Differences between living and deceased donation in human uterus transplantation: A narrative review تفاوت های اهدا زنده و مرده در پیوند رحم در انسان: یک مرور روایتی 2 1 تصمیم برای استفاده از اهداکننده زنده یا مرده برای انجام پیوند رحم، یک ارزیابی سود و زیان است و اساسا بر پایه انتخابهای تیم پزشکی میباشد. مطالعه حاضر جهت تعیین تفاوتهای بین اهدا زنده و مرده در پیوند رحم در انسان بر اساس عوامل تعیینکننده در انتخاب نوع اهداکننده، طراحی شد. جهت انجام این مطالعه مروری، پایگاه اطلاعاتی PubMed بدون محدودیت زمانی، زبانی و مکانی تا می 2022 جستجو شد. از 113 مقاله شناسایی شده، 45 مقاله برای بررسی، وارد مطالعه شد. براساس نتایج، در مقایسه با اهدا زنده، بزرگترین مزیت اهدا مرده، فقدان خطرات جراحی و یا روانی برای اهداکننده میباشد. در مقابل در اهدا مرده، ارزیابی پزشکی جامع قبل از پیوند، کمتر امکان پذیر است و جراحی از قبل برنامهریزی شده، ممکن نیست. براساس یافتههای کارآزماییهای بالینی داوری شده انتشار یافته، میزان شکست گرفت در پیوند رحم با استفاده از اهداکننده زنده و مرده به ترتیب 21% و 36% میباشد. با فرض اینکه همه گیرندههایی که شکست گرفت نداشتهاند تحت انتقال جنین قرار گرفته باشند، میزان تولد زنده در پروسیجرهای پیوند رحم با استفاده از اهداکننده زنده و مرده به ترتیب تقریبا 63% و 71% میباشد. در حال حاضر با توجه به وقوع تولد زنده از هر دو نوع اهدا به ویژه از اهداکننده مرده نولی پار، افزایش تقاضا برای پیوند رحم در آینده نزدیک، کمبود گرفتهای رحمی و فقدان داده کافی جهت مقایسه کامل دو نوع اهدا، استفاده از هر دو اهدا هنوز هم ضروری و منطقی به نظر میرسد. 2 The decision to use a living or deceased donor to perform uterus transplantation (UTx) is an evaluation of benefit and harm and is based on the medical team’s choices. The current study determines the differences between living and deceased donation in human UTx according to determinant factors in choosing the donor type. For this review study, the PubMed database was searched without time, language, and location limitations up to May 2022. From 113 identified articles, 45 papers were included in the study for review. According to the results, in comparison to living donation, the biggest advantage of deceased donation is the lack of surgical and or psychological risks for the donor. In contrast, a comprehensive pre-transplantation medical assessment is less possible in deceased donation, and preplanned surgery cannot be realized. According to published peer-reviewed clinical trials on UTx, the graft failure rates in living and deceased donor UTx are 21% and 36%, respectively. Supposing all recipients who did not have graft failure underwent embryo transfer, live birth rates in living and deceased donor UTx procedures are almost 63% and 71%, respectively. Currently, considering the occurrence of live births from both donations, particularly from nulliparous deceased donor, increased demand for UTx in the near future, shortage of uterus grafts, and lack of sufficient data for a comprehensive comparison between the 2 types of donation, the use of both donations still seems necessary and rational. 193 204 2022/07/25 1401/5/3 2023/01/21 1401/11/1 Sakineh Taherkhani Sakineh Taherkhani School of Medicine, Arak University of Medical Sciences, Arak, Iran. ایران sakinehtaherkhani@yahoo.com Living donors Deceased donors Brain death donors Uterus transplantation Absolute uterine factor infertility Review. اهداکنندگان زنده اهداکنندگان مرده اهداکنندگان مرگ مغزی پیوند رحم نازایی رحمی مطلق مطالعه مروری. Froněk J, Janousek L, Chmel R. 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Uterine artery Doppler and endometrial blood flow in frozen embryo transfer: A cohort study داپلر شریان رحم و جریان خون آندومتر در انتقال جنین منجمد: یک مطالعه مشاهده‌ای 2 1 مقدمه: میزان لانه گزینی پس از فناوری کمک باروری (ART) به دو عامل مهم بستگی دارد: جنین با کیفیت خوب و پذیرش آندومتر. پذیرش آندومتر عمدتاً با اندازهگیری اولتراسوند ضخامت و مورفولوژی آندومتر ارزیابی میشود. هدف: این مطالعه با هدف بررسی رابطه بین شاخصهای داپلر شریان رحمی / پرفیوژن آندومتر و میزان بارداری انجام شد. مواد و روش ها: این مطالعه مشاهده‌ای آینده‌نگر بر روی 250 زن کاندید انتقال جنین در چرخه انتقال جنین منجمد از ژانویه 2022 تا ژولای 2022 انجام شد. برای ارزیابی پذیرش آندومتر، سونوگرافی داپلر