A systematic review and meta-analysis of pregnancy and COVID-19: Signs and symptoms, laboratory tests, and perinatal outcomes 2 1 مقدمه: بیماری کروناویروس 2019 (کووید-19) یک سندروم حاد تنفسی است که در دسامبر 2019 برای اولین بار در ووهان چین گزارش شد. هدف: هدف از این مطالعه بررسی تظاهرات بالینی شامل علائم و نشانهها، تستهای آزمایشگاهی و پیامدهای قبل از زایمان در زنان باردار مبتلا به کووید-19 بود. مواد و روش ها: جستجو در پایگاههای PubMed via LitCovid hub, Embase, Scopus, Web of sciences, و Google scholar در تاریخ 7 اپریل 2020 انجام شد. متا-آنالیز با استفاده از نرمافزار جامع متا-آنالیز (CMA) و با استفاده از روش منتل-هنزل انجام شد. میزان رخداد هر یک از متغیرها با استفاده از دامنه اطمینان %95 محاسبه شد. نتایج: در نهایت 10 مقاله وارد این مطالعه شدند. میزان شیوع تجمعی برای تب، تب پس از زایمان، سرفه، درد عضلانی، خستگی، تنگی نفس، گلو درد و اسهال به ترتیب برابر با 8/66، 1/37، 35، 6/24، 9/14، 6/14، 5/11 و 6/7 درصد بود. نتایج تستهای آزمایشگاهی برای کاهش لنفوسیت، افزایش گلبولهای سفید، نسبت افزایش نوتروفیل، افزایش پروتئین در گردش و نسبت کاهش لنفوسیت به ترتیب برابر 8/49، 7/47، 7/83، 57 و 4/71 درصد بود. میزان سزارین در همه موارد 84 درصد بود. فقط یک نوزاد از مادرانی که کرونا مثبت بودند دراری تست مثبت بوده است. همچنین تنها یک مرگ وجود داشت که به دلیل کاهش نسبت نوتروفیل بود. نتیجه گیری: رایجترین نشانه در زنان بادار مبتلا به بیماری کووید-19، تب بود. از بین تستهای آزمایشگاهی بالاترین مقدار مرتبط با نسبت نوتروفیلها بود. به نظر میرسد با توجه به تفاوتهای بین زنان باردار و جمعیت عمومی، برای درمان این بیماران اقدامات ویژهای باید در نظر گرفته شود. 2 Background: Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 appeared in December 2019 in Wuhan, China. Objective: To investigate the clinical manifestations including signs and symptoms, laboratory results, and perinatal outcomes in pregnant women with COVID-19. Materials and Methods: Scholarly databases such as PubMed via LitCovid hub, Embase, Scopus, Web of sciences, and Google scholar were searched on April 7, 2020. Meta-analysis was performed via comprehensive meta-analysis software using the Mantel-Haenszel method. The event rate with 95% CI was calculated for each variable. Results: Ten studies were selected. The pooled prevalence for fever, post-partum fever, cough, myalgia, fatigue, dyspnea, sore throat, and diarrhea were 66.8%, 37.1%, 35%, 24.6 %, 14.9%, 14.6%, 11.5%, and 7.6%, respectively. Laboratory test results were 49.8% for lymphopenia, 47.7% for leukocytosis, 83.7% for elevated neutrophil ratio, 57% for elevated C-reactive protein, and 71.4% for decreased lymphocyte ratio. The rate of cesarean section for delivery in all cases was 84%. Of the newborns of the corona-positive mothers, only one had a positive test result. Also, there was only one death due to a decreased lymphocyte ratio. Conclusion: Fever was the most common sign and symptom in pregnant women with COVID-19. Among the laboratory tests, the highest amount was related to elevated neutrophil ratio. It seems that due to the differences between pregnant women and the general population, special measures should be considered to treat these patients. 1005 1018 2020/05/20 1399/2/31 2020/10/26 1399/8/5 Soheil Hassanipour Soheil Hassanipour Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. ایران soheil.epid@gmail.com Saeed Bagheri Faradonbeh Saeed Bagheri Faradonbeh Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. ایران s.bagheri88@yahoo.com Khalil Momeni Khalil Momeni Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran. ایران khalilmomeni1365@gmail.com Zahra Heidarifard Zahra Heidarifard Tehran University of Medical Sciences, Tehran, Iran. ایران z.heydari53@yahoo.com Mohammad-Javad Khosousi Mohammad-Javad Khosousi Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. ایران mj.khosousi@gmail.com Leila Khosousi Leila Khosousi Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran. ایران leilakhosousi@gmail.com Hosein Ameri Hosein Ameri Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران hamery7@yahoo.com Morteza Arab-Zozani Morteza Arab-Zozani Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran. ایران arab.hta@gmail.com COVID-19 Pregnancy Diagnosis Signs and symptoms Meta-analysis. کووید-19 بارداری تشخیص نشانه ها و علائم متا-آنالیز. 1. 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The effect of the human cumulus cells-conditioned medium on in vitro maturation of mouse oocyte: An experimental study اثر محیط شرطی شده سلول های کومولوس انسانی روی بلوغ آزمایشگاهی اووسیت موش: یک مطالعه تجربی 2 1 مقدمه: برای افزایش نتایج درمان ناباروری، تلاشهای زیادی برای بهبود روشهای درمان انجام شده است. از آنجا که تکنیکهای کمکی تولیدمثل (ART) عمدتا از روشهای کشتسلولی استفاده میکنند، یکی از روشهای بهبود این فناوری، محیطهای شرطیشده حاصل از منابع و گونههای مختلف است. بهتر است به جای تحریک تخمکگذاری، از بلوغ آزمایشگاهی (IVM) استفاده و از تخمکهای چرخه طبیعی استفاده شود. هدف: در این مطالعه تأثیر محیط شرطیشده حاصل از سلولهای کومولوس انسانی (hCCCM) بر میزان IVM تخمکهای موش نابالغ و مورفولوژی آنها بررسی شده است. مواد و روش ها: در این مطالعه تجربی، 240 تخمک مرحله ژرمینال وزیکول (GV) از موشهای 4 تا 6 هفتگی نژاد NMRI پس از 48 ساعت تزریق 5 واحد PMSGجمعآوری شد. تخمکهای GV بدون کومولوس در hCCCM (گروه آزمون، 120 عدد) و DMEM + 20% FBS (گروه کنترل، 120 عدد) برای IVM کشت داده شدند. گروه کنترل شبیه گروه کنترلی است که در قسمت دیگر پروژه استفاده شده و اخیراً منتشر شده است. میزان IVM و تغییرات شکل و PVS در هر دو گروه آزمون و کنترل در 8، 16 و 24 ساعت بعد از کشت بررسی شدند. تخمکهای بالغ (MII) برای IVF استفاده شدند و میزان باروری بعد از 24، 48 و 72 ساعت ارزیابی شد. نتایج: تفاوت معنیداری بین میزان بلوغ در گروه hCCCM و کنترل (16/24% در مقابل 0%؛ 001/0 =p) مشاهده شد. همچنین در تغییرات مورفولوژیکی بین دو گروه تفاوت معنیداری مشاهده شد (05/0 =p و 04/0 =p). میزان تکوین تخمک های MII بدست آمده از IVM در گروهhCCCM 58/27 % (2 سلولی) و 89/6% (4 سلولی) بود. دادههای این مطالعه نشان داد که hCCCM یک محیط مؤثر برای بلوغ تخمکهای نابالغ در مقایسه با محیط کنترل است. نتیجه گیری: این یافتهها تأیید میکند که hCCCM از رشد و بلوغ آزمایشگاهی تخمک پشتیبانی میکند. علاوه بر این، hCCCM شکل تخمک و اندازه فضای پری ویتلین تخمک را تغییر میدهد. 2 Background: To increase the results of infertility treatment, many efforts have been made to improve the treatment methods. As assisted reproductive technology is mainly using cell culture methods, one of the approaches to improve this technology is conditioned medium from different sources. It is desirable to apply in vitro maturation (IVM) and use oocytes from normal cycles instead of stimulating ovulation. Objective: To investigate the effect of human cumulus cell condition medium (hCCCM) on the IVM of immature mouse oocytes and morphology. Materials and Methods: In this experimental study, 240 germinal vesile oocytes were collected from four-six wk-old mice after 48 hr of 5IU pregnant mare serum gonadotropin (PMSG) injection and cultured in hCCCM (test group, n = 120) and DMEM + 20% FBS (control group, n = 120). The IVM rates and changes in perivitelline space (PVS) and shape were investigated at 8, 16, and 24 hr following the culture. The mature (MII) oocytes were subjected to in vitro fertilization (IVF) and the fertilization rate was assessed in three days. Results: A significant difference was observed between the maturation rates in the hCCCM and control groups (24.16% vs 0%; p = 0.001), as well as morphologic changes between the two groups (p = 0.04, p = 0.05). The development rate for MII oocytes attained from IVM in the hCCCM group was 27.58% (2-cell) and 6.89% (4-cell). Data displayed that hCCCM is an effective medium for oocytes maturation compared to the control medium. Conclusion: hCCCM supports oocyte in vitro growth and maturation. Moreover, hCCCM changes the oocyte shape and size of perivitelline space. 1019 1028 2020/05/202020/05/12 1399/2/23 2020/10/262020/07/29 1399/5/8 Maryam Adib Maryam Adib Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran. ایران maryam.adib2009@gmail.com Seyed Morteza Seifati Seyed Morteza Seifati Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran. ایران seifati@gmail.com Mahmood Dehghani Ashkezari Mahmood Dehghani Ashkezari Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran. ایران mdashkezary@yahoo.com Arezoo Khoradmehr Arezoo Khoradmehr Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران mehrarezoo@gmail.com Roshan Rezaee-Ranjbar-Sardari Roshan Rezaee-Ranjbar-Sardari Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran. ایران Roshan_rezaee@yahoo.com Somayyeh Sadat Tahajjodi Somayyeh Sadat Tahajjodi Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران s.tahajjodi@yahoo.com Behrouz Aflatoonian Behrouz Aflatoonian Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران b.aflatoonian@ssu.ac.ir Germinal vesicle Cumulus cell Conditioned medium In vitro fertilization In vitro maturation Oocyte. ژرمینال وزیکول سلول کومولوس محیط شرطی شده باروری در شرایط آزمایشگاهی بلوغ آزمایشگاهی اووسیت. 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Recombinant human growth differentiation factor-9 improves oocyte reprogramming competence and subsequent development of bovine cloned embryos. Cell Reprogram 2014; 16: 281-289.##Cook-Andersen H, Curnow KJ, Su HI, Chang RJ, Shimasaki S. Growth and differentiation factor 9 promotes oocyte growth at the primary but not the early secondary stage in three-dimensional follicle culture. J Assist Reprod Genet 2016; 33: 1067-1077.##Hreinsson JG, Scott JE, Rasmussen C, Swahn ML, Hsueh AJ, Hovatta O. Growth differentiation factor-9 promotes the growth, development, and survival of human ovarian follicles in organ culture. J Clin Endocrinol Metab 2002; 87: 316-321.