International Journal of Fertility and Sterility

7-11

Authors: Atoosa Keshavarz Motamed; Zhina Zarei; Hosna Mirfakhraee; Fatemeh Shariatinia; Malihe Akbari; Sara Ziagham; Somayeh Igder; Neda Zarei

Recurrent miscarriage (RM) is a condition defined as having three or more consecutive pregnancy losses before the 20 weeks of pregnancy. The present study was undertaken to investigate association of Interleukin-17A (IL-17A) rs2275913 polymorphism with RM. To this end, we searched the international databases (Web of Science, PubMed, Embase, and Scopus) and extracted studies investigating the association of IL-17A rs2275913 polymorphism with RM using the appropriate keywords. The collected data were analyzed with the random-effects model and STATA (version 14). A total of five studies met the eligibility criteria, and total sample size was 998 subjects. Mean age of the cases and controls were 31.41 ± 4.16 and 30.56 ± 3.5 years, respectively. Our results disclosed a significant relationship of the IL-17A rs2275913 AA genotype [odds ratio (OR)=1.68; 95% confidence interval (CI)=1.16- 2.43; I2=19; P=0.294) with RM. There was no statistically significant correlation between IL-17A rs2275913 GG genotype (OR=1.04; 95% CI=0.64-1.7; I2=59.5; P=0.042) and GA genotype (OR=0.85; 95% CI=0.65-1.12; I2=19.1; P=0.293) with RM. Our findings revealed that the IL-17A rs2275913 polymorphism is associated with RM, and the AA genotype of this polymorphism increased possibility of being involved in RM.

20-25

Authors: Michael H. Dahan; Seang-Lin Tan; Suresh Nair; Tehila Feinberg Isaacs

Background: This study aims to determine whether pre or post-processing semen parameters obtained during intrauterine insemination (IUI) predict pregnancy when controlling for confounding effects. Materials and Methods: A prospective cohort study of 2231 semen analyses was conducted at McGill University of IVF center. Any couples who underwent IUI with partner sperm, over a 2.5-year period, were included. Controlled ovarian stimulation was done with Clomiphene Citrate, Letrozole, or Gonadotropins. Statistical analysis was performed using t tests, two types of stepwise logistic regression, and stepwise discriminant analysis. A comparison of pre and post-processing semen parameters was undertaken to determine the probability of pregnancy. Results: There were significant differences between pregnant and non-pregnant women in post-processing concentration (P=0.043), post-processing total motile sperm count (TMSC) (P=0.049), and post-linearity (P=0.012). However, when variable out-of-the-equation logistic regression or discriminant analysis, which controls for confounding effects between variables, were used, the findings were no longer significant. It was statistically proven that when a variable in the equation logistic regression was employed, post-processing concentration (P=0.005) and post-processing TMSC (P=0.009) remained reliable predictors of pregnancy. Conclusion: Two of three prediction models suggested that TMSC’s relationship with pregnancy is due to confounding factors. One model maintained the validity of the TMSC. While TMSC has always been studied as an important predictor of insemination pregnancies, this finding may be due to confounding effects between semen parameters and therefore requires further investigation as to this relationship.

32-39

Authors: Mohammad Rasool Khazaei; Zahra Ami; Mozafar Khazaei; Leila Rezakhani

Background: Men’s infertility and lack of production of healthy and active sperm are concerns of recent years in most countries. Studies on the preparation of extracellular matrix (ECM) from decellularization of testis tissue and spermatogenesis could provide proper results to solve some of the men’s infertility problems. This study aims to decellularize calf testis by different methods to reach a suitable scaffold and introduce it in spermatogenesis studies. Materials and Methods: In this experimental study, calf testis were decellularized by a freeze-de freeze, 1% sodium deoxycholate (SD), 0.1% sodium dodecyl sulfate (SDS), 0.1% SDS-vacuum, 1% SDS, 1% SDS-vacuum, and Triton- X100 methods. The content of DNA, collagen, and glycosaminoglycan (GAG) was analyzed using the kit and staining with Hematoxylin-Eosin, Masson’s trichrome, Alcian blue, and Orcein methods. The morphology of the scaffolds was analyzed with a scanning electron microscope (SEM). Results: Methods of 1% SDS, 1% SDS-vacuum, and 1% SD completely removed the cells. The preservation of collagen and GAG was confirmed using the staining kit and methods. The use of a vacuum showed greater porosity in the SEM images. Toxicity and hemolysis were not observed in the scaffolds. Conclusion: Testis decellularization with 1% SDS and 1% SD, in addition to cell removal, could maintain the ECM structure to a large extent without having cytotoxic and hemolysis effects.

45-53

Authors: Seyyede Fahimeh Mirseyyed; Saeed Zavareh; Meysam Nasiri; Hamid Hashemi-Moghaddam

