International Journal of Fertility and Sterility

13-18

Authors: Ensieh Shahrokh Tehraninejad , Elham Pourmatroud , Mohammad Ali Sadighi Gilani , Mahdi Rakebi , Zahra Azimi Neko , Arezoo Arabipoor

Background: To determine the differences in sperm quality and results of intracytoplasmic sperm injection (ICSI) cycles between three groups of male factor infertile couples: oligozoospermic, obstructive azoospermic and non-obstructive azoospermic. Materials and Methods: In this prospective cohort study, 628 male factor infertile couples who underwent ICSI cycles from April 2004 to March 2006 were enrolled. Three hundred fourteen oligozoospermic patients (group I), 180 obstructive azoospermic patients (group II) and 134 non-obstructive azoospermic patients (group III) were included. Fertilization, cleavage, implantation and clinical pregnancy, early abortion rates were assessed. Chisquare and analysis of variances with Post Hoc (Tukey test) were used for data analysis. Results: Fertilization rates were significantly different in the three groups (group I: 66.6%; group II: 51.8%; group III: 47.7%; p=0.004). There were differences in the implantation rates (I: 19.5%; II: 17.6%; III: 6.4%; p=0.001). The cleavage rates were found to be 55.1% (group I), 47.5% (group II), 45.5%(group III), respectively. The clinical pregnancy rate was the lowest in the third group (I: 37.6%; II: 28.9%; III: 13.4%; p=0.001). There was no significant difference in early abortion rates between the three groups: (I: 10.7%; II: 9.8%; III: 8%; p=0.776). Conclusion: It can be concluded that patients with oligozoospermia may benefit the most from ICSI treatment. ICSI cycles which use spermatozoa from non-obstructive azoospermic patients have a lower chance for successful outcome. The results of this study suggest, in cases of failure to achieve pregnancy after 1 or 2 cycles in non-obstructive azoospermic patients, embryo donation would be a better alternative.

27-30

Authors: Ashraf Moini , Kiandokht Kiani , Firouzeh Ghaffari , Fatemeh Hosseini

Background: This study was designed to evaluate the incidence of uterine pathologies in infertile women with a history of two implantation failures after in vitro fertilization (IVF) and estimate the effect of hysteroscopic correction on achieving a pregnancy in these patients. Materials and Methods: The retrospective study population included 238 infertile women attended the outpatient infertility clinic between November 2007 and December 2008. Patients with at least two previous IVF failures were eligible for this study. All patients had normal findings on hysterosalpingography performed prior their first attempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopy were performed in patients before the subsequent IVF attempt. Results: Out of 238 patients with previous IVF failure who underwent hysteroscopic evaluation, 158 patients (66.4%) showed normal uterine cavity. Abnormal cavity was found in 80 patients (33.6%). We found polyp as the most common abnormality (19.7%) in the patients with previous history of IVF failure. The pregnancy rate was similar between IVF failure patients who treated by hysteroscopy for a detected uterine abnormality (24.6%) and similar patients with normal uterine cavity (21.2%) in hysteroscopic examinations. Conclusion: The intrauterine lesions diagnosed by hysteroscopy in patients with previous IVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polyp showed good outcome, similar to that achieved in patients with a normal hysteroscopy.

45-50

Authors: Khadijeh Arab-sheybani , Masoud Janbozorgi , Aygul Akyuz

Background: In order to establish a reliable non-invasive method for sex determination in a bovine fetus in a routine setting, the possibility of identifying specific sequence in the fetal X and Y-chromosomes has been evaluated in maternal plasma using conventional multiplex polymerase chain reaction (PCR) analysis. The aim of this study was to provide a rapid and reliable method for sexing bovine fetuses. Materials and Methods: In this experimental study, peripheral blood samples were taken from 38 pregnant heifers with 8 to 38 weeks of gestation. DNA template was extracted by phenol-chloroform method from 350 μl maternal plasma. Two primer pairs for bovine amelogenin gene (bAML) and BC1.2 were used to amplify fragments from X and Y chromosomes. A multiplex PCR reaction has been optimized for amplification of 467 bp and 341 bp fragments from X and Y bAML gene and a 190 bp fragment from BC1.2 related to Y chromosome. Results: The 467 bp fragment was observed in all 38 samples. Both 341 and 190 bp fragments were detected only in 24 plasma samples from male calves. The sensitivity and specificity of test were 100% with no false negative or false positive results. Conclusion: The results showed that phenol-chloroform method is a simple and suitable method for isolation of fetal DNA in maternal plasma. The multiplex PCR method is an available non-invasive approach which is cost efficient and reliable for sexing bovine fetuses.