##Zand E, Fathi R, Nasrabadi MH, Atrabi MJ, Spears N, Akbarinejad V. Maturational gene upregulation and mitochondrial activity enhancement in mouse in vitro matured oocytes and using granulosa cell conditioned medium. Zygote 2018; 26: 366-371.##Lee SR, Kim MO, Kim SH, Kim BS, Yoo DH, Park YS, et al. 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Effect of alpha-lipoic acid supplementation on the lipid profile and lipid ratios in women with gestational diabetes mellitus: A clinical trial study بررسی تأثیر مصرف مکمل آلفا لیپوئیک اسید بر روی مقادیر نیمرخ لیپیدی و نسبت های لیپیدی در زنان مبتلا به دیابت بارداری: یک مطالعه کارآزمایی بالینی 2 1 مقدمه: شواهد حاکی از این است که استرس اکسیداتیو نقش مهمی را در بروز دیابت بارداری ایفا میکند. از طرف دیگر زنان مبتلا به دیابت بارداری در معرض خطر ابتلا به ناهنجاریهایی از قبیل نقص عملکرد اندوتلیال عروق و بیماریهای قلبی عروقی هستند. هدف: هدف از مطالعه حاضر بررسی تأثیر مصرف مکمل آلفا لیپوئیک اسید بر روی مقادیر خونی نیمرخ لیپیدی و نسبتهای لیپیدی در زنان مبتلا به دیابت بارداری بود. مواد و روش ها: در این مطالعه 60 خانم مبتلا به دیابت بارداری وارد مطالعه شدند. گروه دارو (30 نفر) روزانه یک عدد کپسول 100 میلیگرمی لیپوئیک اسید و گروه دارونما (30 نفر) روزانه یک عدد کپسول 100 میلیگرمی حاوی استات سلولز به مدت 8 هفته استفاده کردند. مقادیر خونی همگلوبین A1C، تریگلیسرید (TG)، کلسترول تام (TC)، کلسترول لیپوپروتئین با چگالی بالا (HDL-C)، کلسترول لیپوپروتئین با چگالی پایین (LDL-C)، شاخص تریگلیسرید-گلوکز (TyG)، شاخص آتروژنیک پلاسما (AIP)، کلسترول غیر HDL-C (non- HDL-C) و نسبتهای لیپیدی قبل و بعد از مداخله اندازهگیری شد. مقادیر p کوچکتر از 05/0 از نظر آماری معنیدار در نظر گرفته شد. نتایج: مقادیر شاخص TyG (001/0 >p )، TG (006/0 = p)، TG/HDL-C (003/0 = p) و AIP (005/0 = p) به طور معنیداری در گروه دارو بعد از مداخله انجام شده کاهش نشان داد. نتیجه گیری: نتایج مطالعه حاضر نشان داد پس از 8 هفته مصرف مکمل آلفا لیپوئیک اسید در زنان مبتلا به دیابت بارداری مقادیر خونی شاخص TyG، TG، TG/HDL-C و AIP به طور معنیداری کاهش نشان داد. 2 Background: Evidence suggests that Oxidative stress has been shown to plays an important role in gestational diabetes mellitus (GDM) etiology. On the other hand, women with GDM are at an increased risk for complications such as endothelial dysfunction and cardiovascular diseases. Objective: To investigate the effects of alpha-lipoic acid (ALA) on the maternal circulating values of lipid profile and lipid ratios in women with GDM. Materials and Methods: Sixty women with GDM were participated in the present study. The ALA group (n = 30) received ALA (100 mg/day) and the placebo group (n = 30) received cellulose acetate (100 mg/day) for eight wk. The maternal circulating values of hemoglobin A1C, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL-C, and lipid ratios were assessed before and after the intervention. P-value < 0.05 was considered as statistically significant. Results: The values of TyG index (p < 0.001), TG (p = 0.006), TG/HDL-C (p = 0.003), and AIP (p = 0.005) decreased significantly in the ALA group after the intervention. Conclusion: Maternal circulating values of TyG index, TG, TG/HDL, AIP decreased after eight wk of ALA supplementation in women with GDM. 1029 1038 2020/05/202020/05/122019/05/15 1398/2/25 2020/10/262020/07/292020/06/7 1399/3/18 Hadise Aslfalah Hadise Aslfalah Students Research Committee, Arak University of Medical Sciences, Arak, Iran. ایران falah.949@yahoo.com Mehri Jamilian Mehri Jamilian Department of Gynecology and Obstetrics, Endocrinology and Metabolism Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran. ایران mjamilian@arakmu.ac.ir Hadi Ansarihadipour Hadi Ansarihadipour Department of Biochemistry and Genetics, Endocrinology and Metabolism Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran. ایران ansari@arakmu.ac.ir Mahdi Abdollahi Mahdi Abdollahi Decorative and Hygienic Products, Control Laboratory of Food, Beverage, Food and Drug Administration, Arak University of Medical Sciences, Arak, Iran. ایران Abdollahi.m@arakmu.ac.ir Ali Khosrowbeygi Ali Khosrowbeygi Department of Biochemistry and Genetics, Endocrinology and Metabolism Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran. Traditional and Complementary Medicine Research Center (TCMRC), Arak University of Medical Sciences, Arak, Iran. ایران khosrowbeygi@yahoo.com Lipoic acid Gestational diabetes Lipids Triglycerides Cholesterol. لیپوئیک اسید دیابت بارداری لیپید تری گلیسرید کلسترول. Abbasi M, Mazloum Khorasani Z, Etminani K, Rahmanvand R. Determination of the most important risk factors of gestational diabetes in Iran by group analytical hierarchy process. Int J Reprod Biomed 2017; 15: 109-114.##Lappas M, Hiden U, Desoye G, Froehlich J, Hauguel-de Mouzon S, Jawerbaum A. The role of oxidative stress in the pathophysiology of gestational diabetes mellitus. Antioxid Redox Signal 2011; 15: 3061-3100.##Ghate J, Choudhari AR, Ghugare B, Ramji S. Antioxidant role of Vitamin C in normal pregnancy. Biomed Res 2011; 22: 49-51.##Monastra G, De Grazia S, Cilaker Micili S, Goker A, Unfer V. Immunomodulatory activities of alpha lipoic acid with a special focus on its efficacy in preventing miscarriage. Expert Opin Drug Deliv 2016; 13: 1695-1708.##Derosa G, D'Angelo A, Romano D, Maffioli P. A clinical trial about a food supplement 6containing α-lipoic acid on oxidative stress markers in type 2 diabetic patients. Int J Mol Sci 2016; 17: 1802-1809.##Zhang Y, Han P, Wu N, He B, Lu Y, Li Sh, et al. Amelioration of lipid abnormalities by α‐Lipoic acid through antioxidative and anti‐Inflammatory effects. Obesity 2011; 19: 1647-1653.##Akbari M, Ostadmohammadi V, Lankarani KB, Tabrizi R, Kolahdooz F, Khatibi SR, et al. The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials. Metabolism 2018; 87: 56-69.##Di Tucci Ch, Di Feliciantonio M, Vena F, Capone C, Schiavi MC, Pietrangeli D, et al. Alpha lipoic acid in obstetrics and gynecology. Gynecol Endocrinol 2018; 34: 729-733.##Di Fulvio P, Pandolfi A, Formoso G, Di Silvestre S, Di Tomo P, Giardinelli A, et al. Features of endothelial dysfunction in umbilical cord vessels of women with gestational diabetes. Nutr Metab Cardiovasc Dis 2014; 24: 1337-1345.##Contreras-Duarte S, Carvajal L, Garchitorena MJ, Subiabre M, Fuenzalida B, Cantin C, et al. Gestational diabetes mellitus treatment schemes modify maternal plasma cholesterol levels dependent to women' s weight: Possible impact on feto-placental vascular function. Nutrients 2020; 12: 506-527.##Jasper R, Skelding K. Cardiovascular disease risk unmasked by pregnancy complications. Eur J Intern Med 2018; 57: 1-6.##American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014; 37 (Suppl.): S81-S90.##Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry 1972; 18: 499-502.##Niroumand Sh, Khajedaluee M, Khadem-Rezaiyan M, Abrishami M, Juya M, Khodaee G, et al. Atherogenic index of plasma (AIP): A marker of cardiovascular disease. Med J Islam Repub Iran 2015; 29: 240-248.##Pazhohan A, Rezaee Moradali M, Pazhohan N. Association of first-trimester maternal lipid profiles and triglyceride-glucose index with the risk of gestational diabetes mellitus and large for gestational age newborn. J Matern Fetal Neonatal Med 2017; 32: 1167-1175.##Gasevic D, Frohlich J, Mancini GJ, Lear SA. Clinical usefulness of lipid ratios to identify men and women with metabolic syndrome: a cross-sectional study. Lipids Health Dis 2014; 13: 159-168.##Pfalzgraf A, Frigg M, Steinhart H. Alpha.-tocopherol contents and lipid oxidation in pork muscle and adipose tissue during storage. J Agric Food Chem 1995; 43: 1339-1342.##Siangproh W, Rattanarat P, Chailapakul O. Reverse-phase liquid chromatographic determination of α-lipoic acid in dietary supplements using a boron-doped diamond electrode. J Chromatogr A 2010; 1217: 7699-7705.##De Cicco S, Immediata V, Romualdi D, Policola C, Tropea A, Di Florio C, et al. Myoinositol combined with alpha-lipoic acid may improve the clinical and endocrine features of polycystic ovary syndrome through an insulin-independent action. Gynecol Endocrinol 2017; 33: 698-701.##Noori N, Tabibi H, Hosseinpanah F, Hedayati M, Nafar M. Effects of combined lipoic acid and pyridoxine on albuminuria, advanced glycation end-products, and blood pressure in diabetic nephropathy. Int J Vitam Nutr Res 2013; 83: 77-85.##Li Y, Ma QG, Zhao LH, Wei H, Duan GX, Zhang JY, et al. Effects of lipoic acid on immune function, the antioxidant defense system, and inflammation-related genes expression of broiler chickens fed aflatoxin contaminated diets. Int J Mol Sci 2014; 15: 5649-5662.##Bao XH, Xu J, Chen Y, Yang CL, Ye ShD. Alleviation of podocyte injury: the possible pathway implicated in anti-inflammation of alpha-lipoic acid in type 2 diabetics. Aging Clin Exp Res 2014; 26: 483-489.##Chang JW, Lee EK, Kim TH, Min WK, Chun S, Lee KU, et al. Effects of α-lipoic acid on the plasma levels of asymmetric dimethylarginine in diabetic end-stage renal disease patients on hemodialysis: a pilot study. Am J Nephrol 2007; 27: 70-74.##Porasuphatana S, Suddee S, Nartnampong A, Konsil J, Harnwong B, Santaweesuk A. Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alphalipoic acid: A randomized double-blinded placebo-controlled study. Asia Pac J Clin Nutr 2012; 21: 12-21.##Di Tomo P, Di Silvestre S, Cordone VGP, Giardinelli A, Faricelli B, Pipino C, et al. Centella asiatica and lipoic acid, or a combination thereof, inhibit monocyte adhesion to endothelial cells from umbilical cords of gestational diabetic women. 