رحم قبل از جنین انجام شد. انتقال با آندومتر با ظاهر مطلوب (ضخامت آندومتر بیشتر یا مساوی 7 میلیمتر و خط سهگانه. علاوه بر این، بیماران بر اساس حاملگی بالینی به دو گروه مثبت و منفی تقسیم شدند و شاخصهای شریان رحمی و پرفیوژن آندومتر بین این گروهها مقایسه شد). نتایج: داپلر شریان رحمی نشان داد که شاخص ضربان بین دو گروه مثبت و منفی حاملگی بالینی تفاوت معنی‌داری دارد، اما شاخص مقاومت و حداکثر سرعت سیستولیک از نظر آماری تفاوت معنی‌داری با هم ندارند. همچنین پرفیوژن آندومتر بین دو گروه حاملگی بالینی تفاوت معنیداری داشت. پرفیوژن آندومتر در گروههای حاملگی بالینی مثبت به طور معنیداری بهتر بود. نتیجه گیری: سونوگرافی داپلر ابزاری مفید برای ارزیابی پذیرش آندومتر است. 2 Background: The implantation rate after assisted reproductive technology depends on 2 important factors, good quality embryo and endometrial receptivity. Endometrial receptivity is mainly assessed by ultrasound measurement of endometrial thickness and morphology. Objective: This study aimed to investigate the relationship between uterine artery Doppler indices/endometrial perfusion and pregnancy rate. Materials and Methods: This cohort study was done on 250 women who were candidates for frozen embryo transfer from January to July 2022. For assessing endometrial receptivity, we performed a Doppler ultrasound of the uterus before embryo transfer with apparently desirable endometrium (endometrial thickness ≥ 7 mm and 3 line endometrial pattern). In addition, the women were divided into 2 groups according to assisted reproductive technology outcome (clinical pregnancy), group I positive clinical pregnancy, and group II negative clinical pregnancy, and uterine artery indices and endometrial perfusion were compared between these groups. Results: Uterine artery Doppler showed that the pulsatility index was significantly different between positive and negative clinical pregnancy groups, but resistance index and peak systolic velocity (PSV) did not have statistically significant differences. Also, endometrial perfusion was significantly different between the 2 groups of clinical pregnancy. Endometrial perfusion was significantly better in positive clinical pregnancy groups. Conclusion: Doppler ultrasound can help to assess endometrial receptivity. 205 212 2022/07/252022/10/25 1401/8/3 2023/01/212023/01/21 1401/11/1 Fereshteh Bahrami Fereshteh Bahrami Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران fereshtehbahrami1966@gmail.com Maryam Eftekhar Maryam Eftekhar Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران eftekharmaryam@yahoo.com Leila Zanbagh Leila Zanbagh Department of Obstetrics and Gynecology, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران javadkhataie@gmail.com Doppler ultrasonography Embryo transfer Assisted reproductive technology Pregnancy. داپلر انتقال جنین فناوری کمک باروری بارداری. Kim A, Jung H, Choi WJ, Hong SN, Kim HY. 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The relationship between uterine artery two-dimensional color Doppler measurement and pregnancy outcome: A prospective observational study. J Reprod Infertil 2017; 18: 251-256.##Ivanovski M, Damcevski N, Radevska B, Doicev G. Assessment of uterine artery and arcuate artery blood flow by transvaginal color Doppler ultrasound on the day of human chorionic gonadotropin administration as predictors of pregnancy in an in vitro fertilization program. Akush Ginekol (Sofiia) 2012; 51: 55-60.##Zollner U, Specketer MT, Zollner KP, Dietl J. Uterine artery blood flow in the periimplantation period in embryo transfer cycles. Asian Pac J Reprod 2012; 1: 177-182.##Abdel Kader M, Abdelmeged A, Mahran A, Abu Samra MF, Bahaa H. The usefulness of endometrial thickness, morphology and vasculature by 2D Doppler ultrasound in prediction of pregnancy in IVF/ICSI cycles. Egypt J Radiol Nuclear Med 2016; 47: 341-346.##Nandi A, Martins WP, Jayaprakasan K, Clewes JS, Campbell BK, Raine-Fenning NJ. Assessment of endometrial and subendometrial blood flow in women undergoing frozen embryo transfer cycles. Reprod BioMed Online 2014; 28: 343-351.##Mayer RB, Ebner T, Weiss C, Allerstorfer C, Altmann R, Oppelt P, et al. The role of endometrial volume and endometrial and subendometrial vascularization parameters in a frozen embryo transfer cycle. Reprod Sci 2019; 26: 1013-1018.## ##

