International Journal of Fertility and Sterility

1-9

Authors: Eisa Tahmasbpour Marzouni, Hanieh Ilkhani, Asghar Beigi Harchegani, Hossein Shafaghatian, Issa Layali, Alireza Shahriary

Recent studies have indicated that epigenetic alterations are critical for normal function and development of spermatozoa during the fertilization process. This review will focus on the latest advances in epigenome profiling of the chromatin modifications during sperm development, as well as the potential roles of epigenetic mechanisms in the context of male infertility. In this review, all data were collected from published studies that considered the effect of epigenetic abnormalities on human spermatogenesis, sperm parameters quality, fertilization process, embryo development and live births. The database PubMed was searched for all experimental and clinical studies using the Keywords “epigenetic modifications”, “male infertility”, “spermatogenesis”, “embryo development” and “reproductive function”. Post-translational modifications of histone, DNA methylations and chromatin remodeling are among the most common forms of epigenetic modifications that regulate all stages of spermatogenesis and fertilization process. Incorrect epigenetic modifications of certain genes involved in the spermatogenesis and sperm maturation may be a main reason of male reproductive disorder and infertility. Most importantly, abnormal patterns of epigenetic modifications or transgenerational phenotypes and miRNAs expression may be transmitted from one generation to the next through assisted reproductive techniques (ART) and cause an increased risk of birth defects, infertility and congenital anomalies in children. Epigenetic modifications must be considered as a one of the main factors of unexplained male infertility etiology. Due to high risk of transmitting incorrect primary imprints to offspring, there is a need for more research into epigenetic alterations in couples who benefit of ART support.

17-22

Authors: Marziyeh Norozi-Hafshejani, Marziyeh Tavalaee, Mohammad Hassan Najafi, Farnaz Shapouri, Maryam Arbabian, Mohammad Hossein Nasr-Esfahani

Background: Implementation of sperm preparation techniques based on cellular and molecular characteristics can improve the clinical outcomes of couples with male factor infertility. These methods attempt to select better sperm compared to classical methods of preparation such as swim-up and density gradient centrifugation (DGC). In this view, the aim of this study was the comparison of clinical outcomes of magnetic-activated cell separation (MACS) followed by DGC or DGC alone in infertile men undergoing intracytoplasmic sperm injection (ICSI). Materials and Methods: For this prospective single parallel blind clinical trial study, 206 infertile couples with male factor infertility and having abnormal sperm morphology higher than 96% were included. 106 and 100 couples were considered for the study (MACS-DGC) and control group (DGC), respectively. Clinical outcomes of ICSI; fertilization, embryo quality, and implantation, pregnancy rates were compared between two groups. Results: Mean of fertilization (80.19 ± 1.88 vs. 75.63 ± 2.06, P=0.1), top embryo quality on the day 3 (30.22 ± 3.59 vs. 17.96 ± 2.9, P=0.009), clinical pregnancy (30.76% vs. 22.22%, P=0.19), and implantation rate (18.12% vs. 10.42%, P=0.04) were higher in the study group compared to the control group. Conclusion: Sperm preparation by MACS followed by DGC in teratozoospermic men could improve the clinical outcomes after ICSI (Registration number: IRCT201610317223N8).

30-35

Authors: Mohammad Khaje Roshanaee, Seyed-Hosein Abtahi-Eivary, Majid Shokoohi, Masoumeh Fani, Azamsadat Mahmoudian, Maryam Moghimian

Background: Minocycline is a widely used bacteriostatic antibiotic with various functions. The aim of this study was to investigate impact of apoptotic genes in ovary of the torsion/detorsion treated rat model by minocycline. Materials and Methods: This experimental study was performed in 32 female Wistar rats classified in four groups, including: i. sham, ii. TD: torsion/detorsion group received normal saline, iii. TDM: torsion/detorsion group treated with 40 mg/kg Minocycline, and iv. MC: healthy group received 40 mg/kg Minocycline. After treatment period (7 days), histoplogical parameters, oxidative stress markers and hormone profile of serum as well as the expression of Bax and Bcl-2 genes were measured in the ovary of rats. Results: Levels of superoxide dismutase (SOD), glutathione peroxidase (GPX) and estrogen were decreased in the TD group and significantly increased in the treated groups (P=0.001). Levels of malondialdehyde (MDA) and testosterone were increased in the TD group and decreased in the treated groups (P=0.001). Expression level of Bax was elevated in the TD group, while it was attenuated in the treated groups (P=0.001). Expression level of Bcl-2 was significantly increased in treated groups (P=0.001). Conclusion: Minocycline can repair oxidative damage in ovarian tissue and regulate apoptotic-related gene expressions.