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Reproductive function and pregnancy outcomes in women treated for idiopathic hyperprolactinemia: A non-randomized controlled study عملکرد باروری و نتایج حاملگی در خانم های درمان شده به خاطر هیپرپرولاکتینمی: یک مطالعه غیر تصادفی کنترل شده 2 1 مقدمه: مطالعات معدودی بر روی خصوصیات و نتایج حاملگی در زنانی که به خاطر هیپر پرولاکتینمی درمان شدهاند انجام گرفته است. هدف: جهت بررسی خصوصیات دوران بارداری و نتایج حاملگی در زنان درمان شده به خاطر هیپر پرولاکتینمی ایدیوپاتیک با سابقه ناباروری و یا سقط مکرر. مواد و روش ها: یک مطالعه غیرتصادفی کنترل شده در مرکز طب تولید مثل "یونیورس" و کلینیک پزشکی "مدهلث" از 2016 تا 2018 بر روی 96 زن با هیپر پرولاکتینمی ایدیوپاتیک با سن 20 تا 44 سال و ناباروری و یا سابقه سقط مکرر انجام شد. پرولاکتین، هورمون محرک فولیکول، هورمون جسم زرد تخمدان، استرادیول، تستوسترون آزاد و پروژسترون در سرم خون بیماران با روش ایمنواسی مطالعه شد. قبل از اقدام برای بارداری، هیپرپرولاکتینمی با بروموکریپتین درمان شد. از دیدروژسترون برای حمایت فاز لوتئال استفاده شد. نتایج: سطح پرولاکتین به طور معنیداری کاهش یافت و پس از 2 تا 5 ماه طبیعی شد. سیکل قاعدگی بعد از 2 تا 4 ماه منظم شد و تخمکگذاری بعد از 3 تا 7 ماه از سر گرفته شد. حاملگی بعد از 3 تا 14 ماه به دست آمد. سطح استرادیول و پروژسترون سرم به طور معنیداری افزایش یافت. قبل از درمان ارتباط معنیدار منفی بین پرولاکتین و استرادیول و همچنین پرولاکتین و پروژسترون مشاهده شد. تهدید به سقط زودرس از بارزترین عوارض حاملگی بود. از دست رفتن حاملگی در سه ماهه اول در 12/3% موارد مشاهده شد. نتیجه گیری: نتیجه حاملگی در زنان با هیپرپرولاکتینمی ایدیوپاتیک با درمان پیوسته و طولانی بروموکریپتین در قبل از حاملگی و همچنین تجویز دیدروژسترون جهت حمایت فاز لوتئال بهبود مییابد. 2 Background: Few studies have focused to determine the peculiarities of the course of pregnancy and pregnancy outcomes after treatment in women with idiopathic hyperprolactinemia. Objective: To determine the peculiarities of the course of pregnancy and pregnancy outcomes in women treated for idiopathic hyperprolactinemia, with history of infertility and/or recurrent pregnancy loss. Materials and Methods: A non-randomized controlled study was conducted at the Center for Reproductive Medicine "Universe" and Medical Clinic “Medhealth” during 2016-2018, involving 96 women with idiopathic hyperprolactinemia, aged 20-44 yr with infertility and/or a history of recurrent pregnancy loss. Prolactin (PRL), follicle-stimulating hormone, luteinizing hormone, estradiol (E2), free testosterone, and progesterone were studied in blood serum using immunoassay analysis method. Before the occurrence of pregnancy, hyperprolactinemia was treated with bromocriptine. Dydrogesterone was used to support the luteal phase. Results: PRL levels decreased significantly and normalized within two-five months, regular menstrual cycle was restored in two-four months, ovulation was restored in three-seven months, and pregnancy was achieved in three-fourteen months. E2 and progesterone levels increased significantly (p < 0.001). Prior to the treatment, significant negative correlation between PRL and E2 (r = -0.386, p = 0.007), PRL and progesterone (r = -0.420, p = 0.003) was detected. Threatened early abortion prevailed among pregnancy complications. Pregnancy loss in the first trimester was recorded in 3.12% of cases. Conclusion: Pregnancy outcomes in women with idiopathic hyperprolactinemia are improved by prolonged and continuous treatment with bromocriptine before pregnancy and administration of dydrogesterone in support of the luteal insufficiency. 1039 1048 2020/05/202020/05/122019/05/152019/11/14 1398/8/23 2020/10/262020/07/292020/06/72020/06/22 1399/4/2 Khatuna Sokhadze Khatuna Sokhadze Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia. گرجستان xatuna.soxadze507@med.tsu.edu.ge Sophio Kvaliashvili Sophio Kvaliashvili Medical Clinic “Health House”, Tbilisi, Georgia. گرجستان sophokval75@gmail.com Jenaro Kristesashvili Jenaro Kristesashvili Center for Reproductive Medicine “Universe”, Tbilisi, Georgia. گرجستان jenarakrist@hotmail.com Hyperprolactinemia Pregnancy outcome Bromocriptine Dydrogesterone. هیپر پرولاکتینمی نتیجه بارداری بروموکریپتین دیدروژسترون. Saleem M, Martin H, Coates P. Prolactin biology and laboratory measurement: an update on physiology and current analytical issues. Clin Biochem Rev 2018; 39: 3-16.##Crosignani PG. Management of hyperprolactinemic infertility. Middle East Fertility Society Journal 2012; 17: 63-69.##Vander Borght M, Wyns Ch. Fertility and infertility: Definition and epidemiology. Clin Biochem 2018; 62: 2-10.##Majumdar A, Mangal NS. Hyperprolactinemia. J Hum Reprod Sci 2013; 6: 168-175.##El Hachem H, Crepaux V, May-Panloup P, Descamps P, Legendre G, Bouet PE. Recurrent pregnancy loss: current perspectives. Int J Women's Health 2017; 9: 331-345.##Arredondo F, Noble LS. Endocrinology of recurrent pregnancy loss. Semin Reprod Med 2006; 24: 33-39.##Kaur R, Gupta K. Endocrine dysfunction and recurrent spontaneous abortion: An overview. Int J Appl Basic Med Res 2016; 6: 79-83.##Palomba S, Santagni S, La Sala GB. Progesterone administration for luteal phase deficiency in humen reproduction: an old or new issue? J Ovarian Res 2015; 8: 77-91.##Glezer A, Bronstein MD. Approach to the patient with persistent hyperprolactinemia and negative sellar imaging. J Clin Endocrinol Metab 2012; 97: 2211-2216.##Adra A, El Zibdeh MY, Abdul Malek AMM, Hamrahian AH, Salaheldin Abdelhamid AM, Colao A, et al. Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. Middle East Fertility Society Journal 2016; 21: 137-147.##Goyal A, Ganie MA. Idiopathic hyperprolactinemia presenting as polycystic ovary syndrome in identical twin sisters: A case report and literature review. Cureus 2018; 10: e3004.##Chen H, Fu J, Huang W. Dopamine agonists for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history. Cochrane Database of Systematic Reviews 2016; 7: 1-24.##Hirahara F, Andoh N, Sawai K, Hirabuki T, Uemura T, Minaguchi H. Hyperprolactinemic recurrent miscarriage and results of randomized bromocriptine treatment trials. Fertil Steril 1998; 70: 246-252.##Passos VQ, Souza JJ, Musolino NR, Bronstein MD. Long-term follow-up of prolactinomas: normoprolactinemia after bromocriptine withdrawal. J Clin Endocrinol Metab 2002; 87: 3578-3582.##Hekimsoy Z, Kafesciler S, Guclu F, Ozmen B. The prevalence of hyperprolactinemia in overt and subclinical hypothyroidism. Endocrine J 2010; 57: 1011-1015.##Turankar S, Sonone K, Turankar A. Hyperprolactinemia and its comparision with hypothyroidism in primary infertile women. J Clin Diagn Res 2013; 7: 794-796.##Kulshreshtha B, Pahuja I, Kothari D, Chawla I, Sharma N, Gupta Sh, et al. Menstrual cycle abnormalities in patients with prolactinoma and drug-induced hyperprolactinemia. Indian J Endocrinol Metab 2017; 21: 545-550.##Lee DY, Oh YK, Yoon BK, Choi D. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol 2012; 206: 213-218.##Molitch ME. Endocrinology in pregnancy: management of the pregnant patient with a prolactinoma. Eur J Endocrinol 2015; 172: 205-213.##Carp H. A systematic review of dydrogesterone for the treatment of threatened miscarriage. Gynecol Endocrinol 2012; 28: 983-990.##Carp H. A systematic review of dydrogesterone for the treatment of reccurent miscarriage. Gynecol Endocrinol 2015; 31: 422-430.##Kumar A, Begun N, Prasad S, Aggarwal S, Sharma S. Oral dydrogesterone treatment during early pregnancy to prevent recurrent pregnancy loss and its role in modulation of cytokine production: a double-blind, randomized, parallel, placebo-controlled trial. Fertil Steril 2014; 102: 1357-1363.##Mirza FG, Patki A, Pexman-Fieth C. Dydrogesterone use in early pregnancy. Gynecol Endocrinol 2016; 32: 97-106.##Dante G, Vaccaro V, Facchinetti F. Use of progestagens during early pregnancy. Facts Views Vis Obgyn 2013; 5: 66-71.##Saleem M, Martin H, Coates P. Prolactin biology and laboratory measurement: an update on physiology and current analytical issues. Clin Biochem Rev 2018; 39: 3-16.##Crosignani PG. Management of hyperprolactinemic infertility. Middle East Fertility Society Journal 2012; 17: 63-69.##Vander Borght M, Wyns Ch. Fertility and infertility: Definition and epidemiology. Clin Biochem 2018; 62: 2-10.##Majumdar A, Mangal NS. Hyperprolactinemia. J Hum Reprod Sci 2013; 6: 168-175.##El Hachem H, Crepaux V, May-Panloup P, Descamps P, Legendre G, Bouet PE. Recurrent pregnancy loss: current perspectives. Int J Women's Health 2017; 9: 331-345.##Arredondo F, Noble LS. Endocrinology of recurrent pregnancy loss. Semin Reprod Med 2006; 24: 33-39.##Kaur R, Gupta K. Endocrine dysfunction and recurrent spontaneous abortion: An overview. Int J Appl Basic Med Res 2016; 6: 79-83.##Palomba S, Santagni S, La Sala GB. Progesterone administration for luteal phase deficiency in humen reproduction: an old or new issue? J Ovarian Res 2015; 8: 77-91.##Glezer A, Bronstein MD. Approach to the patient with persistent hyperprolactinemia and negative sellar imaging. J Clin Endocrinol Metab 2012; 97: 2211-2216.##Adra A, El Zibdeh MY, Abdul Malek AMM, Hamrahian AH, Salaheldin Abdelhamid AM, Colao A, et al. Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. Middle East Fertility Society Journal 2016; 21: 137-147.##Goyal A, Ganie MA. Idiopathic hyperprolactinemia presenting as polycystic ovary syndrome in identical twin sisters: A case report and literature review. Cureus 2018; 10: e3004.##Chen H, Fu J, Huang W. Dopamine agonists for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history. Cochrane Database of Systematic Reviews 2016; 7: 1-24.##Hirahara F, Andoh N, Sawai K, Hirabuki T, Uemura T, Minaguchi H. Hyperprolactinemic recurrent miscarriage and results of randomized bromocriptine treatment trials. Fertil Steril 1998; 70: 246-252.##Passos VQ, Souza JJ, Musolino NR, Bronstein MD. Long-term follow-up of prolactinomas: normoprolactinemia after bromocriptine withdrawal. J Clin Endocrinol Metab 2002; 87: 3578-3582.##Hekimsoy Z, Kafesciler S, Guclu F, Ozmen B. The prevalence of hyperprolactinemia in overt and subclinical hypothyroidism. Endocrine J 2010; 57: 1011-1015.