Trans differentiating human adipose-derived mesenchymal stem cells into male germ-like cells utilizing Rabbit Sertoli cells: An experimental study تمایز سلول‌های بنیادی مزانشیمی مشتق از چربی انسانی به سلول‌های شبه زایایی نر با استفاده از سلول‌های سرتولی خرگوش: یک مطالعه تجربی 2 1 مقدمه: سلولهای بنیادی مزانشیمی (MSCs) به عنوان عوامل درمانی جدید بالقوه برای درمان ناباروری در نظر گرفته میشوند و بافت چربی (AT) به منبع بالقوه سلولهای بنیادی مزانشیمی تبدیل شده است. برای هدایت صحیح سلولهای بنیادی مزانشیمی در فرآیند تمایز، یک محیط مشابه با محیط in vivo ممکن است ضروری باشد. هدف: این مطالعه با هدف تمایز MSc مشتق از AT انسانی (hAD-MScs) به سلول‌های شبه زایایی نر در شرایط آزمایشگاهی با استفاده از ترکیبی از محیط تهیه ‌شده با سلول‌های سرتولی خرگوش (SCCM)، پروتئین مورفوژنتیک استخوان 4 و اسید رتینوئیک انجام شد. مواد و روش ها: MSc ها از ATهای انسانی اهداکنندگان بارور و نابارور جداسازی شدند. MScهای تأیید شده با استفاده از یک پروتکل 2 مرحلهای متمایز شدند. مرحله اول شامل ng/ml 20 پروتئین مورفوژنتیک استخوان 4 بود. مرحله دوم با استفاده از µm 1 رتینوئیک اسید و/یا SCCM انجام شد. تغییرات مورفولوژیکی و بیان نشانگرهای اختصاصی سلول زایا (GC) شامل فاکتور رونویسی باند اکتامر-4، تحریک شده توسط رتینوئیک اسید-8، پروتئین کمپلکس سیناپتونمال-3، و پروتامین-1 در سلولهای تیمار شده با استفاده از واکنش زنجیرهای پلیمراز کمی ارزیابی شدند. نتایج: القای hAD-MScs منجر به افزایش بیان ژن‌های اختصاصی GC شد که در این میان تیمار SCCM بالاترین میزان بیان را نشان داد. بیان ژنهای پروتئین-3 و پروتامین-1 کمپلکس سیناپتونمال به ترتیب پس از 19 و 26 روز از القاء شناسایی شد. PRM1 در hAD-MScs کشت شده در SCCM زودتر از سایر گروه‌های تیمار شده شناسایی شد. سلول‌های تیمار شده دوک‌های درازتری را نشان دادند و با هم توده‌هایی را تشکیل دادند. نتیجه گیری: hAD-MScs های تمایز یافته به دودمان GC توانایی بیان نشانگرهای اختصاصی GC را در شرایط آزمایشگاهی نشان دادند و سلول‌های سرتولی خرگوش را می‌توان برای القای تمایز hAD-MScs به سلول‌های شبه زایایی استفاده کرد. 2 Background: Mesenchymal stem cells (MSCs) are deemed as potential new therapeutic agents for infertility treatment and adipose tissue (AT) becomes a potential MSCs source. To direct MSCs through the differentiation process properly, an environment comparable to the in vivo niche might be indispensable. Objective: This study aims to differentiate human AT-derived MScs (hAD-MScs) into male germ-like cells in vitro using a combination of rabbit Sertoli cells conditioned medium (SCCM), bone morphogenetic protein 4, and retinoic acid. Materials and Methods: MScs were isolated from human ATs of fertile and infertile donors. The verified MScs were differentiated using a 2-step protocol; the first step included 20 ng/ml bone morphogenetic protein 4 treatment. The second step was performed utilizing 1 μM retinoic acid and/or SCCM. The morphological changes and the expression of germ cell (GC)-specific markers: octamer-binding transcription factor-4; stimulated by retinoic-acid-8, synaptonemal complex protein-3, and protamine-1 were assessed in the treated cells using quantitative polymerase chain reaction. Results: Induction of hAD-MScs resulted in the upregulation of GC-specific genes where SCCM treatment showed the highest expression. The synaptonemal complex protein-3 and protamine-1 gene expression was detected after 19 and 26 days of induction, respectively. PRM1 was detected in hAD-MScs cultured in SCCM earlier than in other treated groups. The treated cells became more elongated-like spindles and formed aggregates. Conclusion: hAD-MScs differentiated to GC lineage exhibited the ability to express GC-specific markers under in vitro conditions, and rabbit’s Sertoli cells can be used for inducing transdifferentiation of hAD-MScs into germ-like cells. 