II was treated with gum acacia solution , group III was treated with NAC, group IV was treated with TiO2nanoparticles, and group V was treated with 100 mg/kg of NAC and 1200 mg/kg TiO2nanoparticles. Total testosterone, glutathione (GSH), and serum malondialdehyde (MDA) levels were estimated. The testes were subjected to histopathological, electron microscopic examinations, and immunohistochemical detection for tumor necrosis factor (TNF)-α. Cells from the left testis were examined to detect the degree of DNA impairment by using the comet assay. Results TiO2nanoparticles induced histopathological and ultrastructure changes in the testes as well as positive TNF-α immunoreaction in the testicular tissue. Moreover, there was an increase in serum MDA while a decrease in testosterone and GSH levels in TiO2nanoparticles-treated group. TiO2resulted in DNA damage. Administration of NAC to TiO2- treated rats led to improvement of the previous parameters with modest protective effects against DNA damage. Conclusion TiO2-induced damage to the testes was mediated by oxidative stress. Notably, administration of NAC protected against TiO2’s damaging effects.

263-266

Authors: Mania Kaveh, Kobra Tahermanesh, Abolfazl Mehdizadeh Kashi, Banafsheh Tajbakhsh, Gazal Mansouri, Kambiz Sadegi

Endometriosis affects about 10% of women of reproductive age. Its main feature is the presence of stroma and endometrial glands in sites other than the uterus, mainly in pelvis. Pelvic peritoneum, ovaries, uterine ligaments, bladder, intestines, andcul-de-sac are among the affected areas. Sometimes endometriosis can be found outside of the pelvis and even above abdominal cavity, like indiaphragm.Herein, we present a case of an asymptomatic diaphragmatic endometriosis that was discovered incidentally during laparoscopy of pelvic endometriosis, as well as our appropriately proposed treatment protocol.