##Turankar S, Sonone K, Turankar A. Hyperprolactinemia and its comparision with hypothyroidism in primary infertile women. J Clin Diagn Res 2013; 7: 794-796.##Kulshreshtha B, Pahuja I, Kothari D, Chawla I, Sharma N, Gupta Sh, et al. Menstrual cycle abnormalities in patients with prolactinoma and drug-induced hyperprolactinemia. Indian J Endocrinol Metab 2017; 21: 545-550.##Lee DY, Oh YK, Yoon BK, Choi D. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol 2012; 206: 213-218.##Molitch ME. Endocrinology in pregnancy: management of the pregnant patient with a prolactinoma. Eur J Endocrinol 2015; 172: 205-213.##Carp H. A systematic review of dydrogesterone for the treatment of threatened miscarriage. Gynecol Endocrinol 2012; 28: 983-990.##Carp H. A systematic review of dydrogesterone for the treatment of reccurent miscarriage. Gynecol Endocrinol 2015; 31: 422-430.##Kumar A, Begun N, Prasad S, Aggarwal S, Sharma S. Oral dydrogesterone treatment during early pregnancy to prevent recurrent pregnancy loss and its role in modulation of cytokine production: a double-blind, randomized, parallel, placebo-controlled trial. Fertil Steril 2014; 102: 1357-1363.##Mirza FG, Patki A, Pexman-Fieth C. Dydrogesterone use in early pregnancy. Gynecol Endocrinol 2016; 32: 97-106.##Dante G, Vaccaro V, Facchinetti F. Use of progestagens during early pregnancy. Facts Views Vis Obgyn 2013; 5: 66-71.## ##

Association of acne, hirsutism, androgen, anxiety, and depression on cognitive performance in polycystic ovary syndrome: A cross-sectional study رابطه آکنه، هیرسوتیسم، آندروژن، افسردگی و اضطراب بر عملکرد شناختی در زنان مبتلا به سندرم تخمدان پلی‌کیستیک: یک مطالعه مقطعی 2 1 مقدمه: در حالی که سندرم تخمدان پلیکیستیک (PCOS) غالباً با پریشانی روانی همراه است، بیشترین مشخصات بالینی آن شامل آکنه، پرمویی و افزایش سطح هورمونهای آندروژن میباشد. هدف: ارزیابی میزان افسردگی و اضطراب، هیرسوتیسم، آکنه و سطح هورمونهای آندروژن در PCOS و گروه کنترل و ارتباط آن با عملکرد شناختی. موارد و روش ها: این مطالعه مقطعی روی 53 بیمار مبتلا به PCOS و 50 زن سالم به عنوان گروه کنترل انجام شد. دادهها با استفاده از پرسشنامهای شامل اطلاعات دموگرافیک نمونهها، پرسشنامه افسردگی و اضطراب بک، ویژگیهای کلینیکی و یافتههای آزمایشگاهی هیپراندروژنیسم بود. علاوه بر این، سطح آکنه و هیرسوتیسم افراد به ترتیب توسط سیستم درجهبندی آکنه جهانی و سیستم امتیازی فریمان-گالوی مورد ارزیابی قرار گرفت. ارزیابی شناختی مونترال (MoCA) ارزیابی یک آزمایش غربالگری برای اختلال شناختی است که حوزههای عمده شناختی را پوشش میدهد. نتایج: از نظر میانگین سطح آکنه (02/0 =p)، هیرسوتیسم (001/0 <p)، تستوسترون کل (008/0 =p) شاخص آندروژن آزاد (009/0 =p)، افسردگی (001/0 =p) و اضطراب (01/0 =p) اختلاف معنیداری بین دو گروه مشاهده شد. ارزیابی دو گروه از نظر MoCA نشان داد که در مقایسه با گروه کنترل، میانگین مقادیر در زنان گروه مورد کمتر است. اختلاف نمرات در دو گروه در زمینههای توانایی بینایی-مکانی (009/0 =p)، عملکرد اجرایی (05/0 =p)، توجه (03/0 =p) و کل نمرات MoCA از نظر آماری معنیدار بود (002/0 =p). نتیجه گیری: بیماران PCOS نسبت به زنان کنترل سالم در آزمونهای عملکرد اجرایی، توجه و عملکرد بینایی و فضایی از کارایی کمتری برخوردار بودند. 2 Background: While polycystic ovary syndrome (PCOS) is often associated with psychological distress, its most frequent clinical characteristics include acne, hirsutism and increased level of androgen hormones. Objective: To evaluate the level of depression and anxiety, hirsutism, acne, and level of androgen hormones in PCOS and control group and its association with cognitive function. Materials and Methods: This cross-sectional study was conducted on 53 women with PCOS and 50 healthy women as a control group. Data were collected using a questionnaire including the samples’ demographic information, clinical features, clinical findings of hyperandrogenism, and the Beck Depression and Anxiety questionnaire. In addition, the acne and hirsutism levels of the subjects were evaluated using the global acne grading system and the Ferriman-Gallwey scoring system, respectively. The Montreal Cognitive Assessment (MoCA) is a screening test for cognitive impairment that covers major cognitive domains. Results: A significant difference was found between the two groups in the mean levels of acne, hirsutism, total testosterone, free androgen index, depression, and anxiety. However, some mean values of the MoCA were lower in the women of case group compared to the control group. Additionally, a significant difference was observed between the two groups in the domains of visual-spatial ability (p = 0.009), executive function (p = 0.05), attention (p = 0.03), and total MoCA scores (p = 0.002). Conclusion: The PCOS women demonstrated significantly lower performance on the tests of executive function, attention, and visual-spatial function than the healthy control women. 1049 1058 2020/05/202020/05/122019/05/152019/11/142019/08/18 1398/5/27 2020/10/262020/07/292020/06/72020/06/222020/06/20 1399/3/31 Saeideh Mehrabadi Saeideh Mehrabadi Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. ایران saidehmehrabadi@yahoo.com shahideh Jahanian Sadatmahalleh shahideh Jahanian Sadatmahalleh Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. ایران shahideh.jahanian@modares.ac.ir Anoshirvan Kazemnejad Anoshirvan Kazemnejad Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. ایران KAZEM_AN@modares.ac.ir Ashraf Moini Ashraf Moini Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran. Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. ایران ashafmoini@gmail.com PCOS Cognitive function Androgen Depression and anxiety. PCOS عملکرد شناختی آندروژن افسردگی و اضطراب مطالعه کوهورت. Barnard L, Balen AH, Ferriday D, Tiplady B, Dye L. Cognitive functioning in polycystic ovary syndrome. Psychoneuroendocrinology 2007; 32: 906-914.##Lauritsen MP, Bentzen JG, Pinborg A, Loft A, Forman JL, Thuesen LL, et al. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone. Hum Reprod 2014; 29: 791-801.##Ramos FK, da Silva Lara LA, Kogure GS, Silva RC, Ferriani RA, Silva de Sá MF, et al. Quality of life in women with polycystic ovary syndrome after a program of resistance exercise training. Rev Bras Ginecol Obstet 2016; 38: 340-347.##Mehrabadi S, Jahanian Sadatmahalleh S, Kazemnejad A. [Association of depression and anxiety with cognitive function in patients with polycystic ovary syndrome]. J Mazandaran Univ Med Sci 2017; 27: 159-170. (in Persian)##Chaudhari AP, Mazumdar K, Mehta PD. Anxiety, depression, and quality of life in women with polycystic ovarian syndrome. Indian J Psychol Med 2018; 40: 239-246.##Deveci E, Ozturk A, Kirpinar I, Koyuncu A, Engin I, Melikoğlu M, et al. Neurocognition in patients with acne vulgaris. J Psychiatry 2014; 17: 1-7.##Gupta MA, Gupta AK, Vujcic B. Increased frequency of attention deficit hyperactivity disorder (ADHD) in acne versus dermatologic controls: analysis of an epidemiologic database from the US. J Dermatolog Treat 2014; 25: 115-118.##Barry JA, Parekh HSK, Hardiman PJ. Visual-spatial cognition in women with polycystic ovarian syndrome: the role of androgens. Hum Reprod 2013; 28: 2832-2837.##Schattmann L, Sherwin BB. Effects of the pharmacologic manipulation of testosterone on cognitive functioning in women with polycystic ovary syndrome: a randomized, placebo-controlled treatment study. Horm Behav 2007; 51: 579-586.##https://doi.org/10.1016/j.yhbeh.2007.02.002##Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med 2014; 44: 2029-2040.##Spritzer PM. Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances. Arq Bras Endocrinol Metabol 2014; 58: 182-187.##Dadfar M, Kalibatseva Z. Psychometric properties of the persian version of the short beck depression inventory with Iranian psychiatric outpatients. Scientifica 2016; 2016: 8196463. 1-7.##Fallahi Khesht-Masjedi M, Omar Z, Kafi Masoleh SM. Psychometrics properties of the Persian version of beck anxiety inventory in north of Iranian adolescents. Int J Educ Psychol Res 2015; 1: 145-153.##Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695-699.##Wong A, Yiu S, Nasreddine Z, Leung KT, Lau A, Soo YO, et al. Validity and reliability of two alternate versions of the montreal cognitive assessment (Hong Kong version) for screening of mild neurocognitive disorder. PloS One 2018; 13: e0196344. 1-12.##Lumezi BG, Berisha VL, Pupovci HL, Goçi A, Hajrushi AB. Grading of hirsutism based on the ferriman-gallwey scoring system in kosovar women. Postepy Dermatol Alergol 2018; 35: 631-635.##Zohra FT, Sultana T, Islam S, Nasreen T. Evaluation of severity in patients of acne vulgaris by global acne grading system in Bangladesh. Clin Pathol 2017; 1: 1-5.##Vankrieken L. Testosterone and the free androgen index. ZB158th edition. Los Angeles: Diagnostics Products; 1997.##Dharshana S, Singh AK, Sharma S, Mohan SK, Joshi A. Depression, mood change and self-esteem among adolescents aged 12-25 years with acne vulgaris in India. Ann Trop Med Public Health 2016; 9: 31-36.##Ergun T, Seckin D, Ozaydin N, Bakar O, Comert A, Atsu N, et al. Isotretinoin has no negative effect on attention, executive function and mood. Journal of the European Academy of Dermatology and Venereology 2012; 26: 431-439.##Ormerod AD, Thind CK, Rice SA, Reid IC, Williams JHG, McCaffery PJA. Influence of isotretinoin on hippocampal-based learning in human subjects. Psychopharmacology 2012; 221: 667-674.##Fuermaier A, Tucha L, Koerts J, Aschenbrenner S, Kaunzinger I, Hauser J, et al. Cognitive impairment in adult ADHD-perspective matters. Neuropsychology 2015; 29: 45-58.##Bowe WP, Logan AC. Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles. Lipids Health Dis 2010; 9: 141-152.