International Journal of Fertility and Sterility

251-255

Authors: Soghra Hosseini Aghdam; Alyeh Ghasemzadeh; Laya Farzadi; Kobra Hamdi; Nazli Navali; Parvin Hakimi; Marayam Baradaran-Binazir; Mohammad Nouri; Amir Fattahi; Ralf Dttrich

Background: Growth hormone (GH) is a potential treatment in the assisted reproductive technology (ART) to improve endometrial receptivity and thickness. In the current study, we investigated the effect of the intrauterine administration of GH on the endometrial thickness (EMT) and ART outcomes in the patients with refractory thin endometrium. Materials and Methods: In this clinical trial study, women with a refractory thin endometrium and a history of one or more frozen embryo transfer (FET) cancellation who were referred to the infertility center of the Tabriz Al-Zahra hospital (Tabriz, Iran) and Milad Infertility Clinic (Tabriz, Iran) received intrauterine injections of GH every other day from day 14 of the menstrual cycle until the EMT reached ≥7 mm in addition to the routine endometrium preparation protocol. EMT was evaluated during the treatment and in the cases with EMT ≥7 mm, biochemical/clinical pregnancy was evaluated after embryo transfer. Results: Thirty-one women aged 35.29 ± 6.21 years were included in this study. The mean amount of EMT was significantly increased following the GH treatment (7.03 ± 1.23 mm) vs. before treatment (5.14 ± 1.1 mm, P<0.001). The EMT reached ≥7 mm in the 65% patients (20/31). Also, the embryo transfer resulted in pregnancy in the patients, biochemical pregnancy: 9/20 (45%) and clinical pregnancy: 7/20 (35%). There was a positive correlation between EMT on the day 13 of cycle (before the treatment) and the maximum EMT (r=0.577 and P=0.001). The EMT was statistically different on the embryo transfer day between clinically pregnant and non-pregnant women (7.18 ± 0.56 vs. 6.21 ± 0.72 mm, P=0.007). Conclusion: The intrauterine administration of GH could be an appropriate therapeutic strategy for patients with refractory thin endometrium. This treatment could significantly increase the EMT as well as implantation and pregnancy rates in these patients (registration number: IRCT20210220050429N1).

263-267

Authors: Zahra Asgari; Sara Farzadi; Reihaneh Hosseini; Alireza Hadizadeh; Masoud Mortezazadeh

Background: Deep infiltrating endometriosis (DIE) is described as an endometriotic tissue that penetrates more than 5 mm under the peritoneal surface. It’s suggested that trans vaginal sonography (TVS) is 79% sensitive and 94% specific in the assessment of intestinal DIE. Considering the possibility that DIE ultrasonography (rectal and\or vaginal ultrasonography) might be more accurate, we designed this study to assess this study to evaluate the accuracy of DIE ultrasonography. Materials and Methods: In this retrospective cross-sectional study, we designed and conducted this study from 2019 to 2020 on patients suspected of severe endometriosis. Our patients underwent ultrasonographic imaging and based on the results became candidates for surgery. We compared histopathological results with sonographic findings using crosstabulation and chi-square tests were used to measure accuracy. P<0.05 were considered statistically significant. Results: Following pathological assessments of 109 cases, 97 cases had ovarian endometrioma, 42 cases had intestinal involvement and 56 cases had uterosacral DIE. The results for accuracy were as the following; uterosacral ligament (USL) involvement SE: 96.4% and SP: 59.1%; intestinal involvement SE: 97.6% and SP: 73.8%; and Cul de sac involvement with SE: 100% and SP: 50.8%. With regards to ovarian endometrioma, ultrasonographic imaging was 99.0% sensitive and 84.6% specific. With regards to intestinal involvement, ultrasonography performed a reliable overall diagnosis (97.6% sensitive and 73.8% specific). However, the results showed lower accuracy regarding the level of intestinal involvement. The accuracy for other sites and cavities was low except for ovarian endometrioma. Conclusion: The results of the present study demonstrated that pre-operative TVS and Transrectal ultrasound (TRUS) can be a helpful paraclinical tool in the assessment and diagnosis of DIE and endometriosis in general and particularly with adnexal and bowel lesions, it can have some shortcomings with respect to cul de sac and USLs.

275-280

Authors: Fahimeh Monirian; Batul Khodakarami; Leili Tapak; Fatemeh Kimiaei Asadi; Soodabeh Aghababaei

Background: The aim of this study was to determine the effect of couples coping enhancement counseling (CCEC) on stress and dyadic coping of infertile couples. Materials and Methods: In this parallel randomized controlled trial study in 2020, seventy infertile couples were randomly divided into case and control groups. The intervention was performed in 7 sessions of couple counseling based on CCEC for the intervention group, no intervention was performed in the control group. Fertility Problem Inventory, Dyadic Coping Inventory and demographics questionnaires were completed by both couples separately before the intervention and 4 weeks after the last consultation session. Data were analyzed using IBM SPSS statistics 24 and statistical tests such as mean ± SD, frequency, percentage, Independent t test, Mann-Whitney test, Chi-square test or Fisher’s exact test and Analysis of covariance. Significant level was considered less than 0.05. Results: The mean stress scores of women in the intervention group before and after intervention decreased from (156.83 ± 23.57) to (139.43 ± 22.39) and the mean scores of dyadic coping increased from (126.83 ± 19.89) to (138.26 ± 16.92), these differences were statistically significant (P<0.001), also the mean stress scores of men in the intervention group before and after the intervention decreased from (143.80 ± 23.40) to (128.03 ± 22.24), the mean scores of dyadic coping increased (131.34 ± 20.67) to (136.40 ± 19.38), these differences were statistically significant (P<0.001). Conclusion: Positive effects of CCEC were observed in reducing infertility stress and increasing dyadic coping in both women and men after the intervention, the effect of the intervention on women was greater than that of men. As a result, this intervention can play an important role in reducing stress and increasing the solidarity and support of infertile couples for infertility treatments (registration number: IRCT20120215009014N367).

