International Journal of

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Background: Thiopental sodium and Propofol are two widely-used drugs in the induction of anesthesia in assisted reproductive technology (ART). However, the side effects and outcome of recovery from anesthesia of these drugs on ART have not been identified yet.
Objective: This study aimed at investigating the side effects and hemodynamic effects of using thiopental sodium and propofal as well as effects of these drugs on pregnancy outcome in ART cycles.
Materials and Methods: In this double blinded) randomized controlled trial, 90 woman candidate for ART were randomly divided into two groups. 47 patients received Propofol (2.5 mg/kg) and 43 patients received thiopental (5mg/kg) for anesthesia induction. The entry hemodynamic parameters of the patients were documented. During the anesthesia process, hemodynamic parameters were checked at five-minute intervals.
Results: The results of the study showed a statistically significant difference between two groups in terms of their response to verbal stimulation (p<0.001), the normalization time of the rate and quality of breathing (p<0.001), nausea (p<0.001), and vomiting (p<0.001). Also, in comparison with the other group, all these parameters were better in Propofol group. There was found no significant difference between two groups in terms of other variables.
Conclusion: Based on the findings of the study, Propofol has fewer known side effects. Vomiting and nausea as two known side effect of anesthesia are significantly lower in patients receiving Propofol than patients who received thiopental.

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Introduction: Regarding to the recent advances in assisted reproductive techniques (ART), twin and multiple pregnancies have increased during past years.
Objective: This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy.
Materials and Methods: In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96) and ART group (n=31). Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, Neonatal Intensive Care Unit (NICU) admission, mortality, respiratory distress, and icterus) were recorded using a questionnaire.
Results: Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD) were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1st and 5th min Apgar score <7, NICU hospitalization, mortality, respiratory distress, and icterus).
Conclusion: With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART.

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Background: Knowledge about assisted reproductive techniques (ART) and its procedures affect the attitude of infertile people. Making decisions about the use of ART is affected by one's perception and attitude.
Objective: The aim of this cross-sectional study was to determine the attitude of infertile couples toward applying ART, and to investigate its related factors.
Materials and Methods: A randomized cross-sectional study was conducted on 184 infertile couples who had referred to the Research and Clinical Center of Infertility, Yazd, Iran for diagnosis and treatment in June 2014. The data was collected using a two-part questionnaire containing demographic and attitudinal statements. For data analysis, SPSS statistical software and statistical tests of mean differences (t-test), Pearson correlation and analysis of variance were used.
Results: A significant relationship between spouse's attitude (p<0.01), relative's attitude (p<0.01), the applied knowledge of ART (p<0.01), and attitude of infertile couples toward applying the ART was observed; however, there was not any significant relationship between gender and socioeconomic status toward applying ART (p>0.05).
Conclusion: In conclusion, making a decision and accepting ART can be influenced by couple's attitude, their family's attitude and applied knowledge of ART

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Background: Psychological interventions such as counseling for infertile patients seem to increase pregnancy rate.
Objective: The aim of this systematic review and meta-analysis was to examine if counseling improves pregnancy rate among infertile patients. Thus, randomized controlled trials investigating the effect of counseling on pregnancy rate in infertile patients undergoing ART were pooled in a meta-analysis.
Materials and Methods: The databases of PubMed, Scopus, Cochrane, Google Scholar, and Persian databases including SID, Iran Medex, and Magiran were searched from 1997 to July 2016 to identify relevant articles. Included studies were trials on infertile patients (women or couples) receiving counseling independent of actual medical treatment. The outcome measure was pregnancy rate. Out of 620 relevant published trials, a total of nine RCTs were ultimately reviewed systematically and included in a meta-analysis to measure the efficacy of counseling on pregnancy rate. Odds ratio and Risk difference were calculated for pregnancy rate. All statistical analyses were done by Comprehensive Meta-analysis Version 2.
Results: Nine RCTs involving 1079 infertile women/couples were included in the study. The findings from RCTs indicated significant effect of counseling on pregnancy rate so that there was a positive impact of counseling on pregnancy rate (OR= 3.852; 95% CI: 2.492-5.956; p=0.00) and (RD= 0.282; 95%; CI: 0.208-0.355; p=0.00).
Conclusion: Counseling was found to improve patients’ chances of becoming pregnant. So counseling represents an attractive treatment option, in particular, for infertile patients who are not receiving medical treatments.

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Background: There are controversial views on accepting a reproductive donation inthe world.
Objective: This study aimed to determine the relationship between the socioculturalbeliefs and infertile couples’ attitude toward reproductive donation in Mashhad, Iran.
Materials and Methods: This descriptive correlational study was conducted out on 115infertile couples visiting Milad Infertility Center in Mashhad, Iran with using conveniencesampling. The research instruments were valid and reliable sociocultural beliefs andattitude questionnaires, which were completed by the respondents on a self-reportbasis.Results:The mean score of attitude toward reproductive donation in infertile womenand men was 58.3±12.6 and 57.8±12.0, and the mean score of sociocultural beliefs ininfertile women and men was 67.7±11.5 and 67.6±12.4, respectively. There was a directcorrelation between sociocultural beliefs and attitude toward reproductive donationin infertile women (p<0.001) and men (p<0.001), that is, women and men with ahigher score of sociocultural beliefs had a higher score of attitude as well. A directcorrelation was also seen between sociocultural beliefs and infertile women and men’spublic attitude, their attitude towards genetic bound between parents and children,their attitude regarding the issue of confidentiality of the donation process, as well asattitude in relation to oocyte donation, embryo donation, and surrogacy (p<0.001).
Conclusion: The findings suggest that sociocultural beliefs that surround reproductivedonation could influence infertile couple’s attitude toward accepting these therapeuticalternatives in infertile couples. It is therefore recommended to take steps toincorporate sociocultural beliefs into the routine care of infertile couples with the helpof social media to give them ability for making more pragmatic decision in relation totheir chosen options

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Background: The three-parent assisted reproductive technique may increase oocyte competence.
Objective: In this case-control study, the suitability of germinal vesicle transfer (GVT), synchronous ooplasmic transfer (sOT), asynchronous ooplasmic transfer using cryopreserved MII oocyte (caOT), and asynchronous ooplasmic transfer using waste MII oocyte (waOT) for maturation of the human-aged non-surrounded nucleolus germinal vesicle-stage (NSN-GV) oocyte were investigated.
Materials and Methods: NSN-GV oocytes were subjected to four methods: group A (GVT), B (sOT), C (caOT) D (waOT), and E (Control). The fusion rates, MI, MII, ICSI observations and cleavage at 2-cell, 4-cell, and 8-cell stages were compared in the groups.
Results: In GVT, none of the oocytes fused. In sOT, all oocytes fused, 20 achieved the MI, 14 progressed to MII, 8 fertilized, 6 cleaved and 5, 4, and 3 achieved the 2-cells, 4-cells and 8-cells, respectively. In caOT, all oocytes fused and achieved the MI, 8 progressed to MII and fertilized, 6 cleaved and 6, 5, and 5 achieved the 2-cells, 4-cells, and 8-cells respectively. In waOT, all oocytes fused, 5 and 3 progressed to MI and MII, respectively, but only one fertilized, cleaved and reached a 4-cells stage. In group E, 6 and 2 oocytes progressed to MI and MII, respectively, and only one fertilized but arrested at the zygote stage. caOT had the highest survival rate when compared to sOT (p = 0.04), waOT (p = 0.002), and control (p = 0.001).
Conclusion: The caOT method was beneficial over sOT, waOT, and GVT in supplementing the developmental capacity of human-aged NSN-GV oocytes.

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