##Khoubnasabjafari M, Ansarin K, Jouyban A. Reliability of malondialdehyde as a biomarker of oxidative stress in psychological disorders. Bioimpacts 2015; 5: 123-127.##Bazarganipour F, Ziaei S, Montazeri A, Foroozanfard F, Kazemnejad A, Faghihzadeh S. Psychological investigation in patients with polycystic ovary syndrome. Health Qual Life Outcomes 2013; 11: 141-148.##Porter RJ, Bourke C, Gallagher P. Neuropsychological impairment in major depression: its nature, origin and clinical significance. Aust N Z J Psychiatry 2007; 41: 115-128.##Kizilbash AH, Vanderploeg RD, Curtiss G. The effects of depression and anxiety on memory performance. Arch Clin Neuropsychol 2002; 17: 57-67.##https://doi.org/10.1016/S0887-6177(00)00101-3##Beaudreau SA, O'Hara R. The association of anxiety and depressive symptoms with cognitive performance in community-dwelling older adults. Psychol Aging 2009; 24: 507-512.##Basso MR, Bornstein RA. Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task. Neuropsychology 1999; 13: 557-563.##Huang G, Wharton W, Travison TG, Ho MH, Gleason C, Asthana S, et al. Effects of testosterone administration on cognitive function in hysterectomized women with low testosterone levels: a dose-response randomized trial. J Endocrinol Invest 2015; 38: 455-461.##Christiansen K, Knussmann R. Sex hormones and cognitive functioning in men. Neuropsychobiology 1987; 18: 27-36.##Moffat SD, Hampson E. A curvilinear relationship between testosterone and spatial cognition in humans: possible influence of hand preference. Psychoneuroendocrinology 1996; 21: 323-337.##Hashemi F, Yaghmaei P, Saadati N, Haghighi Poodeh S, Ramezani Tehrani F, Hedayati M. Association of serum adipsin levels with polycystic ovarian syndrome. Razi J Med Sci 2012; 19: 1-6.##Postma A, Meyer G, Tuiten A, van Honk J, Kessels RP, Thijssen J. Effects of testosterone administration on selective aspects of object-location memory in healthy young women. Psychoneuroendocrinology 2000; 25: 563-575.##Aleman A, Bronk E, Kessels RPC, Koppeschaar HPF, van Honk J. A single administration of testosterone improves visuospatial ability in young women. Psychoneuroendocrinology 2004; 29: 612-617.##Thilers PP, Macdonald SWS, Herlitz A. The association between endogenous free testosterone and cognitive performance: a population-based study in 35 to 90 year-old men and women. Psychoneuroendocrinology 2006; 31: 565-576.##Ghazeeri Gh, Fakih A, Abbas HA, Harajly S, Awwad J. Anxiety, cognitive, and depressive assessment in adolescents with polycystic ovarian syndrome: a pilot study. J Pediatr Adolesc Gynecol 2013; 26: 269-273.##Prickett Ch, Brennan L, Stolwyk R. Examining the relationship between obesity and cognitive function: a systematic literature review. Obes Res Clin Pract 2015; 9: 93-113.##Kim B, Feldman EL. Insulin resistance as a key link for the increased risk of cognitive impairment in the metabolic syndrome. Exp Mol Med 2015; 47: e149. 1-10.##Gholizadeh S, Jahanian Sadatmahalleh Sh, Ziaei S. The association between estradiol levels and cognitive function in postmenopausal women. Int J Reprod Biomed 2018; 16: 455-458.## ##

Iranian temporal changes in semen quality during the past 22 years: A report from an infertility center بررسی تغییرات کیفیت سمن ایرانیان طی 22 سال گذشته: یک گزارش از یک مرکز ناباروری 2 1 مقدمه: اگرچه گزارشهای متعددی در مورد تغییرات زمانی در کیفیت مایع منی از سراسر جهان وجود دارد. در آخرین بررسی شاهد کاهش پیش از حد در کیفیت اسپرم در سراسر جهان بودهایم که این مقاله اولین گزارش از این نوع بررسی در کشور ما است. هدف: ارزیابی تغییرات زمانی بر کیفیت مایع منی در میان جمعیت ایرانی که به پژوهشکده ناباروری مراجعه کردهاند. مواد و روش ها: از طریق یک مطالعه گذشتهنگر, پارامترهای مایع منی 707 مرد مراجعهکننده به مرکز ناباروری در بین سالهای 1990 تا 1992 (گروه اول) با 1108 مرد مراجعهکننده در بین سالهای 2010 تا 2012 (گروه دوم) مقایسه شدند. نتایج: با وجود افزایش غلظت اسپرم از 44/84 از گروه اول تا 55/95 در گروه دوم ولی مورفولوژی طبیعی اسپرم از 2/62 به 4/44 کاهش یافت و گرید A اسپرم (اسپرم با حرکت سریع) از 6/38 تا 6/30 کاهش و گرید B (اسپرم با حرکت آهسته) از 30/21 تا 3/30 افزایش داشتیم و گرید C و گرید D ثابت باقی ماندند. همچنین اثر سن بر پارامترهای اسپرم در هر گروه بررسی کردیم. نتیجه گیری: تغییرات منسجم در کیفیت مایع منی در طول زمان را مشاهده کردیم که نتایج باید از گروههای بزرگتری در آینده مورد بررسی قرار گیرد. 2 Background: Despite numerous reports about temporal changes in semen quality from all over the world, the debates continue. The latest systemic review has shown an overtime decrease in semen quality worldwide. Objective: To assess the temporal changes in the semen quality among Iranian population referred to an infertility center. Materials and Methods: In this retrospective cross-sectional study, semen parameters including concentration, motility, and morphology were compared between Iranian men reffered to Research and Clinical Center for Infertility, Yazd between 1990 to 1992 (group 1, n = 707) and 2010 to 2012 (group 2, n = 1108). Demographic characteristics and semen analysis were collected from the records. The effect of age on semen parameters was also investigated. Results: Despite the increase in sperm concentration l in group 2, sperm with normal morphology decreased significantly (p < 0.001). Grade-A motility decreased (p < 0.001), grade B motility increased (p < 0.001), and grade C and D motile sperm remained constant (p = 0.303 and p = 0.315, respectively). Also, no significant correlation between the age and semen parameters were observed. Conclusion: This study showed inconsistent temporal changes in the participant semen quality. Significant temporal decline were obtained between various semen parameters, sperm morphology and grade A motility. These results should be further evaluated by larger studies in the future. 1059 1064 2020/05/202020/05/122019/05/152019/11/142019/08/182018/12/13 1397/9/22 2020/10/262020/07/292020/06/72020/06/222020/06/202020/06/20 1399/3/31 Serajeddin Vahidi Serajeddin Vahidi Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Vahidi.seraj@gmail.com Mohammad Reza Moein Mohammad Reza Moein Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران moein1339@yahoo.com Fatemeh Yazdinejad Fatemeh Yazdinejad Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران fatemehyazdi1368@yahoo.com Saeed Ghasemi-Esmailabad Saeed Ghasemi-Esmailabad Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Qasemisaeed@yahoo.com Nima Narimani Nima Narimani Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Hasheminejad Kidney Center, Iran University of Medical Science, Tehran, Iran. ایران Nima_dr2001@yahoo.com Infertility Semen quality Temporal changes. ناباروری کیفیت سمن تغییرات وابسته به زمان. Mcdougal WS, Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-walsh urology infertility epidemiology. Philadelphia: Elsevier Health Sciences; 2015.##Monga M, Alexandrescu B, Katz SE, Stein M, Ganiats T. Impact of infertility on quality of life, marital adjustment, and sexual function. Urology 2004; 63: 126-130.##Meacham RB, Joyce GF, Wise M, Kparker A, Niederberger C. Urologic Diseases in America Project. Male infertility. J Urol 2007; 177: 2058-2066.##Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. BMJ 1992; 305: 609-613.##Fisch H, Braun SR. Trends in global semen parameter values. Asian J Androl 2013; 15: 169-173.##Cocuzza M, Esteves SC. Shedding light on the controversy surrounding the temporal decline in human sperm counts: a systematic review. Sci World Journal 2014; 2014: 365691: 1-10.##Geoffroy-Siraudin C, Loundou AD, Romain F, Achard V, Courbière B, Perrard MH, et al. Decline of semen quality among 10 932 males consulting for couple infertility over a 20-year period in Marseille, France. Asian J Androl 2012; 14: 584-590.##Shine R, Peek J, Birdsall M. Declining sperm quality in New Zealand over 20 years. N Z Med J 2008; 121: 50-56.##Berling S, Wolner-Hanssen P. No evidence of deteriorating semen quality among men in infertile relationships during the last decade: a study of males from Southern Sweden. Hum Reprod 1997; 12: 1002-1005.##Fisch H, Goluboff ET, Olson JH, Feldshuh J, Broder SJ, Barad DH. Semen analyses in 1,283 men from the United States over a 25-year period: no decline in quality. Fertil Steril 1996; 65: 1009-1014.##Fisch H. Declining worldwide sperm counts: disproving a myth. Urol Clin North Am 2008; 35: 137-146.##World Health Organisation. WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. UK: Concern Singapore Press; 1987.##World Health Organization. WHO Laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4th ed. UK: Cambridge University Press; 1999.##Buck Louis GM, Sundaram R, Schisterman EF, Sweeney A, Lynch CD, Kim S, et al. Semen quality and time to pregnancy: the longitudinal investigation of fertility and the environment study. Fertil Steril 2014; 101: 453-462.##Hamilton JA, Cissen M, Brandes M, Smeenk JM, de Bruin JP, Nelen WL, et al. Total motile sperm count: a better indicator for the severity of male factor infertility than the WHO sperm classification system. Hum Reprod 2015; 30: 1110-1121.##Mukhopadhyay D, Varghese AC, Pal M, Banerjee SK, Bhattacharyya AK, Sharma RK, et al. Semen quality and age-specific changes: a study between two decades on 3,729 male partners of couples with normal sperm count and attending an andrology laboratory for infertility-related problems in an Indian city. Fertil Steril 2010; 93: 2247-2254.##Selevan ShG, Borkovec L, Slott VL, Zudova Z, Rubes J, Evenson DP, et al. Semen quality and reproductive health of young Czech men exposed to seasonal air pollution. Environmental Health Perspectives 2000; 108: 887-894.##Jorgensen N, Joensen UN, Jensen TK, Jensen MB, Almstrup K, Olesen IA, et al. Human semen quality in the new millennium: a prospective cross-sectional population-based study of 4867 men. BMJ Open 2012; 2: e000990.##Rolland M, Le Moal J, Wagner V, Royere D, De Mouzon J. Decline in semen concentration and morphology in a sample of 26,609 men close to general population between 1989 and 2005 in France. Hum Reprod 2013; 28: 462-470.##Itoh N, Kayama F, Tatsuki J, Tsukamoto T. Have sperm counts deteriorated over the past 20 years in healthy, young Japanese men? Results from the Sapporo area. J Androl 2001; 22: 40-44.##Costello MF, Sjoblom P, Haddad Y, Steigrad SJ, Bosch EG. No decline in semen quality among potential sperm donors in Sydney, Australia, between 1983 and 2001. J Assist Reprod Genet 2002; 19: 284-290.##Vahidi S, Ardalan A, Mohammad K. Prevalence of primary infertility in the Islamic Republic of Iran in 2004-2005. Asia Pac J Public Health 2009; 21: 287-293.## ##