51-58

Authors: Zahra Asgari , Sima Mozafar-Jalali , Nasrin Faridi-tazehkand , Somayeh Sabet

Background: Maternal infection during pregnancy is a risk factor for some behavioral problems with neurodevelopmental origin. This study aimed to evaluate the effects of exposure of pregnant mice to the bacterial lipopolysaccharide (LPS) on sexual behaviour and serum level of pituitary-gonadal hormones of offspring in adulthood. Materials and Methods: In this Expremental study, pregnant NMRI mice (n=7/group) were treated with intra-peritoneal administration of LPS (1, 5 and 10 μg/kg) at day 10 of gestation. Induction of the pro-inflammatory cytokines, Tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and interleukin-6 (IL-6) were measured in maternal serum 2 hours following the maternal LPS challenge. Behavior in the adult male offspring reproductive activity was investigated using receptive female mice. Concentrations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in adult offspring serum were measured using the enzyme-linked immunosorbent assay (ELISA) method (at postnatal day 60, n=10/group). Results: One-way ANOVA showed that LPS administration induces a significant increase in TNF-α, IL-1β and IL-6 levels of maternal serum. Prenatal LPS exposure reduces sexual behavior and serum concentration of LH and testosterone in adult male offspring. Conclusion: The overall results suggest that prenatal exposure to LPS increases proinflammatory cytokine levels, affects development of neuroendocrine systems and results in the inhibition of reproductive behaviors and reactivity of hypothalamic–pituitary-gonadal (HPG) axis in adult male offspring.

79-86

Authors: Nafisehsadat Nekuei , Mohammad Hossein Nasr Esfahani , Ashraf Kazemi

Background: The preconception period is crucial to fertility and pregnancy health. Offering education and counseling to couples being treated for infertility improves the outlook of treatment. The aim of this study is to assess preconception education and counseling in a population of Iranian couples treated for infertility. Materials and Methods: This is a cross-sectional study of 268 individuals who presented to fertility clinics across the city of Isfahan, Iran. Questionnaires and patient records were used to collect data. We evaluated the components of standard preconception counseling (lifestyle, diet, sexual health, substance abuse, and social counseling) versus preconception counseling offered to couples that were receiving infertility treatment (failure, follow-up, and side effects of treatment). Results: We found that no counseling had been given to about 76.9% about lifestyle, 70.9% about diet, 90.7% about sexual health, and 90.7% about the psychosocial aspects of infertility. No counseling had been given to 46.6% of individuals about a follow-up and also to 46.6% of individuals about the side effects of treatment. In more than 75% of the cases, counseling was offered to couples whose etiology of infertility was unknown. Conclusion: We have found serious flaws in the education and preconception counseling of infertile Iranian couples; action is required by medical and health teams to address these shortcomings.

95-100

Authors: Metin İshak Öztürk , Orhan Koca , Muzaffer Oğuz Keleş , Seda Yılmaz , Muhammet Ihsan Karaman