213 228 2022/07/252022/10/252022/08/31 1401/6/9 2023/01/212023/01/212023/01/23 1401/11/3 Alaa Mutee' Khudair Alaa Mutee' Khudair Medical Laboratory Sciences Department, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine. فلسطین akhudair@iugaza.edu.ps Mazen Medhat Alzaharna Mazen Medhat Alzaharna Medical Laboratory Sciences Department, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine. فلسطین mzaharna@iugaza.edu.ps Fadel Akram Sharif Fadel Akram Sharif Medical Laboratory Sciences Department, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine. فلسطین fsharif@iugaza.edu.ps Adipose tissue-derived mesenchymal stem cell Bone morphogenetic protein 4 Germ-line cells Retinoic acid Sertoli cells. سلول های بنیادی مزانشیمی مشتق از بافت چربی پروتئین مورفوژنتیک استخوان 4 سلول های زایا رتینوئیک اسید سلول های سرتولی. Ghaem Maghami R, Mirzapour T, Bayrami A. Differentiation of mesenchymal stem cells to germ‐like cells under induction of Sertoli cell‐conditioned medium and retinoic acid. Andrologia 2018; 50: e12887.##Nagamatsu G, Hayashi K. Stem cells, in vitro gametogenesis and male fertility. Reproduction 2017; 154: F79-F91.##Zhankina R, Baghban N, Askarov M, Saipiyeva D, Ibragimov A, Kadirova B, et al. Mesenchymal stromal/stem cells and their exosomes for restoration of spermatogenesis in non-obstructive azoospermia: A systemic review. Stem Cell Res Ther 2021; 12: 229.##Mouka A, Tachdjian G, Dupont J, Drévillon L, Tosca L. In vitro gamete differentiation from pluripotent stem cells as a promising therapy for infertility. Stem Cells Dev 2016; 25: 509-521.##Majidi F, Bamehr H, Shalchian Z, Kouchakian MR, Mohammadzadeh N, Khalili A. Differentiation of human umbilical cord mesenchymal stem cell into germ‐like cell under effect of co‐culture with testicular cell tissue. Anat Histol Embryol 2020; 49: 359-364.##De Felici M. The formation and migration of primordial germ cells in mouse and man. Molecular mechanisms of cell differentiation in gonad development. Cham: Springer; 2016.##Irie N, Sybirna A, Surani MA. What can stem cell models tell us about human germ cell biology? Curr Top Dev Biol 2018; 129: 25-65.##Madeja ZE, Pawlak P, Piliszek A. Beyond the mouse: Non-rodent animal models for study of early mammalian development and biomedical research. Int J Dev Biol 2019; 63: 187-201.##Banco B, Grilli G, Giudice C, Tomas Marques A, Cotti Cometti S, Visigalli G, et al. Immunophenotyping of rabbit testicular germ and Sertoli cells across maturational stages. J Histochem Cytochem 2016; 64: 715-726.##Grieco V, Banco B. Rabbit sertoli cells: Immunohistochemical profile from neonatal to adult age. Methods Mol Biol 2018; 1748: 37-47.##Ziaeipour S, Ahrabi B, Naserzadeh P, Aliaghaei A, Sajadi E, Abbaszadeh H-A, et al. Effects of Sertoli cell transplantation on spermatogenesis in azoospermic mice. Cell Physiol Biochem 2019; 52: 421-434.##Afsartala Z, Rezvanfar MA, Hodjat M, Tanha S, Assadollahi V, Bijangi K, et al. Amniotic membrane mesenchymal stem cells can differentiate into germ cells in vitro. In Vitro Cell Dev Biol Anim 2016; 52: 1060-1071.##Volarevic V, Bojic S, Nurkovic J, Volarevic A, Ljujic B, Arsenijevic N, et al. Stem cells as new agents for the treatment of infertility: Current and future perspectives and challenges. Biomed Res Int 2014; 2014: 507234.##Choudhery MS, Badowski M, Muise A, Pierce J, Harris DT. Donor age negatively impacts adipose tissue-derived mesenchymal stem cell expansion and differentiation. J Transl Med 2014; 12: 8.##Camilleri ET, Gustafson MP, Dudakovic A, Riester SM, Garces CG, Paradise CR, et al. Identification and validation of multiple cell surface markers of clinical-grade adipose-derived mesenchymal stromal cells as novel release criteria for good manufacturing practice-compliant production. Stem Cell Res Ther 2016; 7: 107.##Liu H, Chen M, Liu L, Ren S, Cheng P, Zhang H. Induction of human adipose-derived mesenchymal stem cells into germ lineage using retinoic acid. Cell Reprogram 2018; 20: 127-134.##Ghatreh Samani K, Eliyasi Dashtaki M, Alaei Sh, Saki Gh. Differentiation potential of adipose tissue‐derived mesenchymal stem cells into germ cells with and without growth factors. Andrologia 2021; 53: e13892.##Bräunig P, Glanzner WG, Rissi VB, Gonçalves PBD. The differentiation potential of adipose tissue-derived mesenchymal stem cells into cell lineage related to male germ cells. Arq Bras Med Vet Zootec 2018; 70: 160-168.