Analysis of factors associated with ovarian reserve in a group of poor responders to in vitro fertilization: A cross-sectional study بررسی عوامل مرتبط با ذخیره تخمدان در یک گروه با پاسخ ضعیف به لقاح آزمایشگاهی: یک مطالعه موضعی مقطعی 2 1 مقدمه: ذخیره پایین تخمدان و میزان بالای عدم موفقیت حاملگی با تخمکهای با تعداد کم و کیفیت نامناسب در افرادی که پاسخ ضعیف به لقاح آزمایشگاهی دارند مشاهده شده است. هدف: بررسی اثر سن، میزان توده بدنی، آندومتریوز و سابقه جراحی تخمدان بر روی ذخیره تخمدان در یک گروه با پاسخ ضعیف به لقاح آزمایشگاهی. مواد و روش ها: در این مطالعه موضعی مقطعی 749 زن که به کلینیک یاسمین بیمارستان عمومی ملی دکتر سیپتومانگونکوسومو ارجاع شده بودند از ژانویه 2013 تا ژوئن 2017 مورد مطالعه قرار گرفتند. دو تعریف پاسخ ضعیف و کریتریای پوسیدون استفاده شد و نمونهگیری به روش متوالی انجام شد. شرکتکنندگان بر اساس آزمایش ذخیره تخمدان به دو گروه با پاسخ ضعیف و خوب تقسیم شدند. شرکتکنندگانی که کمتر یا مساوی 3 تخمک داشتند در گروه با پاسخ ضعیف قرار گرفتند. بر این اساس 188 شرکتکننده با 9 تخمک (4 تا 47) در گروه با پاسخ ضعیف قرار گرفتند در حالیکه گروه با پاسخ خوب 2 تخمک (0 تا 3) داشتند. نتایج: سن و هورمون آنتیمولرین به طور معنیداری در ارتباط با ذخیره تخمدان در گروه با پاسخ ضعیف بود. در آنالیز چند متغیره سن تنها پیشگوییکننده پاسخ تخمدان در گروه با پاسخ ضعیف بود. آندومتریوز پیشگوییکننده معنیدار در گروههای پوسیدون 1 و 4 بود در حالیکه سابقه جراحی پیشگوییکننده معنیدار در گروههای پوسیدون 2 و 3 بود. نهایتا افزایش توده متوسط بدنی باعث کاهش ریسک طبقبندی شدن در گروه 3 پوسیدون شد. نتیجه گیری: سن، هورمون آنتیمولرین، متوسط توده بدنی، آندومتریوز و سابقه جراحی تخمدان میتوانند ریسک طبقهبندی شدن در گروههای پوسیدون را تحت تأثیر قرار دهد. 2 Background: Poor ovarian reserve and a high rate of pregnancy failure associated with low quality and quantity of oocytes are observed in poor responders to in vitro fertilization. Objective: To assess the effect of age, body mass index (BMI), endometriosis, and history of ovarian surgery on ovarian reserve in a group of poor responders. Materials and Methods: In this cross-sectional study 749 women who referred to Yasmin Clinic of Dr. Cipto Mangunkusumo National General Hospital from January 2013 to June 2017 were enrolled. Two definitions of poor responders and Poseidon criteria and consecutive sampling techniques were used. Participants were divided into good and poor responder groups based on the ovarian reserve test; participant with oocyte ≤ 3 was classified as a poor responder. Based on this, 188 participants with nine (4-47) oocytes were included in the poor responder group. While, good responder comprised of two (0-3) oocytes. Results: Age and anti-Mullerian hormone level (AMH) were significantly associated with ovarian reserve in the poor-responder group (p < 0.001). However, in multivariate analyses, age was the only significant predictor of ovarian response in the poor-responder group (p = 0.004). While endometriosis was the significant predictor of Poseidon groups 1 and 4, surgical history was the significant predictor of Poseidon groups 2 and 3. Meanwhile, an increase in BMI decreased the risk of classification under Poseidon group 3. Conclusion: Age, AMH, BMI, endometriosis, and history of ovarian surgery affected the risk of classification of the Poseidon group. 1065 1072 2020/05/202020/05/122019/05/152019/11/142019/08/182018/12/132019/08/22 1398/5/31 2020/10/262020/07/292020/06/72020/06/222020/06/202020/06/202020/04/18 1399/1/30 Budi Wiweko Budi Wiweko Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی wiwekobudi@yahoo.co.id Quamila Fahrizani Afdi Quamila Fahrizani Afdi Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی quamilaafdi@gmail.com Achmad Kemal Harzif Achmad Kemal Harzif Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی kemal.achmad@gmail.com Gita Pratama Gita Pratama Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی gitapratama@yahoo.com Kanadi Sumapraja Kanadi Sumapraja Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی kanadisuma@yahoo.com Raden Muharam Raden Muharam Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی r.muharam@yahoo.com Andon Hestiantoro Andon Hestiantoro Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی hestiantoro@gmail.com Sarah Chairani Zakirah Sarah Chairani Zakirah Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. اندونزی sarahchairani@gmail.com Ovarian reserve Poseidon In vitro fertilization. ذخیره تخمدان پوسیدون لقاح آزمایشگاهی. Stern K. Assisted reproductive technology: What's new and what's important? Aust Fam Physician 2012; 41: 762-768.##Ferraretti AP, Marca AL, Fauser B, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of "poor response" to ovarian stimulation for in vitro fertilization: The bologna criteria. Hum Reprod 2011; 26: 1616-1624.##Liu KE, Case A. Advanced reproductive age and fertility. J Obstet Gynaecol Can 2011; 33: 1165-1167.##Disseldorp JV, Eijkemans R, Fauser B, Broekmans F. Hypertensive pregnancy complications in poor and normal responders after in vitro fertilization. Fertil Steril 2010; 93: 652-657.##Mouzon Jd, Goossens V, Bhattacharya S, Castilla JA, Ferraretti AP, Korsak V, et al. Assisted reproductive technology in Europe, 2006: Results generated from European registers by ESHRE. Hum Reprod 2010; 25: 1851-1162.##PERFITRI. Laporan IVF di Indonesia [unpublished organization report]. Perhimpunan Fertilisasi In Vitro Indonesia; 2012.##Yasmin IVF Clinic. Laporan Tahunan Klinik Yasmin [unpublished clinic report]. Klinik Yasmin, Dr.Cipto Mangunkusumo General Hospital; 2014.##Yasmin IVF Clinic. Laporan Tahunan Klinik Yasmin [unpublished clinic report]. Klinik Yasmin, Dr.Cipto Mangunkusumo General Hospital; 2015.##Fauser BCJM, Diedrich K, Devroey P, Evian Annual Reproduction Workshop Group 2007. Predictors ov ovarian response: Progress towards individualized treatment in ovulation induction and ovarian stimulation. Hum Reprod Update 2008; 14: 1-14.##Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Repod Update 2006; 12: 685-718.##Broekmans FJ, Knauff EAH, te Velde ER, Macklon NS, Fauser BC. Female reproductive ageing: Current knowledge and future trends. Trends Endocrinol Metab 2007; 18: 58-65.##Findlay JK, Hutt KJ, Hickey M, Anderson RA. What is the "ovarian reserve"? Fertil Steril 2015; 103: 628-630.##Wiweko B, Hestiantoro A, Sumapraja K, Natadisastra M, Febia E, Andriyana H, et al. Anti mullerian hormone serum level indicates ovarian response in controlled ovarian hyperstimulation of IVF Cycles. Indones J Obstet Gynecol 2010; 34: 114-118.##Padhy N, Gupta S, Mahla A, Latha M, Varma T. Demographic characteristic and clinical profile of poor responders in IVF/ ICSI: A comparative study. J Hum Reprod Sci 2012; 3: 91-94.##Ubaldi F, Vaiarelli A, D Anna R, Rienzi L. Management of poor responders in IVF: Is there anything new? BioMed Res Int 2014; 2014: 1-11.##Fritz MA, Speroff L. Clinical gynecology endocrinology and infertility. Philadelphia: Lippincott Williams & Wilkins; 2011: 107-113.##Pasquali R, Pelusi C, Genghini S, Cacciari M, Gambineri A. Obesity and reproductive disorders in women. Hum Reprod Update 2003; 9: 359-372.##Kitajima M, Defrere S, Dolmans MM, Colette S, Squifflet J, Langendonckt AV, et al. Endometriomas as a possible cause of reduced ovarian reserve in women with endometriosis. Fertil Steril 2011; 96: 685-691.##Kitajima M, Masuzaki H. Ovarian reserve in patients with endometriosis. In Harada T, editor. Endometriosis: Pathogenesis and Treatment. 26th chapter. Japan: Springer; 2014. 419-429.##Alviggi C, Andersen CY, Buehler K, Conforti A, De Placido G, Esteves SC, et al. A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil Steril 2016; 105: 1452-1453.##Humaidan P, Alviggi C, Fischer R, Esteves SC. The novel POSEIDON stratification of ' Low prognosis patients in Assisted Reproductive Technology' and its proposed marker of successful outcome. F10000Res 2016; 5: 2911-2921.##Halawaty S, ElKattan E, Azab H, ElGhamry N, Al-Inany H. Effect of obesity on parameters of ovarian reserve in premenopausal women. J Obstet Gynaecol Can 2010; 32: 687-690.##Wiweko B, Maidarti M, Priangga MD, Shafira N, Fernando D, Sumapraja K, et al. Anti-mullerian hormone as a diagnostic and prognostic tool for PCOS patients. J Assist Reprod Genet 2014; 31: 1311-1316.##Fruzzetti F, Perini D, Lazzarini V, Parrini D, Genazzani AR. Adolescent girls with polycystic ovary syndrome showing different phenotypes have a different metabolic profile associated with increasing androgen levels. Fertil Steril 2009; 92: 626-634.##Freeman EW, Gracia CR, Sammel MD, Lin H, Lim LCL, Strauss JF. Association of AMH levels with obesity in late reproductive age women. Fertil Steril 2007; 87: 101-106.##De Pergola G, Maldera S, Tartagni M, Pannacciulli N, Loverro G, Giorgino R. Inhibitory effect of obesity on gonadotropin, estradiol, and inhibin B Levels in fertile women. Obesity (Silver Spring) 2006; 14: 1954-1960.