Background: Varicocele, the abnormal dilatation of the veins in the pampiniform plexus is commonly seen in infertile patients. In this study, we aim to examine sperm DNA damage after the creation of experimental varicocele in rats and to observe the change of this damage after a varicocelectomy. Materials and Methods: In this experimental study, a total of 30 adult male Wistar albino rats were divided into three groups. The 10 rats in group 1 underwent a sham operation, an experimental varicocele was created in both the10 rats in group 2 and the 10 rats in group 3 (a total of 20 rats). While the rats of group 2 were sacrificed after four weeks, the rats in group 3 underwent a varicocelectomy after four weeks and were sacrificed four weeks after the varicocelectomy to observe its effects. Sperm DNA fragmentation was assessed with a Halomax® kit. The DNA Fragmentation Index (DFI) was calculated and the groups were compared according to their DFI. Statistical analysis was performed using the Mann-Whitney U test. Results: Median sperm DFI was 17.6 (range: 7.6) in the right testicle and 18.3 (range: 6.8) in the left testicle in the control group; 30.7 (range: 8.8) in the right testicle and 31.8 (range: 9.6) in the left testicle in the varicocele group; 27.1 (range: 8.1) in the right testicle and 28.6 (range: 8.9) in the left testicle in the varicocelectomy group. DNA damage in both right and left testicles was statistically significant between the three groups (p<0.05). Conclusion: The results of this study show that varicocele leads to increased sperm DNA damage and this damage is decreased by varicocelectomy.

111-116

Authors: Fatemeh Hassani , Manizheh Karami , Mohammad Reza Jalali Nadoushan , Poopak Eftekhari Yazdi

Background: Nitric oxide (NO) involves in polycystic ovary syndrome (PCOS), a cause of infertility in women during the reproductive age. The PCOS is now categorized as an inflammatory phenomenon. The aim of this study was to evaluate the role of NO, a proinflammatory agent, in this syndrome at histological and biochemical levels. Materials and Methods: In this experimental study, animals were female Wistar rats (weighing 200-250 g) kept under standard conditions. L-Arginine (50-200 mg/kg), a precursor of NO, was injected intra-peritoneally (i.p.) through a period ranging from 9 to14 days/ once a day. The rats' estrous cycle was studied using Papanicolaou test; those showing phase of Diestrous were grouped into experimental and control groups. The control group solely received saline (1 ml/kg, i.p.) throughout all experiments. To evaluate the inflammatory effect of NO, the rats were treated an anti-inflammatory agent, naloxone hydrochloride (0.4 mg/kg, i.p.), prior to L-arginine. At the end of the treatment period all animals’ ovaries were assessed for histopathological and histochemical investigations. Also, activation of NO synthase (NOS) in the experiments was studied using NADPH-diaphorase technique. Results: The ovaries of rats treated with L-arginine showed polycystic characteristics in contrast to those collected from control or naloxone pretreated groups, based on image analysis. A difference in enzyme activation was also shown in the sections that belonged to the groups that received L-arginine when compared with the pre-naloxone and control groups. Conclusion: Based on these results, we believe that NO may play a major role in the pathophysiology of PCOS.

127-130

Authors: Sanam Moradan , Mohammad Forouzeshfar

Background: This study was undertaken to determine if there were different abortion rates between normal and abnormal yolk sacs. Materials and Methods: In this cohort study, the yolk sac characteristics of 193 consecutive pregnant women, of 5-6.5 weeks gestation, with normal body mass index (BMI) were prospectively evaluated. All patients underwent two-dimensional transvaginal ultrasonography, which was performed by the same sonographer. We considered the following yolk sac characteristics as normal for classification: diameter: 2-5 mm; round shape; absence of degenerative changes; equal number with embryos; echogenic rim and hypoechoic center. Yolk sacs that had diameters smaller than 2 mm or larger than 5 mm; a shape that was not round (i.e., oval or distorted); the presence of degenerative changes; hyper- or hypo-echogenic rim; hyperechoic center and unequal number with embryos were considered abnormal. Based on the above classification, patients were divided into two groups, study (abnormal yolk sac) and control (normal yolk sac). The study group contained 22 cases and the control group consisted of 164 cases. The primary outcome measure was the abortion rate between both groups. Chi-square and students’t test were used for data analysis. Results: A total of 193 cases were evaluated. We excluded 2 cases. Among the remaining 191 cases, 22 (11.51%) had abnormal yolk sacs of which spontaneous abortion occurred in 14 (63.63%) cases. In the control group, out of 169 (89.49%) cases, spontaneous abortion was noted in 6 (3.55%). There was a statistically significant difference in abortion rates between the two groups (p=0.000). Conclusion: According to the results of this study, it is obvious that abnormal yolk sac characteristics are associated with spontaneous abortion.

