International Journal of Fertility and Sterility

82-87

Authors: Effat Merghati Khoei , Abbas Norouzi Javidan , Mahboobeh Abrishamkar , Mir Saeed Yekaninejad , Samira Chaibakhsh , Seyyed Hasan Emami-Razavi , Asie Mansouri , Koorosh Kamali , Tannaz Shoja , Marzieh Hajiaghababaei , Abolghasem Nikfallah

Background: This study developed and validated a questionnaire to measure the sexual health of patients with spinal cord injuries (SCI). Materials and Methods: This was a cross-sectional study conducted at the Brain and Spinal Injury Research Center (BASIR), Tehran, Iran. Extensive review of literature, expert opinions, and encounters with SCI patients were used to develop and validate the questionnaires. There were 40 (32 males, 8 females) patients with SCI that presented for treatment at BASIR who enrolled in the study. Participants completed the questionnaires while they were admitted for medical care and during treatment follow-up visits. Participants completed the questionnaires twice, at a 2-4 week interval. Reliability testing for each measure was performed separately. Cronbach’s alpha was used for internal consistency and test-retest was used for reliability. Results: An expert committee approved the face and content validities of the questionnaires, Internal consistency of our questionnaires, was acceptable according to Cronbach’s alpha that ranged from 0.73 for the sexual activity measure to 0.90 for the sexual adjustment measure. Test-retest reliability was satisfactory. Intraclass Correlation Coefficient (ICC) of measures ranged from 0.65 for sexual function to 0.84 for sexual activity. Conclusion: The sexual health measures has provided a valid assessment of sexualityrelated matters in this sample of patients with SCI, which suggests that evaluation of sexual well-being may be useful in clinical trials and practice settings. Overall, the sexual health measures shows good internal consistency and test-retest reliability.

96-99

Authors: Maryam Kianpour , Mehdi Nematbakhsh , Sayad Mehdi Ahmadi , Mehrangiz Jafarzadeh , Masomeh Hajjarian , Zahra Pezeshki , Tahereh Safari , Fatemeh Eshraghi-Jazi

Background: Endometriosis is known as one of the most common disease in women of reproductive age. Due to important role of vascular endothelial growth factor (VEGF) in neo-vascularization for the implantation of endometrial cell, and also presence of different studies reported VEGF level in the serum and peritoneal fluid (PF) in endometriosis patients, this study was designed to determine the serum and PF levels of VEGF in endometriosis patients, and to compare with normal subjects. Materials and Methods: In this descriptive study, 179 women subjected to laparoscopy for the evaluation of infertility or pelvic pain were allocated into the following two groups: group I: different types of endometriosis patients (n=90) and group II: non-endometriosis patients (n=89). The PF from pelvis and venous blood samples were obtained. The VEGF concentration of the serum and PF were measured using enzyme immunoassay kit and were compared using t test. Results: The level of VEGF in serum was significantly less than that in PF in both groups (p=0.00). However, endometriosis patients had significantly higher level of VEGF in peritoneal fluid than non-endometriosis patients (p=0.043). Conclusion: According to our findings, endometriosis is not associated with change in the level of circulating VEGF.

108-115

Authors: Fatemeh Hassani , Poopak Eftekhari-Yazdi , Leila Karimian , Mojtaba Rezazadeh Valojerdi , Bahar Movaghar , Mohammad Fazel , Hamid Reza Fouladi , Fatemeh Shabani , Lars Johansson

Background: The aim of this study is to investigate the effect of ISM1 culture medium on embryo development, quality and outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. This study compares culture medium commonly used in the laboratory setting for oocyte recovery and embryo development with a medium from MediCult. We have assessed the effects of these media on embryo development and newborn characteristics. Materials and Methods: In this prospective randomized study, fertilized oocytes from patients were randomly assigned to culture in ISM1 (MediCult, cycles: n=293) or routine lab culture medium (G-1TM v5; Vitrolife, cycles: n=290) according to the daily media schedule for oocyte retrieval. IVF or ICSI and embryo transfer were performed with either MediCult media or routine lab media. Embryo quality on days 2/3, cleavage, pregnancy and implantation rates, baby take home rate (BTHR), in addition to the weight and length of newborns were compared between groups. Results: There were similar cleavage rates for ISM1 (86%) vs. G-1TM v5 (88%). We observed a significantly higher percentage of excellent embryos in ISM1 (42.7%) compared to G-1TM v5 (39%, p<0.05). Babies born after culture in ISM1 had both higher birth weight (3.03 kg) and length (48.8 cm) compared to G-1TM v5 babies that had a birth weight of 2.66 kg and a length of 46.0 cm (p<0.001 for both). Conclusion: This study suggests that ISM1 is a more effective culture medium in generating higher quality embryos, which may be reflected in the characteristics of babies at birth.