##Su HI, Sammel MD, Freeman EW, Lin H, DeBlasis T, Gracia CR. Body size affects measures of ovarian reserve in late reproductive age women. Menopause 2008; 15: 857-861.##Lemos NA, Arbo E, Scalco R, Weiler E, Rosa V, Cunha-Filho JS. Decreased antimüllerian hormone and altered ovarian follicular cohort in infertile patients with mild/minimal endometriosis. Fertil Steril 2008; 89: 1064-1068.##Dokras A, Habana A, Giraldo J, Jones E. Secretion of inhibin B during ovarian stimulation is decreased in infertile women with endometriosis. Fertil Steril 2000; 74: 35-40.##Hwu YM, Wu FSY, Li SH, Sun FJ, Lin MH, Lee RKK. The impact of endometrioma and laparoscopic cystectomy on serum anti-Mullerian hormone levels. Reprod Biol Endocrinol 2011; 9: 80-87.##Uncu G, Kasapoglu I, Ozerkan K, Seyhan A, Oral Yilmaztepe A, Ata B. Prospective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve. Hum Reprod 2013; 28: 2140-2145.##Kitajima M, Newaz Khan K, Harada A, Taniguchi K, Inoue T, Kaneuchi M, et al. Association between ovarian endometrioma and ovarian reserve. Front Biosci 2018; 10: 92-102.##Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril 2012; 98: 591-598.##Lind T, Hammarström M, Lampic C, Rodriguez-Wallberg K. Anti-Müllerian hormone reduction after ovarian cyst surgery is dependent on the histological cyst type and preoperative anti-Müllerian hormone levels. 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Radioprotective effect of a combination of melatonin and metformin on mice spermatogenesis: A histological study ارزیابی اثر محافظت پرتوی ترکیب ملاتونین و متفورمین بر سیستم اسپرماتوژنسیس موش سوری: مطالعه هیستوپاتولوژی 2 1 مقدمه: سیستم اسپرماتوژنسیس شامل سلولهایی با حساسیت پرتوی بالا مثل اسپرماتوگونی که اسپرمهای بالغ را بوجود میآورند، میباشد. از این رو این سیستم هدفی است برای اثرات سمی بودن پرتوهای یونیزان در طول رادیوتراپی سرطان شکم و لگن و نیز پرتودهی تصادفی. بعضی مطالعات استفاده از رادیوپروتکتورها را برای محافظت از سلولهای با حساسیت بالا به پرتو درون بیضهها پیشنهاد کردهاند. ملاتونین و متفورمین دو رادیوپروتکتور مهمی هستند که توانایی آنها در محافظت از مرگ سلولها از طریق خنثی کردن رادیکالهای آزاد و تحریک پاسخ به DNA آسیب دیده نشان داده شده است. هدف: این مطالعه به هدف ارزیابی اثرات رادوپروتکتیوی ملاتونین و متفورمین روی سیستم اسپرماتوژنسیس موشها وقتی بصورت تنها و ترکیبی تزریق میشوند انجام شده است. مواد و روش ها: موشها به هشت گروه تقسیم میشوند: کنترل، ملاتونین، متفورمین، متفورمین + ملاتونین، تابش پرتو، متفورمین+پرتو، ملاتونین+ پرتو، و متفورمین+ملاتونین+ پرتو. 37 روز پس از پرتودهی بافتهای بیضه برای ارزیابی هیستولوژیکی جمعآوری میشوند. نتایج: تزریق ملاتونین به تنهایی اثرات سمی پرتوها در بیضهی موشها را بطور موثری بهبود میبخشد. متفورمین اثرات محافظت پرتوی روی برخی پارامترها مثل تعداد اسپرماتوگونی و تعداد اسپرمهای بالغ را نشان میدهد. ترکیب ملاتونین و متفورمین بطور موثری میتواند کاهش تعداد اسپرمهای را در مقایسه با تزریق هریک از این داروها به تنهایی به طور موثرتری جبران نماید. نتیجه گیری: ترکیب ملاتونین با متفورمین میتواند بطور موثری سییستم اسپرماتوژنسیس موشها را در برابر پرتوهای یونیزان نسبت به تزریق هر یک به تنهایی محافظت کند. 2 Background: The spermatogenesis system includes highly radiosensitive cells. Hence, this system is a potential target for toxic effects of ionizing radiation during radiotherapy of abdomen and pelvis cancers, as well as after accidental radiation events. Accordingly, metformin and melatonin are two important radioprotectors that have shown an ability to prevent cell death through neutralization of free radicals and stimulating DNA damage responses. Objective: To evaluate the radioprotective effects of melatonin and metformin on mice spermatogenesis when administered alone or as a combination. Materials and Methods: In this histological Study, 40 (6-8 wk, 30 gr) NMRI mice were divided into 8 groups (n = 5/each) as control, metformin, melatonin, melatonin + metformin, radiation, radiation + melatonin, radiation + metformin, and radiation + melatonin + metformin. 37 days after the irradiation, the testicular tissues were collected for histological evaluation. Results: Single administration of melatonin could ameliorate effectively radiation toxicity in mice testis. Metformin showed radioprotective effects on some parameters such as the numbers of spermatogonia and mature sperms. Interestingly, the melatonin and metformin combination reversed the reduced number of sperms rather than single drug administration. Conclusion: The combination of melatonin with metformin can protect mice spermatogenesis against ionizing radiation more effectively compared to the single forms of these drugs. 1073 1080 2020/05/202020/05/122019/05/152019/11/142019/08/182018/12/132019/08/222019/09/8 1398/6/17 2020/10/262020/07/292020/06/72020/06/222020/06/202020/06/202020/04/182020/06/27 1399/4/7 Elham Tajabadi Elham Tajabadi Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran. ایران elhamtajabadi91@yahoo.com Abdolreza Javadi Abdolreza Javadi Department of Pathology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ایران reza.javadi@sbmu.ac.ir Nasim Ahmadi Azar Nasim Ahmadi Azar Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran. ایران nassim_ahmadiazar@yahoo.com Masoud Najafi Masoud Najafi Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran. Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran. ایران najafi_ma@yahoo.com Alireza Shirazi Alireza Shirazi Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Radiation Oncology Department, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. ایران shirazia@sina.tums.ac.ir Dheyauldeen Shabeeb Dheyauldeen Shabeeb Department of Physiology, College of Medicine, University of Misan, Misan, Iraq. عراق zahamtop5@gmail.com Ahmed Eleojo Musa Ahmed Eleojo Musa Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences (International Campus), Tehran, Iran. ایران ahmedmusaele@yahoo.com Radiation Testis Leydig cells Melatonin Metformin Spermatogenesis. پرتو بیضه اسپرماتوگونی ملاتونین متفورمین اسپرماتوژنسیس. Macià i Garau M, Lucas Calduch A, López EC. Radiobiology of the acute radiation syndrome. Reports of Practical Oncology & Radiotherapy 2011; 16: 123-130.##Barnett GC, West CML, Dunning AM, Elliott RM, Coles CE, Pharoah PDP, et al. Normal tissue reactions to radiotherapy: towards tailoring treatment dose by genotype. Nat Rev Cancer 2009; 9: 134-142.##Mahmood J, Jelveh S, Calveley V, Zaidi A, Doctrow SR, Hill RP. Mitigation of lung injury after accidental exposure to radiation. Radiat Res 2011; 176: 770-780.##Dorr H, Meineke V. Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles. BMC Med 2011; 9: 126-131.##Marjault HB, Allemand I. Consequences of irradiation on adult spermatogenesis: Between infertility and hereditary risk. Mutat Res 2016; 770: 340-348.##Grewenig A, Schuler N, Rübe CE. Persistent DNA damage in spermatogonial stem cells after fractionated low-dose irradiation of testicular tissue. Int J Radiat Oncol Biol Phys 2015; 92: 1123-1131.##Takino S, Yamashiro H, Sugano Y, Fujishima Y, Nakata A, Kasai K, et al. Analysis of the effect of chronic and low-dose radiation exposure on spermatogenic cells of male large Japanese field mice (Apodemus speciosus) after the Fukushima Daiichi nuclear power plant accident. Radiat Res 2017; 187: 161-168.##Fukunaga H, Butterworth KT, Yokoya A, Ogawa T, Prise KM. Low-dose radiation-induced risk in spermatogenesis. Int J Radiat Biol 2017; 93: 1291-1298.##Shakhov AN, Singh VK, Bone F, Cheney A, Kononov Y, Krasnov P, et al. Prevention and mitigation of acute radiation syndrome in mice by synthetic lipopeptide agonists of Toll-like receptor 2 (TLR2). PloS One 2012; 7: e33044. 1-12.##Najafi M, Cheki M, Hassanzadeh Gh, Amini P, Shabeeb D, Musa AE. The radioprotective effect of combination of melatonin and metformin on rat duodenum damage induced by ionizing radiation: A histological study. Adv Biomed Res 2019; 8: 51-61.##Farhood B, Aliasgharzadeh A, Amini P, Rezaeyan A, Tavassoli A, Motevaseli E, et al. Mitigation of radiation-induced lung pneumonitis and fibrosis using metformin and melatonin: A histopathological study. Medicina 2019; 55: 417-426.##Mahdavi M, Mozdarani H. Protective effects of famotidine and vitamin C against radiation induced cellular damage in mouse spermatogenesis process. Iran J Radiat Res 2011; 8: 223-230.##Asghari A, Akbari Gh, Meghdadi A, Mortazavi P. Effects of melatonin and metformin co-administration on testicular ischemia/reperfusion injury in rats. J Pediatr Urol 2016; 12: 410. e1-e7.##Ghanbari E, Nejati V, Khazaei M. 