135-136

Authors: Firoozeh Ahmadi , Nahid Keramat , Hadieh Haghighi

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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

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203-206

Authors: Aytul Corbacioglu, M.D , Bulent Baysal, M.D

Background: This study investigated the effects of serum estradiol (E2) and progesterone levels on preovulatory endometrial thickness and echogenicity in controlled ovarian hyperstimulation (COH) cycles for in vitro fertilization (IVF). Materials and Methods: In this retrospective study, we evaluated the data of 241 in vitro fertilization-embryo transfer cycles. Cycles were classified into three groups according to endometrial thickness measured on the day of human chorionic gonadotropin (hCG) administration as: i. ≤8 mm, ii. 8-14 mm, and iii. ≥14 mm. Echogenic patterns were described as trilaminar, isoechogenic, and hyperechogenic. Serum E2 and progesterone levels were evaluated on the day of hCG administration. Data were analyzed using X2 test, Student’s t test and analysis of variance (ANOVA). Results: Serum E2 levels increased in parallel with endometrial thickness, although differences among the three groups were insignificant. There was no correlation between serum progesterone levels and endometrial thickness. There was no significant difference in the steroid hormone concentrations between the echogenic patterns. Conclusion: Serum steroid hormone levels on the day of hCG administration do not affect the ultrasound appearance of the endometrium in COH cycles.

211-216

Authors: Vahid Esmaeili, M.Sc , Abdolhossein Shahverdi , Ali Reza Alizadeh, Ph.D , Hiva Alipour, D.V.M , Armin Towhidi, Ph.D , Morteza Zarrabi, M.D

Background: Mammalian spermatozoa are characterized by a high proportion of polyunsaturated fatty acids (PUFAs), but reliable data concerning dietary effects on fatty acid (FA) profile in ram's sperm and the persistency of FA in the ration to the FA in sperm has not been reported. Therefore, the aim of this study was to determine the stability of saturated and unsaturated FAs in ram's sperm despite removing FA sources from their diet. Materials and Methods: Nine Kalkoohi rams were used in a completely randomized design and they were assigned to 3 groups. The treatments were diet supplemented (35 g/d/ram) by C16:0 (RP-10®), C18: 2 (Sunflower oil; SO) and n-3 (Fish oil; FO) with Vitamin E. Fifteen weeks after the start of the supplemented diet, rams were offered a basal diet without any supplementary FA source for 35 days when the sperm’s FA ratio was determined. The data were analyzed by ANOVA (Analysis of variance) using the General Linear Model (GLM) procedure of SAS Institute. Results: Thirty five days after removing the fat supplement from the diet, major FA in sperm consisted of: C14:0, C16:0, C18:0, C18:1 cis, C18:2 cis and C22:6 n-3 docosahexaenoic acid (DHA). The percentage of C14:0 (p=0.8) and C18:1 cis (P =0.4) were similar among all the treatments. Interestingly, 35 days after the removal of fatty acid source, the percentage of C22:6 was highest in the FO treated group. Conclusion: The different sperm FA profile among various groups suggests that dietary FA had significant direct or indirect impacts on sperm FA profile after 35 days which might lead to physical and chemical changes in sperm characteristics.

225-230

Authors: Shahin Eghbalsaied, Ph.D , Kamran Ghaedi, Ph.D , Somayeh Shahmoradi, M.Sc , Akbar Pirestani, Ph.D , Hamidreza Amini, M.Sc , Talat Saiedi, M.Sc , Akbar Pirestani, Ph.D , Linda Nicol, B.Sc , Alan McNeilly, D.Sc