##Bakhmet EI, Tomilin AN. Key features of the POU transcription factor Oct4 from an evolutionary perspective. 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Is sperm telomere length altered in teratozoospermia specimens? A case-control study آیا طول تلومر اسپرم در نمونه های تراتواسپرمیا دچار تغییر می گردد؟ یک مطالعه مورد-شاهدی 2 1 مقدمه: ناباروری مردان به عنوان یک نقص چندعاملی شناخته شده است و بسیاری از دلایل آن ناشناخته است. تراتواسپرمی به عنوان یکی از نواقص در شاخصه های مایع منی به وسیله وجود بیش از 85% اسپرماتوزوا غیرطبیعی از نظر مورفولوژی در نمونه مایع منی تعریف میشود که در پیشبرد باروری نیز ناتوان هستند. یکی از جدیدترین موضوعات در مطالعات تغییرات ژنتیکی، بررسی تغییرات طول تلومر اسپرمها و نقش آنها در ناباروری مردان است. مطالعهی حال حاضر بر ارزیابی تغییرات طول تلومر در تراتواسپرمی تمرکز دارد. هدف: بررسی هر گونه تفاوتی در طول تلومر بین نمونه های تراتواسپرمی و نرمال. مواد و روش ها: در این مطالعه مورد-شاهدی، 60 مرد مراجعهکننده به کلینیک باروری اراک، بین نوامبر 2017 تا فوریه 2018 در دو دسته تراتواسپرمی و نورمواسپرمی طبقهبندی گردیدند. استخراج DNA ژنوم اسپرم صورت گرفته و سپس طول تلومر با استفاده از تکنیک qPCR مورد ارزیابی قرار گرفت. نتایج: ارزیابیهای آماری طول نسبی تلومر توسط محاسبه نسبت تلومر به ژن تک کپی برای نمونههای تراتواسپرمی و نرمال انجام گرفت. نتایج به صورت معناداری نشان دادند که طول نسبی تلومر در نمونههای تراتواسپرمی تقریبا 3 برابر کوتاهتر از نمونههای نرمال هستند (001/ 0> p). نتیجه گیری: طول تلومر یکی از مواردی است که اخیرا در حوزهی فاکتورهای زیستی مؤثر بر ویژگیهای مایع منی مورد توجه قرار گرفته. نتایج مطالعه حال حاضر، کاهش طول تلومر در تراتواسپرمی را نشان میدهند و پیشنهاد میکند که این تغییرات ممکن است یکی از فاکتورهای مشارکتکننده در عدم کفایت این نوع از نمونهها باشد. به هر صورت شناسایی فرایندهای مولکولی مرتبط نیاز به مطالعات دقیق بیشتری خواهد داشت. 2 Background: Male factor infertility is a multifactorial defect, and many of its etiologies are unknown. Teratozoospermia is determined by the existence of over 85% morphologically abnormal spermatozoa in semen which are almost incompetent in fertilization function. One of the most novel issues in genetic alterations studies is the variation of sperm telomere lengths (STL) and its collaboration with male infertility. The present study has been focused on STL alterations in teratozoospermia. Objective: Investigation of differences in telomere length of teratozoospermia specimens and sperms with normal parameters. Materials and Methods: In this case-control study, 60 men referred to Arak Fertility Clinic, Markazi province, Iran from November 2017 to February 2018 were categorized into teratozoospermia and normozoospermic groups. Sperm genomic DNA extraction was conducted, and STL were evaluated using quantitative polymerase chain reaction. Results: Statistical evaluation of relative telomere length was calculated by the ratio of telomere to single-copy gene for teratozoospermia and normal specimens. Results significantly demonstrated that relative telomere length in teratozoospermia samples is nearly 3 times shorter than in normal samples (p >0.001). Conclusion: Our results represent the reduction of telomeres length in teratozoospermia and suggest that this alteration might be one of the factors contributing to the sperm fertility potential of this kind of specimen. However, defining relevant molecular processes requires further detailed investigations. 229 236 2022/07/252022/10/252022/08/312021/08/13 1400/5/22 2023/01/212023/01/212023/01/232023/02/1 1401/11/12 Maryam Fattahi Maryam Fattahi Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Fattahi.inbox@gmail.com Mohadese Maghsudlu Mohadese Maghsudlu Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. ایران m.maghsudlu.2@gmail.com Mohammad Hasan Sheikhha Mohammad Hasan Sheikhha Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران sheikhha@yahoo.com Telomere Teratozoospermia Sperm Male infertility. طول تلومر تراتواسپرمی اسپرم ناباروری مردان. Duca Y, Calogero AE, Cannarella R, Condorelli RA, La Vignera S. Current and emerging medical therapeutic agents for idiopathic male infertility. 