Background: Although there are numerous animal models of polycystic ovary syndrome (PCOS), they often fail to accurately replicate the reproductive and metabolic phenotypes associated with PCOS. The objective of this study is to assess oxidative status and inflammatory levels in a rat model of PCOS subjected to a new high-fat diet (HFD) in combination with letrozole. Materials and Methods: In this experimental study, mature, six-week-old female Sprague-Dawley rats (n=20) were divided into four groups: control (standard diet); letrozole (letrozole plus a standard diet); HFD; and letrozole+HFD. After 16 weeks, the rats underwent vaginal smear analysis, measurement of hormonal and lipid profiles, and an oral glucose tolerance test (OGTT). Ovarian tissue morphology, oxidative parameters, and inflammatory status were evaluated. Results: The experimental groups exhibited anoestrus profiles in the vaginal smears and abnormal ovarian morphology, which was not observed in the control group. Steroid hormone levels were significantly higher in the letrozole+HFD group compared to the other groups (P=0.00). The experimental groups also showed abnormal glucose levels and lipid metabolism. The relative expression levels of inflammatory genes were significantly elevated in the experimental groups compared to the control group (P=0.00), and the letrozole+HFD group exhibited the highest expression level (P=0.00). The HFD, letrozole, and letrozole+HFD groups demonstrated significantly increased levels of malondialdehyde (MDA) and reactive oxygen species (ROS), while the levels of enzymatic antioxidants were significantly reduced compared to the control group (P=0.00). Conclusion: The combination of a new HFD and letrozole treatment induces inflammation and oxidative stress (OS) in a rat model of PCOS. This model accurately exhibits abnormal metabolic phenotypes and disruptions in hormonal profiles associated with PCOS.

60-66

Authors: Hanieh Najafiarab; Amirreza Keyvanfar; Farima Rahimi Mansour; Hamidreza Didar; Shaghayegh Hooshmand Chayijan; Shahrzad Rajaei Firouzabadi; Maryam Sadat Hosseini; Zahra Bakhtiyari; Farah Farzaneh

Background: Women with uterine fibroids (UFs) experience many clinical manifestations that affect their quality of life (QOL). The Uterine Fibroid Symptom and Health-related Quality of Life (UFS-QOL) questionnaire is an English instrument specifically designed to assess fibroid-related symptoms and their impact on QOL. This study aims to investigate the reliability and validity of the Persian version of the UFS-QOL questionnaire in Iranian women with UF. Materials and Methods: In this psychometric study, women with UFs who presented to Imam Hossein Hospital (Tehran, Iran) between August 2022 and January 2023 were enrolled in this study. A forward-backward approach was applied to translate the UFS-QOL questionnaire into Persian. The reliability of the UFS-QOL questionnaire was assessed by internal consistency and test-retest correlation. Confirmatory factor analysis (CFA) was used to assess convergent validity between items and subscales of the UFS-QOL questionnaire. Pearson’s correlation coefficient was used to assess convergence validity between subscales of the UFS-QOL and the World Health Organization Quality of Life Brief Version 26 questionnaire (WHOQOL-BREF-26). Results: Overall, we assessed 226 women with UFs. All subscales of the UFS-QOL questionnaire had acceptable internal consistency (Cronbach’s alpha>0.7). Test-retest analysis indicated significant positive correlations between two measurements of all subscales of the UFS-QOL questionnaire: symptom severity (P<0.001), concern (P<0.001), activities (P<0.001), energy/mood (P<0.001), control (P<0.001), self-consciousness (P=0.002), and sexual function (P<0.001). The Kaiser-Meyer-Olkin (KMO) measure value was 0.920, and the result of Bartlett’s test of sphericity was significant (P<0.001). CFA identified six factors for the health-related QOL (HRQL) questionnaire, which explained 73.827% of the total variation. Most subscales of the UFS-QOL questionnaire correlated with domains of the WHOQOL-BREF-26 questionnaire (P<0.05). Conclusion: The Persian version of the UFS-QOL questionnaire is a valid and reliable instrument to evaluate UFrelated symptoms and QOL among Iranian women.

76-80

Authors: Federica Romanelli; Maria Laura Zenclussen; Ana Claudia Zenclussen; Nicole Meyer

In our experimental study, we explored the impact of maternal reduced heme oxygenase-1 (HO-1) gene (Hmox1) expression on the in vitro fertilization (IVF) rate through the use of heterozygous Hmox1 knockout mice models (HET/Hmox1+/ -). Also, we hypothesized a beneficial role of gametes exposure during fertilization to carbon monoxide (CO), one of HO-1 by-products, that might be relevant for the improvement of IVF rates. IVF technique was performed by using oocytes obtained from wild-type (WT) or Hmox1+/ - dams fertilized with WT, Hmox1+/ - or Hmox1-/ - mice-derived sperm. The fertilization step occurred either in a conventional incubator (37°C, 5% CO2) or in an incubator implemented with CO (500 ppm). The superovulation yield of WT and Hmox1+/ - mice and the number of fertilized oocytes was assessed using an optical microscope. The dams’ Hmox1 heterozygous knockout neither impact the superovulation yield, nor did influence the fertilization success rate. Moreover, CO exposure during fertilization could not significantly improve the outcome. Our study showed that the maternal Hmox1+/ - condition is not affecting the IVF rate in mice. Furthermore, we discovered that CO exposure cannot be exploited to ameliorate this critical step of the IVF protocol.

87-90

Authors: Behnaz Nouri; Hanieh Najafiarab; Shaghayegh Hooshmand Chayijan

Presacral or retrorectal tumors are rare, usually asymptomatic, and diagnosed accidentally during physical examination or imaging. Symptomatic tumors may present with perianal pain, bowel dysfunction, and urinary symptoms due to the mass compression or invasion of the surrounding tissues and organs. Surgical resection is the first choice for treating presacral tumors. Clinicians should choose surgical procedures based on the location and size of the tumors. We presented a 43-year-old woman who suffered from pelvic pain and primary infertility from two years ago. A large mass between the posterior vaginal wall and the rectum was found on recto-vaginal examination. Magnetic resonance imaging (MRI) revealed a large 120×115 mm benign multiloculated cystic mass. Eventually, the mass was removed through laparoscopic surgery. The pathology report indicated a carcinoid tumor (grade I) with no lymphovascular invasion. Thus, presacral tumors are resectable through laparoscopy with lower complications than open surgery.