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Intraovarian insertion of autologous platelet growth factors as cell-free concentrate: Fertility recovery and first unassisted conception with term delivery at age over 40 2 1 مقدمه: استفاده از پلاسمای غنی از پلاکت اتولوگ به عنوان درمان تخمدانی هنوز استاندارد نشده و محل مناقشه میباشد. مورد: یک خانم 41 و نیم ساله با کاهش ذخیره تخمدان (هورمون آنتیمولرین سرم 163/0 میلیگرم در میلیلیتر) و با تاریخچه 10 بار IVF ناموفق برای مشاوره اندوکرینولوژی مراجعه کرد. او و همسرش از قبول تخمک اهدایی خودداری کردند. هر دو در وضعیت خوب سلامتی بوده و تستهای آزمایشگاهی طبیعی بود بجز ترومبوسیتوز ملایم که در خانم مشاهده شد. بیمار تحت تزریق داخل تخمدانی عصاره فاکتور رشد پلاکتی تازه به همراه ماده بدون سلول غنی شده قرار گرفت. هورمون آنتیمولرین سرم بعد از 6 هفته درمان به میزان 115% افزایش یافت. تخمکگذاری خودبخودی در ماه بعد از تزریق مشاهده شد و سرم جفتی گونادوتروپین به میزان 804 میلی واحد در میلیلیتر مشاهده شد. بعد یک حاملگی بیخطر ترم یک نوزاد پسر بدون عارضه متولد شد. نتیجه گیری: این اولین مورد گزارش شده تزریق داخل تخمدانی عصاره فاکتور رشد پلاکتی تازه و به دنبال آن وقوع بدون کمک حاملگی و تولد یک نوزاد زنده میباشد. به عنوان یک روش بهبود یافته درمان عرفی با پلاسمای غنی از پلاکت این روش ممکن است که در درمان مواردی که نتیجه درمانهای کمک به باروری قبلی شکست خورده، موفقتر باشد. نقش عرفی ترومبوسیتوز به موازات عملکردهای دیگر اثبات شده است. با ادامه تجربه در استفاده از فاکتورهای رشد پلاکت اتولوگ در تخمدان، تحقیقات بیشتر پروتکلهای آزمایشگاهی / آمادهسازی نمونه، روش تزریق و انتخاب بیمار را مشخص خواهد نمود. 2 Background: The use of autologous platelet-rich plasma as an ovarian treatment has not been standardized and remains controversial. Case Presentation: A 41½-year old woman with diminished ovarian reserve (serum anti- Müllerian hormone= 0.163 mg/mL) and a history of 10 unsuccessful in vitro fertilization cycles presented for reproductive endocrinology consult. She and her partner declined donor oocyte in vitro fertilization. They were both in good general health and laboratory tests were unremarkable, except for mild thrombocytosis (platelets = 386K; normal range 150-379K) discovered in the female. The patient underwent intraovarian injection of fresh platelet-derived growth factor concentrate administered as an enriched cell-free substrate. Serum anti- Müllerian hormone increased by 115% within 6 wks of treatment. Spontaneous ovulation occurred the month after injection and subsequently the serum human chorionic gonadotropin was noted at 804 mIU/mL. Following an uneventful obstetrical course, a male infant was delivered at term without complication. Conclusion: This is the first description of intraovarian injection of enriched platelet-derived growth factors followed by unassisted pregnancy and live birth. As a refinement of conventional ovarian platelet-rich plasma therapy, this procedure may be particularly valuable for refractory cases where prognosis for pregnancy appears especially bleak. A putative role for thrombocytosis is also viewed in parallel with mechanisms of action as advanced earlier. With continued experience in ovarian application of autologous platelet growth factors, additional research will evaluate laboratory protocol/sample preparation, injection technique, and patient selection. 1081 1086 2020/05/202020/05/122019/05/152019/11/142019/08/182018/12/132019/08/222019/09/82020/07/18 1399/4/28 2020/10/262020/07/292020/06/72020/06/222020/06/202020/06/202020/04/182020/06/272020/10/28 1399/8/7 E. Scott Sills E. Scott Sills Reproductive Biology Group IVF, San Clemente, California USA. Department of Obstetrics and Gynecology, Palomar Medical Center; Escondido, California USA. Gen 5 Fertility Center; San Diego, California USA. آمریکا ess@prp.md Natalie S Rickers Natalie S Rickers Reproductive Biology Group IVF, San Clemente, California USA. Gen 5 Fertility Center; San Diego, California USA. آمریکا Samuel H Wood Samuel H Wood Department of Obstetrics and Gynecology, Palomar Medical Center; Escondido, California USA. Gen 5 Fertility Center; San Diego, California USA. آمریکا Ovarian rejuvenation Platelet-rich plasma Cytokines Infertility IVF. جوان سازی تخمدان پلاسمای غنی از پلاکت یوتوکین ها ناباروری IVF. Lefebvre J, Antaki R, Kadoch IJ, Dean NL, Sylvestre C, Bissonnette F, et al. 450 IU versus 600 IU gonadotropin for controlled ovarian stimulation in poor responders: A randomized controlled trial. Fertil Steril 2015; 104: 1419-1425.##Ghahremani-Nasab M, Ghanbari E, Jahanbani Y, Mehdizadeh A, Yousefi M. Premature ovarian failure and tissue engineering. J Cell Physiol 2020; 235: 4217-4226.##Sills ES, Brady AC, Omar AB, Walsh DJ, Salma U, Walsh APH. IVF for premature ovarian failure: first reported births using oocytes donated from a twin sister. Reprod Biol Endocrinol 2010; 8: 31-33.##Pantos K, Nitsos N, Kokkali G, Vaxevanoglou T, Markomichali C, Pantou A, et al. Ovarian rejuvenation and folliculogenesis reactivation in peri-menopausal women after autologous platelet-rich plasma treatment. Hum Reprod 2016 (Suppl.): P-401.##Sills ES, Rickers NS, Li X, Palermo GD. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate-activated autologous platelet rich plasma. Gynecol Endocrinol 2018; 34: 756-760.##Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pantou A, Vaxevanoglou T, et al. A case series on platelet-rich plasma revolutionary management of poor responder patients. Gynecol Obstet Invest 2019; 84: 99-106.##Sills ES, Rickers NS, Svid Ch, Rickers JM, Wood SH. Normalized ploidy following 20 consecutive blastocysts with chromosomal error: Healthy 46,XY pregnancy with IVF after intraovarian injection of autologous enriched platelet-derived growth factors. Int J Mol Cell Med 2019; 8: 84-90.##Sills ES, Rickers NS, Petersen JL, Li X, Wood SH. Regenerative effect of intraovarian injection of autologous platelet rich plasma: Serum anti-Mullerian hormone levels measured among poor-prognosis in vitro fertilization patients. Int J Regen Med 2020: 3: 1-5.##Steller D, Herbst N, Pries R, Juhl D, Hakim SG. Impact of incubation method on the release of growth factors in non-Ca2+-activated PRP, Ca2+-activated PRP, PRF and A-PRF. J Craniomaxillofac Surg 2019; 47: 365-372.##Théry C, Amigorena S, Raposo G, Clayton A. Isolation and characterization of exosomes from cell culture supernatants and biological fluids. Curr Protoc Cell Biol 2006; 30: 302201-3022029.##Guo ShCh, Tao ShC, Yin WJ, Qi X, Yuan T, Zhang ChQ. Exosomes derived from platelet-rich plasma promote the re-epithelization of chronic cutaneous wounds via activation of YAP in a diabetic rat model. Theranostics 2017; 7: 81-96.##Marron KD, Sills ES, Cummins PL, Harrity C, Walsh DJ, Walsh AP. Impact of pre-mixing AMH serum samples with standard assay buffer: Ovarian reserve estimations and implications for clinical IVF providers. J Reprod Endocrinol Infertil 2016; 2: 10.##Rosenwaks Z, Navot D, Veeck L, Liu HC, Steingold K, Kreiner D, et al. Oocyte donation. The norfolk program. Ann N Y Acad Sci 1988; 541: 728-741.##Sauer MV, Paulson RJ, Lobo RA. Reversing the natural decline in human fertility: An extended clinical trial of oocyte donation to women of advanced reproductive age. JAMA 1992; 268: 1275-1279.##https://doi.org/10.1001/jama.1992.03490100073030##Gu Y, Xu Y. Successful spontaneous pregnancy and live birth in a woman with premature ovarian insufficiency and 10 years of amenorrhea: A case report. Front Med 2020; 7: 18.##Sills ES, Wood SH. Autologous activated platelet rich plasma injection into adult human ovary tissue: Molecular mechanism, analysis, and discussion of reproductive response. Biosci Rep 2019; 39: pii: BSR20190805. 1-15.##Johnson J, Canning J, Kaneko T, Pru JK, Tilly JL. Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 2004; 428: 145-150.##Zhang S, Li P, Yuan Zh, Tan J. Effects of platelet-rich plasma on activity of human menstrual blood-derived stromal cells in vitro. Stem Cell Res Ther 2018; 48: 1-11.##Zhang S, Li P, Yuan Zh, Tan J. Platelet-rich plasma improves therapeutic effects of menstrual blood-derived stromal cells in rat model of intrauterine adhesion. Stem Cell Res Ther 2019; 61: 1-12.##Wood SH, Sills ES. Intraovarian vascular enhancement by stromal injection of platelet-derived growth factors: Exploring subsequent oocyte chromosomal status and IVF outcomes. Clin Exp Reprod Med 2020; 47: 94-100.##Marschalek J, Ott J, Aitzetmueller M, Mayrhofer D, Weghofer A, Nouri K, et al. The impact of repetitive oocyte retrieval on the ovarian reserve: a retrospective cohort study. Arch Gynecol Obstet 2019; 299: 1495-1500.##Hatırnaz Ş, Tan SL, Hatırnaz E, Çelik Ö, Kanat-Pektaş M, Dahan MH. Vaginal ultrasound-guided ovarian needle puncture compared to laparoscopic ovarian drilling in women with polycystic ovary syndrome. Arch Gynecol Obstet 2019; 299: 1475-1480.## ##

Corrigendum to “The effectiveness of counseling based on acceptance and commitment therapy on body image and self-esteem in polycystic ovary syndrome: An RCT” [Int J Reprod BioMed 2020; 18: 243–252] 2 2 The authors have been informed of an error that occurred on table 3, page 248 in which correct form of the table is as follows: Table III. Comparison of mean scores of body image concern and self-esteem and its changes before the intervention, after the intervention, and follow-up in two groups Variable Intervention group Control group P-value* Body image concern Before intervention 40.84 ± 13.50 44.07 ± 9.71 0.32* After intervention 37.04 ± 12.69 44.46 ± 10.68 0.03* Follow-up 36.22 ± 12.28 43.60 ± 10.91 0.03* P-value** 0.001** 0.105** Self-esteem Before intervention 28.34 ± 5.69 29.11 ± 3.37 0.55* After intervention 31.82 ± 4.96 29.42 ± 3.36 0.05* Follow-up 30.59 ± 5.40 30.73 ± 4.30 0.92* P-value** < 0.001** 0.006** Data presented as Mean ± SD; *Independent t test; **Test of within-subject contrasts of repeated measures On behalf of the author, the publisher wishes to apologize for this error. The online version of article has been updated on December 2020. 1087 1087 2020/05/202020/05/122019/05/152019/11/142019/08/182018/12/132019/08/222019/09/82020/07/182020/12/26 1399/10/6 2020/10/262020/07/292020/06/72020/06/222020/06/202020/06/202020/04/182020/06/272020/10/282020/12/20 1399/9/30 Fatemeh Moradi Fatemeh Moradi Student Research Committee, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Akram Ghadiri-Anari Akram Ghadiri-Anari Department of Internal Medicine, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Ali Dehghani Ali Dehghani Department of Biostatistics and Epidemiology, Public Health School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Seyed Reza Vaziri Seyed Reza Vaziri Clinical Psychologist, Private Counseling Center of Negaresh, Yazd, Iran. ایران Behnaz Enjezab Behnaz Enjezab Department of Midwifery, Research Center for Nursing and Midwifery Care, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران self-esteem polycystic Corrigendum ## ##