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Anti-fertility effect of Aerva lanata crude extract in male Dams offspring: An experimental study اثر ضد باروری عصاره خام Aerva lanata در فرزندان نر رت های حامله: یک مطالعه تجربی 2 1 مقدمه: Aerva lanata، گیاهی است که به عنوان غذا استفاده میشود و همچنین با عنوان تقویتی توسط زنان باردار برای تسکین درد معده و جلوگیری از سقط جنین مصرف میشود. این گیاه علاوه بر سایر خواص مشخصه، دارای فعالیتهای ضد باروری و ضد لانهگزینی است. هدف: این مطالعه به بررسی سمیت بر روی بیضه فرزندان رتهای تیمار شده با عصاره آبی خام Aerva lanata میپردازد. مواد و روش ها: 25 سر موش صحرایی باردار ویستار با وزن 180 تا 240 گرم به طور تصادفی در 5 گروه (هر کدام 5 سر) قرار گرفتند. گروه A به عنوان کنترل انتخاب شد. گروههای B، C، D و E به ترتیب 200، 400، 800 و 1000 میلیگرم به ازای هر کیلوگرم وزن بدن عصاره Aerva lanata را از روز 12 تا 19 بارداری دریافت کردند. نوزادان (به دنیا آمده از رتها) وزن شدند، تحت نظر گرفته شدند و 6 هفته پس از زایمان قربانی شدند. بیضههای تولههای نر برای انجام مراحل بافتشناسی به دست آمد و بافتشناسی بیضه مورد بررسی قرار گرفت. نتایج: هیچ ناهنجاری فاحشی در گروه‌های مورد آزمایش مشاهده نشد، تعداد توله‌ها به‌طور معنی‌داری در گروه E کاهش یافت (01/0 = p)، آنالیز وزن نوزادان کاهش معنی‌داری را در گروه‌های C و E نشان داد (به ترتیب 04/0 = p و 02/0 =p ). میانگین وزن بیضههای تولهها در گروههای B، C، D و E (به ترتیب 03/0، 03/0، 01/0 و 001/0 >) به طور قابل توجهی در مقایسه با گروه کنترل کاهش یافته بود. از نظر بافتشناسی، بافتهای بیضه تولههای تیمار شده درجات مختلفی از اختلال و به هم ریختگی ترتیب سلولی اپیتلیوم ژرمینال را به شیوهای وابسته به دوز در مقایسه با گروه کنترل نشان دادند. نتیجه گیری: این مطالعه سمیت بر روی بیضه و احتمالاً نقش ضد باروری Aerva lanata را در نوزادان رتها نشان داد. 2 Background: Aerva lanata, a herb used as food and also consumed as a tonic by pregnant women to relieve stomach pains and prevent miscarriage. In addition to other characterized properties, it possesses antifertility and anti-implantation activities. Objective: This study investigates the testicular toxicity of the testes of offsprings of Dams treated with crude aqueous extract of Aerva lanata. Materials and Methods: 25 pregnant Wistar rats (Dams) weighing 180-240 gr were randomly earmarked into 5 groups (n = 5/each). Group A served as control; groups B, C, D, and E received 200, 400, 800, and 1000 mg/kg body weight of Aerva lanata extract, respectively, beginning from 12th to 19th day of gestation. The pups (delivered of Dams) were weighed, observed, and sacrificed 6 wk post-parturition. The testes of the male pups were obtained for histological procedures the testis histology was examined. Results: No gross malformation was observed in the treatment groups, the number of pups/litter was significantly reduced in group E (p = 0.01), pups weight analysis showed a significant reduction in groups C and E (p = 0.04, and 0.02 respectively), and the mean pup testes weight was significantly reduced in groups B, C, D, and E (p = 0.03, 0.03, 0.01, and < 0.001 respectively) when compared with control. Histologically, the treated pup testes tissues showed varying degrees of disruption and distortion of the cellular arrangements of the germinal epithelium in a dose dependent manner compared to the control. Conclusion: The study revealed a testicular toxicity and possibly antifertility role of Aerva lanata in dams’ pups. 237 244 2022/07/252022/10/252022/08/312021/08/132021/08/19 1400/5/28 2023/01/212023/01/212023/01/232023/02/12023/01/23 1401/11/3 Raphael Eguono Uwejigho Raphael Eguono Uwejigho Department of Anatomy, Faculty of Basic Medical Sciences, University of Medical Sciences, Ondo State, Laje Campus, Ondo City, Ondo State, Nigeria. نیجریه ruwejigho@unimed.edu.ng Kingsley Afoke Iteire Kingsley Afoke Iteire Department of Anatomy, Faculty of Basic Medical Sciences, University of Medical Sciences, Ondo State, Laje Campus, Ondo City, Ondo State, Nigeria. نیجریه aiteire@unimed.edu.ng Felix Udawmojo Enemali Felix Udawmojo Enemali Department of Anatomy, Faculty of Basic Medical Sciences, University of Medical Sciences, Ondo State, Laje Campus, Ondo City, Ondo State, Nigeria. نیجریه fenamali@unimed.edu.ng Amaranthaceae Fertility Male fertility Male reproductive system Local herbs. تاج خروس باروری باروری نر دستگاه تناسلی نر گیاهان محلی. Hao D-C. Ranunculales medicinal plants: Biodiversity, chemodiversity and pharmacotherapy. UK: Academic Press; 2019.