122-129

Authors: Ali Louei Monfared

Background: The lipid composition of a mammal’s spermatozoa and seminal plasma vary in both structure and function. Evidence exists to suggest that dietary supplementation with the appropriate polyunsaturated fatty acids (PUFAs) affects spermatogenesis, semen quality and sperm motility. Therefore, this study has been conducted to evaluate the correlations between serum lipid profile and histological, anatomical and seminal parameters of testes in clinically healthy goats. Materials and Methods: In this analytic, cross-sectional study, we chose a total of ten mature Iranian male goats that comprised a homogenous group through simple random sampling. Blood samples were taken from the jugular vein; the sera were separated and subsequently used for measurement of serum lipids, lipoproteins and testosterone levels. In addition, we collected semen from the animals and evaluated the seminal characteristics. We also performed histological and anatomical assessments of the testes. Results: The findings demonstrated that serum levels of high density lipoprotein (HDL-c) had a significant positive correlation with interstitial testicular tissue area (r=0.73; p<0.001), seminiferous tubule area (r=0.61; p<0.01), the number of Leydig cells (r=0.53; p<0.05), the diameter of the Leydig cell nuclei (r=0.54; p<0.05), scrotal circumference (r=0.83; p<0.001), testis weight (r=0.72; p<0.001), the number of live, normal sperm (r=0.94 ; p<0.001) and serum testosterone levels (r=0.88; p<0.001). Significant but negative correlations were found between serum triglyceride concentration and seminiferous tubule area (r=-0.53; p<0.05), the diameter of the Leydig cell nuclei (r=-0.55; p<0.05), testis weight (r =-0.64; p<0.01), total sperm number (r=-0.82; p<0.001), number of live, normal sperm (r=-0.55; p<0.05) and serum testosterone levels (r=-0.79; p<0.001). In addition, a significant negative correlation was observed between serum very low density lipoprotein (VLDL-c) concentration and the percent of live sperm (r=-0.67; p<0.01), and serum testosterone levels (r=-0.65; p<0.01). Conclusion: The present results indicated that among serum lipids only the levels of HDL-c positively correlated with testicular parameters. High serum triglyceride levels exerted direct adverse effects at the testicular level, which was mainly observed in the seminiferous tubules (STs), characterization of Leydig cells and semen quality.

138-141

Authors: Hikmet Hassa , Yunus Aydin , Tufan Oge , Vehbi Yavuz Tokgoz

We presented a cerebral venous thrombosis case associated with lack of proper medical evaluation required for confirmation of suppression and exclusion of current pregnancy before starting assisted reproductive technology (ART) cycle. This is a case-report study about a 37-year-old woman who presented to emergency room with abdominal pain and tenderness. Initial human chorionic gonadotropin (hCG) value was 17616 IU/L. Endometrium was heteregenous and incompatible with a normal intrauterine pregnancy. She had a history of antagonist protocol/controlled ovarian hyperstimulation (COH) started 38 days ago in a different in vitro fertilization (IVF) center. Because of the fertilization failure, she had no embryo transfer. With ectopic pregnancy diagnosis, we made surgical exploration and observed a material which was consistent with ectopic pregnancy on the right tuba uterina. Partial salpingectomy was applied because of actively bleeding ectopic pregnancy. Two days after discharging from hospital; she presented to emergency room again with syncope and generalized tonic-clonic seizure. By cranial tomography generalized edema, cerebral venous thrombosis was established. Enoxaparine sodium 0.6 ml twice daily was administered. Six days after hospitalisation, she was discharged with normal neurological examination under phenytoin 200 mg daily and enoxaparine sodium 0.6 ml daily. Before ART treatment, clinicians must always rule out the likelihood of existing pregnancy by measuring estradiol, follicle stimulating hormone (FSH), and luteinizing hormone (LH). On the other hand, low-molecularweight heparine may be effective in cerebral venous thrombosis treatment. Therefore, intracerebral thrombosis is one of the rare mortal complications of ART.

142-146

Authors: Changjun Zhang , Haiying Peng , Yueyue Hu

A 24-year-old man was diagnosed with klinefelter’s syndrome (KS) and his wife was found to have an inversion on chromosome 9-46, XX, inv (9) (p11q21)- because of infertility. Intracytoplasmic sperm injection (ICSI) was performed for fertilization after fluorescence in-situ hybridization (FISH) was used to analyze the aneuploidy rate of the X and Y chromosomes of the ejaculated sperms of the patient, and 99 sperms were haploid among 100 sperms that were to be analyzed. A twin pregnancy was achieved. The chromosomes of the two fetuses were identified as 46, XY and 46, XY, inv (9)(p11q21) after a prenatal diagnosis at 18 weeks gestation. Two healthy twins were born through caesarean section at 32 weeks gestation because of premature rupture of membranes (PROM).