286-291

Authors: Nader Namvarsigaroudi; Zahra Tahmasebi Fard

Background: Impaired expression of genes which act on hormone signaling pathways is one of the factors affecting miscarriage. In this study, the expression levels of insulin receptor (INSR) and insulin receptor substrates-1 (IRS-1) genes in endometrial tissue of infertile women and fertile women with miscarriage in less than twenty weeks gestation for unknown reasons were evaluated. Materials and Methods: In this case-control study, forty-two fertile women with children and 42 infertile women, who underwent in vitro fertilization (IVF), were selected. Both groups had abortions under twenty weeks gestation for unknown reasons. The endometrial tissue of all patients was prepared to evaluate the expression of INSR and IRS-1 genes by quantitative real-time polymerase chain reaction (PCR) method after RNA extraction. Results: There was a statistically significant relationship between the expressions of INSR and IRS-1 genes in the endometrial tissue of the infertile women compared with the fertile women (P=0.002 and P=0.008, respectively). The expression level of genes was decreased in both groups by age and increasing body mass index (BMI). Comparison of genes expression levels in healthy and diabetic participants in each group showed a significant difference (P<0.0001), but no meaningful difference was indicated between diabetic infertile and fertile groups in terms of gene expression. INSR gene expression levels showed an increase in the fertile group in the second 10 weeks and a decrease in IRS-1 gene expression. But in the infertile group, both genes showed a slight increase in expression. Conclusion: It seems a decreased expression of insulin signaling pathway genes in the endometrial tissue of infertile women can be one of reasons for unspecified abortion. These genes may be strong molecular markers for infertility

299-305

Authors: Zeynab Mohammadi; Seyedmostafa Hosseinianvari; Negin Ghazalian; Masoumeh Fani; Azam sadat Mahmudian; Balal Brazvan; Majid Shokoohi; Seyd-Hosein Abtahi-Evari; Maryam Moghimian

Background: The ovarian Ischemia/reperfusion is one of the gynecological emergency concerns that may lead to the ovary damage and folliculogenesis. The present research aimed to evaluate the impact of the Chrysin (CH) on the ischemia-reperfusion (I/R) injury in the rat model. Materials and Methods: In this experimental research, 48 adult female rats, 8 weeks age and 180-200 g weight, have been categorized into 6 equal groups (n=8) including one sham and 5 ovarian torsion groups (OT+CH groups) that received different treatments. Each group has been treated 30 min before detorsion with gavage of CH or normal saline for 1 week and pregnant mare serum gonadotropin (PMSG) has been injected on the day 5 for initiating folliculogenesis. Finally, bio-chemical, molecular, histopathological, apoptotic and hormonal evaluations were performed. Results: The anti-oxidant enzyme, superoxide dismutase and glutathione peroxidase, ameliorated in the ovarian tissues of the OT+CH groups in comparison with the OT group (P<0.001). Moreover, the level of serum Luteinizing hormone considerably declined and estradiol level (P<0.001), partly enhanced in the rats treated with CH in comparison with the ones in the OT group (P<0.05). In addition, histopathological scores of the OT+CH groups ameliorated in comparison with the OT group scores (P<0.05). Furthermore, the expression Caspase-3 and Bax genes were significantly increased while the expression of Bcl-2 was notably decreased in the OT group in comparison with the sham group (P<0.05). Conclusion: Here, it seems that CH is possibly beneficial for the protection of ovaries against reperfusion injury and ischemia.

310-319

Authors: Mehran Nouri; Nooshin Abdollahi; Kimia Leilami; Mahsa Shirani

Background: Infertility is a major clinical problem that affects people psychologically and medically. For the past 40 years, studies have linked nearly 50% of childlessness to male infertility. It is worth noting that unlike other factors contributing to infertility, diet is a tunable factor and can be applied in counseling infertile men. The goal of this study was to determine the relationship between plant diet index (PDI) and semen parameters in Iranian infertile men. Materials and Methods: In this cross-sectional study, dietary intake was determined by a valid 168-item questionnaire (FFQ). In this study, four dependent semen parameters, including total sperm motility (TSM), sperm concentration (SC), normal sperm morphology (NSM), and semen volume (SV) were measured. Results: Results of this study stated that greater adherence to the healthful plant-based diet index (hPDI), can significantly increase sperm density and motility in men, as well as greater adherence to the PDI dietary pattern is related to a lower risk of sperm volume deficiency, and ultimately more adherence to the unhealthful plant-based diet index (uPDI), can reduce the risk of sperm motility. Conclusion: In this study, for the first time, the relationship between PDI, hPDI, uPDI and male infertility was evaluated. Altogether, this study demonstrated that nutrition has an impact on semen quality and fertility of men.