##Mintah SO, Asafo-Agyei T, Archer MA, Atta-Adjei Junior P, Boamah D, Kumadoh D, et al. Medicinal plants for treatment of prevalent diseases. In: Perveen Sh, Al-Taweel A. Pharmacognosy: Medicinal plants. UK: Intechopen; 2018.##Akunne TC, Uzor Ph, Onyeto CA, Okereke EK. Safe African Medicinal plants for clinical studies. In: Kuete V. Toxicological survey of African Medicinal plants. London: Elsevier; 2014: 535-555.##Karemore MN, Avari JG. Herbal medicines used during pregnancy, childbirth and postpartum care. Int J Pharm Sci Res 2017; 8: 5326-5335.##Musaddiqa S, Mustafaa K, Ahmadb S, Aslama S, Alic B, Khakwania S, et al. Pharmaceutical, ethnopharmacological, phytochemical and synthetic importance of genus Aerva: A review. Natural Product Communications 2018; 13: 375-385.##Zhao Y, Kumar D, Prasad DN, Singhb RK, Ma Y. Morphoanatomic, physicochemical, and phytochemical standardization with HPTLC fingerprinting of aerial parts of Aerva lanata (Linn) Juss ex schult. J Trad Chinese Med Sci 2015; 2: 39-44.##Savadi RV, Alagawadi KR. Antifertility activity of ethanolic extracts of plumbago indica and Aerva lanata on albino rats. Int J Green Pharmcol 2009; 3: 230-233.##Carlson B. Human embryology and developmental biology. 5th Ed. Philadelphia: Saunders; 2013.##Costa KCS, Bezerra SB, Norte CM, Nunes LMN, de Olinda TM. Medicinal plants with teratogenic potential: Current considerations. Braz J Pharm Sci 2012; 48: 427-433.##Ghuman S, Coopoosamy RM. Crude sample preparation, extraction and in vitro screening for antimicrobial activity of selected wound healing medicinal plants in KwaZulu-Natal, South Africa: A review. J Med Plant Res 2011; 5: 3572-3576.##Kpemissi M, Eklu-Gadegbeku K, Veerapur VP, Potârniche AV, Adi K, Vijayakumar S, et al. Antioxidant and nephroprotection activities of Combretum micranthum: A phytochemical, in-vitro and ex-vivo studies. Heliyon 2019; 5: e01365.##Kpemissi M, Eklu-Gadegbeku K, Veerapur VP, Negru M, Taulescu M, Chandramohan V, et al. Nephroprotective activity of Combretum micranthum G. Don in cisplatin induced nephrotoxicity in rats: In-vitro, in-vivo and in-silico experiments. Biomed Pharmacother 2019; 116: 108961.##Ema M, Miyawaki E, Kawashima K. Critical period for adverse effects on development of reproductive system in male offspring of rats given di-n-butyl phthalate during late pregnancy. Toxicol Lett 2000; 111: 271-278.##Picut CA, Remick AK, de Rijk EP, Simons ML, Stump DG, Parker GA. Postnatal development of the testis in the rat: Morphologic study and correlation of morphology to neuroendocrine parameters. Toxicol Pathol 2015; 43: 326-342.##https://doi.org/10.1177/0192623314547279##Shields VDC, Heinbockel Th. Introductory chapter: Histological microtechniques. In: Heinbockel Th, Shields VDC. Histology. UK: IntechOpen; 2018.##Ankul SS, Gowri K, Chitra V. A review on phytochemical constituents and pharmacological activities of the plant: Aerva Lanata. Res J Pharm Technol 2020; 13: 1580-1586.##Weichbrod RH, Thompson GAH, Norton JN. Management of animal care and use programs in research, education, and testing. 2nd Ed. Boca Raton (FL): CRC Press/Taylor & Francis; 2018.##Athira P, Nair SN. Pharmacognostic review of medicinal plant Aerva lanata. J Pharn Sci Res 2017; 9: 1420-1423.##Omotoso KS, Aigbe FR, Salako OA, Chijioke MC, Adeyemi OO. Toxicological evaluation of the aqueous whole plant extracts of Aerva lanata Juss. ex Schult (Amaranthaceae). J Ethnopharmacol 2017; 208: 174-184.##Bitasta M, Madan S. Aerva lanata: A blessing of mother nature. J Pharmacogn Phytochem 2016; 5: 92-101.##Shaik A, Yalavarthi PR, Bannoth CK. Role of anti-fertility medicinal plants on male & female reproduction. 