Background: Multiple births occur frequently in some Iranian sheep breeds, while infertility scarcely occurs. Mutation detection in major fecundity genes has been explored in most of Iranian sheep flocks over the last decade. However, previously reported single nucleotide polymorphisms (SNPs) for bone morphogenetic protein receptor-(BMPR)-1B and growth differentiation factor ) GDF9( known to affect fertility have not been detected. This study was conducted to assess whether any significant mutations in GDF9 were extracted from slaughtered ewe ovaries of Iranian Afshari sheep breed. Materials and Methods: Ovaries defined as poor, fair, and excellent quality based on external visual appearance of follicles were used for histology and RNA extraction processes. High quality RNAs underwent reverse transcriptase-polymerase chain reaction (RT-PCR) from GDF9 mRNA, and the products sequenced. Results: No streak ovaries, which are considered indicators of infertility due to homozygocity for some mutations in GDF9 and BMP15, were found. Sequencing results from GDF9 cDNA showed that G2 (C471T), G3 (G477A), and G4 (G721A) mutations were observed from 1, 4, and 1 out of 12 ewes, respectively. Though all 3 mutations were previously reported, this is the first report on their presence in Iranian breeds. The first and second mutations do not alter the amino acids, while G4 is a non-conservative mutation leading to E241K in the prohormone. Conclusion: As the G4 mutation was observed only in ovaries defined superficially as top quality, it could be considered as one of reasons for higher ovulation rate in some sheep. Furthermore since multiple mutations were observed in some cases, it might be possible that combinations of minor mutations in GDF9 and BMP15 interact to affect fecundity in some Iranian sheep breeds.

235-240

Authors: Ashraf Moini, M.D , Laleh Bahar, M.D , Mansour Ashrafinia, M.D , Bita Eslami, MPH , Reihaneh Hosseini, M.D , Narges Ashrafinia, M.D

Background: Endometriosis is the presence of endometrial glands and stroma in sites other than the uterine cavity, which is associated with infertility. The objective of this study was to evaluate the effect of laparoscopic surgical treatment on clinical pregnancy in infertile women with minimal or mild endometriosis. Materials and Methods: This clinical trial study was performed in infertile women who were referred to the gynecological clinic between April 2008 and March 2009. After confirmation of minimal or mild endometriosis by diagnostic laparoscopy, patients were randomly assigned into two groups using consecutively numbered, opaque sealed envelops. The first group consisted of women who only underwent diagnostic laparoscopy (no treatment) before randomization. The second group of patients underwent operative laparoscopies. T-test and chi-square test were used when appropriate. A p-value less than 0.05 was considered statistically significant. Results: Analysis with 38 patients in each group showed characteristics such as age, body mass index (BMI), and duration of infertility were statistically similar in both groups. At 9 months follow-up, 9 (24%) women who had operative laparoscopies became pregnant compared with 7 (18%) women in the diagnostic laparoscopy group. The pregnancy rate showed no statistically significant difference between both groups (p=0.49). No complications were reported in either group. Conclusion: The present study suggested that laparoscopic surgical treatment was not superior to diagnostic laparoscopy in pregnancy occurrence in infertile women with minimal and mild endometriosis. (IRCT Number: IRCT201012311952N2).

241-244

Authors: Mohammad Taqi Rafiei, Ph.D

Background: A significant number of pregnancies are associated with the cytogenetic abnormalities of the fetus. Amniocentesis and chorionic villus sampling (CVS) are procedures used for prenatal genetic diagnosis. In this study, we compare the safety and complications of mid-trimester amniocentesis and transabdominal CVS. Materials and Methods: This analytic cross-sectional study was performed in 308 patients from 2.11.2007 to 26.10.2009. We had 155 cases of amniocentesis, which we performed in weeks 15-23 of pregnancy; and 153 cases of CVS, which we performed during weeks 10-14 of pregnancy. Results: There were 2 cases (1.2%) of premature rupture of membrane (PROM) in amniocentesis which occurred 1 and 10 days after the procedure and caused pregnancy loss before 20 weeks. We had 1 case (0.7%) of abortion in CVS, which occurred 10 days after the procedure. Additionally, there was 1 case of amniotic fluid leakage (0.7%) in which, after admission to the hospital and observation, leakage was stopped and the pregnancy continued normally. Conclusion: In this study, we had more complications with amniocentesis cases than CVS. CVS is a procedure performed in the earlier stages of pregnancy and its complications are less than amniocentesis. We suggest CVS to be the procedure of choice for genetic diagnosis.