42-48

Authors: Parisa Mostafaei, Firouzeh Ghaffari, Zahra Zolfaghari, Samira Vesali

Background: The aim of our study was to detect the rate of unexplained total fertilization failure (TFF) after intracytoplasmic sperm injection (ICSI) and identify its risk factors and retreatment prognosis. Materials and Methods: In this retrospective case-control study, we searched the computerized database of the Royan Institute (Tehran, Iran) from March 2015 to March 2019 and retrieved all cases diagnosed with TFF after ICSI. TFF cases that did not have any recognized risk factors were classified as unexplained (subgroup A). Cases with recognized risk factors were classified as subgroup B. The control group was randomly selected from infertile couples who underwent ICSI cycles with fertilization of at least one oocyte during the same time interval. Characteristics and treatment outcomes of the cases with unexplained TFF (subgroup A) were compared to the control group, and to the other TFF cases (subgroup B). Results: Out of 18,750 couples who underwent ICSI cycles, 296 (1.58%) experienced TFF for the first time. Of these, 49 (16.5%) couples were diagnosed as unexplained TFF (subgroup A) and 247 (83.5%) were placed in subgroup B, TFF with expected risk factors. Multivariable logistic regression analysis showed that the total number of mature oocytes (P<0.001), duration of infertility (P=0.043), and women’s body mass index (BMI, P<0.001) were significant predictive factors for unexplained TFF. In the ICSI cycle after TFF, clinical pregnancy and live birth rates in subgroup A were higher than subgroup B. Although differences between these groups were not statistically significant (P=0.14 and P=0.07, respectively), this finding could be clinically important. Conclusion: Unexplained TFF following ICSI is a rare event significantly related to a lower number of mature oocytes, longer duration of infertility and higher female BMI. It has a good prognosis in retreatment cycles in comparison with expected TFF cases. Clinicians should take this into consideration for patient counseling and management.

55-59

Authors: Smriti Dharuman, Supraja Ajith Kumar, Subbusamy Kanakasabapathy Balaji, Usha Vishwanath, Royapuram Parthasarathy Parameshwari, Muthukumar Santhanakrishnan

Polycystic ovary syndrome (PCOS) is a common condition with a multifactorial aetiology. Chronic periodontitis (CP) is an immunoinflammatory disease that is linked to PCOS via the excessive production of reactive oxygen species (ROS), which leads to an imbalance in the antioxidant system. However, limited studies have evaluated the relationship between these diseases. The current study aims to evaluate the levels of advanced oxidation protein products (AOPP) in patients with periodontitis and PCOS. Four groups, each consisting of 12 patients, with both PCOS and CP (PCOSCP), systemically healthy women with CP, periodontally healthy women with PCOS (PCOSPH), and periodontally and systemically healthy women (PH) were included in the study. Clinical parameters such as clinical attachment loss, bleeding on probing (BOP), and periodontal inflamed surface area (PISA) index were noted. AOPP were evaluated in the saliva and serum samples by spectrophotometric detection. Salivary and serum AOPP levels were highest in the PCOSCP group (75.16 ± 7.50 μmol/l, 97.92 ± 6.50 μmol/l, respectively). Statistical significance (P<0.05) was noted between the salivary AOPP levels of the PCOSCP group and PCOS group. PISA was greatest in the PCOSCP group (1338.40 ± 285.96 mm2) followed by the PCOS group (680.33 ± 79.49 mm2), which showed the impact of PCOS on gingival inflammation. According to the results of this study, increased levels of advanced oxidative protein products appeared to show the effect of CP on worsening PCOS.