International Journal of Fertility and Sterility

141-146

Authors: Mohammad Hossein Nasr Esfahani , Marziyeh Tavalaee

Varicocele is considered as one of the main etiologies of male infertility. Along with altered semen parameters, increased DNA fragmentation is believed to play an important role in varicocele-induced infertility. DNA damage may result from intra- or extra-testicular factors. Among these, apoptosis, abnormal chromatin packaging and oxidative stress are the most researched and are addressed in this review. Significant evidence suggests that varicoceles have a harmful effect on testicular function and a varicocelectomy not only prevents progressive decline in testicular function, but also reverses the damage. However, the degree to which varicocele repair improves pregnancy rates and the success of assisted reproductive technology (ART) remains controversial. Therefore, the role of varicocele repair on DNA fragmentation is also discussed.

157-164

Authors: Fatemeh Ghasemian , Roya Faraji , Mohaddese Mohammadi Sardoo , Mohammad Hadi Bahadori

Background: We designed this study to detect the cryoinjury rate on human sperm after serial freezing and thawing, taking into consideration the effects of using cryovials and straws. Materials and Methods: In this experimental study, semen specimens obtained from 15 subjects were divided into normozoospermic and oligozoospermic groups. Each of the normozoospermic and oligozoo spermic semen specimens were additionally divided into two groups: i. washed and ii. unwashed. Specimens were repeatedly freeze-thawed by using cryovials and straws with the fast liquid nitrogen vapor method, until no motile sperm remained. Sperm motility, recovery, and morphology rate were then determined after thawing, and compared between the groups while taking into consideration the effects of using cryovials and straws. Results: Motile spermatozoa were observed in all normozoospermic samples up to thaw 6 with both cryovials and straws while in oligozoospermic specimens up to thaw 4 (straw) and thaw 3 (cryovial) in the freeze-thawing cycle. Normozoospermic sample analysis showed no significant difference in morphology rate. There was a significant increase in motility and recovery percentages for washed samples, which was observed with straws in compared to the unwashed groups. Oligozoospermic sample analysis indicated a significant increase in motility, recovery (p<0.01), and morphology (p<0.001) rates in washed specimens compared to unwashed specimens using straws. The importance of washing sperm was obvious for oligozoospermic specimens. Conclusion: Normozoospermic sperm resisted freezing longer than oligozoospermic sperm. Use of straws and cryovials made significant differences in motility, recovery, and morphology of sperm in each thaw. This difference was slightly higher for oligozoospermic specimens. Results indicated that the percentage of motility was higher for washed normozoospermic specimens in each thaw when straws were used, whereas the percentage of motility, recovery, and morphology were promoted after frozen oligozoospermic specimens were washed using straws.

175-178

Authors: Maryam Eftekhar , Elham Rahmani , Tahereh Eftekhar

Background: Human chorionic gonadotropin (HCG), one of the initial embryonic signals, is probably a major regulator of the embryo-endometrial relationship. This study aims to assess the advantage of HCG supplementation during the secretory phase of hormonally prepared cycles for the transfer of cryopreserved-thawed embryos. Materials and Methods: This study was a randomized clinical trial. Infertile women who were candidates for frozen-thawed embryo transfers entered the study and were divided into two groups, HCG and control. The endometrial preparation method was similar in both groups: all women received estradiol valerate (6 mg) po per day from the second day of the menstrual cycle and progesterone in oil (100 mg) intramuscular (I.M.) when the endometrial thickness reached 8 mm. Estradiol and progesterone were continued until the tenth week of gestation. In the HCG group, patients received an HCG 5000 IU injection on the first day of progesterone administration and the day of embryo transfer. Results: In this study, 130 couples participated: 65 in the HCG group and 65 in the control group. There was no statistically significant difference between groups regarding basic characteristics. Implantation rate, chemical pregnancy, clinical pregnancy, ongoing pregnancy, and abortion rates were similar in both groups. Conclusion: Although HCG has some advantages in assisted reproductive technology (ART) cycles, our study did not show any benefit of HCG supplementation during the secretory phase of frozen cycles (Registration Number: IRCT201107266420N4).

185-188

Authors: Attaollah Ghahiri , Aidin Moshreffar , Aida Najafian , Mojdeh Ghasemi , Hatav Ghasemi Tehrani

Background: Our goal was to assess the diagnostic value of creatine phosphokinase (CPK) and its isoenzyme CPK- muscle brain (MB) in ectopic pregnancy (EP) in order to locate a simpler diagnostic approach for EP. Materials and Methods: This was a prospective study that performed consecutive sampling for 20 months in two major hospitals in Isfahan, Iran. All pregnant patients in their first trimester of gestation that presented with complaints of vaginal bleeding, abdominal pain, or both enrolled in this study. Blood sampling was performed for laboratory analyses (CPK, CPK-MB). After their diagnosis was established, patients were put in either the EP or non-EP group. We used SPSS software version 10 for data analysis, diagnostic parameters were determined, and a relative operating characteristic (ROC) curve was plotted for each biochemical marker. Results: A total of 106 patients, 53 in the EP group and 53 in the non-EP group enrolled in this study. The results for CPK were as follows: sensitivity (69.81%), specificity (64.15%), positive predictive value (PPV; 66.07%), negative predictive value (NPV; 68%), positive likelihood ratio (PLR) (1.95), and negative likelihood ratio (NLR) (0.49). The results for CPK-MB were: sensitivity (71.7%), specificity (56.6%), PPV (62.29%), NPV (66.7%), PLR (1.65), and NLR (0.5). The area under the ROC curve for CPK was 0.692 and for CPK-MB it was 0.647. Conclusion: Although we have observed a significant elevation in CPK and CPK-MB serum levels in EP, transvaginal ultrasound (TVS) is still the better diagnostic tool for EP.

195-200

Authors: Nahid Nasiri , Ahmad VosoughTaqi Dizaj , Poopak Eftekhari-Yazdi , Mohammad Reza Akhond

Background: There is a lack of studies regarding the effects of ultrasound (US) and replication of its exposure on pre-implantation events in mammals. Thus, this study assesses the reproductive performance of mouse oocytes that have been obtained from ovaries irradiated with US waves versus non-irradiated ovaries. Also comparision of their parthenogenesis, ovulation, fertilization, and pre-implantation development rates. Materials and Methods: In this experimental study, we divided extracted ovaries into three experimental groups that received the same dosage, but different replicates of radiation for each group. Results were compared with the control and sham groups. Continuous wave (CW) US, at a spatial average intensity of 355 mW/cm2 and a frequency of 3.28 MHz, was administered for 5 minutes to the ovaries at an interval between pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) injections. Statistical analysis was performed using the ANOVA test and the level of significance was determined to be 0.05. Results: Data collection was based on microscopic visualization. According to the obtained results, metaphase II (MII) oocyte numbers and the percentage of blastocysts significantly reduced in the USexposed groups versus the unexposed groups. Fertilization rate was comparable between groups while parthenogenesis was significantly higher in the US-exposed groups compared to the unexposed groups. Conclusion: Structural damage to cells, intracellular organelles and proteins, as well as changes in signaling pathways induced by US may be reasons for some of the observed adverse effects in groups that have received more US exposure.

205-207

Authors: Firozeh Ahmadi , Hadieh Haghighi

-