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Live birth rates in day 5 fresh versus vitrified single blastocyst transfer cycles: A cross-sectional analysis نرخ تولد زنده در چرخه های انتقال بلاستوسیست منفرد تازه در روز 5 در مقابل انتقال منجمد: یک مطالعه مقطعی 2 1 مقدمه: استفاده از انتقال جنین منجمد (FET) در فرآیندهای کمک به تولیدمثل در سراسر جهان افزایش یافته است. تحریک کنترل شده تخمدان و سپس انتقال جنین تازه ممکن است همزمانی آندومتر و جنین را مختل کند. با این حال، شواهد متناقضی در مورد نرخ تولد زنده (LBR) و نرخ حاملگی بالینی (CPR) وجود دارد. هدف: مقایسه LBRs و CPRs در چرخه‌های انتقال بلاستوسیست تازه اتولوگ منفرد روز 5 در مقابل سیکل‌های انتقال بلاستوسیست منجمد شده، برای بررسی تأثیر تحریک کنترل ‌شده تخمدان بر ناهمزمانی جنین-آندومتر. مواد و روش ها: یک تجزیه و تحلیل مقطعی بزرگ از 6002 انتقال جنین (ET) شامل 3774 چرخه تازه و 2228 چرخه FET از سال 2016 تا 2019 انجام شد. در ضمن تجزیه و تحلیل چند متغیره و زیر گروهی برای پاسخ‌دهندگان بالا (بیش از 20 تخمک) انجام شد. نتایج: تجزیه و تحلیل تک متغیره تفاوتی در LBR و CPR نشان نداد. با این حال، تجزیه و تحلیل چند متغیره کاهش قابل توجهی در LBR و CPR در FET در مقایسه با انتقال امبریوهای تازه نشان داد. سن شرکت‌کننده جوان‌تر، سابقه حاملگی در لقاح آزمایشگاهی قبلی، گسترش بلاستوسیست پیشرفته، تروفکتودرم با کیفیت بالاتر و تعداد تجمعی کمتر ETs همگی شانس LBR و CPR را بهبود بخشیدند. لقاح آزمایشگاهی معمولی، به جای تزریق داخل سیتوپلاسمی اسپرم، CPR را بهبود بخشید اما LBR را بهبود نبخشید. شاخص توده بدنی LBR و CPR را تحت تأثیر قرار نداد. در زیر گروه مطالعه شده تجزیه و تحلیل چند متغیره پاسخدهندگان بالا تفاوتی در LBR یا CPR نشان نداد. نتیجه گیری: این مطالعه با تحلیل چند متغیره نشان می‌دهد که LBR و CPR در ETs تازه نسبتاً در حدود 14% بالاتر در مقایسه با FETs میباشد. یک استراتژی یکسان انجماد، بدون دلیل مناسب، ممکن است به نتایج نامطلوب منجر شود. در افراد با پاسخ‌دهی بالا، چرخه‌های فریز کردن ممکن است مفید باشد، در عین حال نتایج مشابه به نظر می‌رسد. 2 Background: The use of frozen embryo transfers (FET) in assisted reproduction has increased worldwide. Controlled ovarian hyperstimulation in a fresh transfer may impair endometrial-embryo synchronicity. However, there is conflicting evidence on live birth rates (LBR) and clinical pregnancy rates (CPR). Objective: To compare LBRs and CPRs between single autologous day 5 fresh vs. vitrified blastocyst transfer cycles, to investigate the impact of controlled ovarian hyperstimulation on embryo-endometrium asynchrony. Materials and Methods: A large cross-sectional analysis of 6002 embryo transfers (ET) comprised 3774 fresh and 2228 FET cycles from 2016 to 2019. Multivariate and subgroup analysis were performed for high responders (> 20 oocytes). Results: Univariate analysis showed no difference in LBR (28.3% vs. 27.4%, p = 0.43) and CPR (32.2% vs. 30.9%, p = 0.30); however, multivariate analysis demonstrated significantly lower LBR (OR 0.864, p = 0.046, 95% CI 0.749-0.997) and CPR (OR 0.852, p = 0.024, 95% CI 0.742-0.979) in FET compared to fresh ETs. Younger participant age, previous in vitro fertilization pregnancy, advanced blastocyst expansion, higher trophectoderm quality, and lower cumulative number of ETs all improved the odds of LBR and CPR. Conventional in vitro fertilization, rather than intracytoplasmic sperm injection, improved CPR but not LBR. Body mass index affected neither LBR nor CPR. In the subgroup, multivariate analysis of high responders showed no difference in LBR or CPR. Conclusion: This study demonstrates relatively higher LBR and CPR of nearly 14% for fresh ETs compared to FETs, in multivariate analysis. A universal freeze-all strategy, without appropriate indication, may lead to suboptimal outcomes. In high responders, freeze-all cycles may be beneficial, as outcomes appear similar. 245 254 2022/07/252022/10/252022/08/312021/08/132021/08/192022/07/10 1401/4/19 2023/01/212023/01/212023/01/232023/02/12023/01/232023/02/14 1401/11/25 Violet Kieu Violet Kieu Reproductive Services Unit, Royal Women’s Hospital, Melbourne, VIC, Australia. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia. Melbourne IVF, Melbourne, VIC, Australia. استرالیا violet.kieu@unimelb.edu.au Alex Polyakov Alex Polyakov Reproductive Services Unit, Royal Women’s Hospital, Melbourne, VIC, Australia. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia. Melbourne IVF, Melbourne, VIC, Australia. استرالیا alex.polyakov@mivf.com.au Genia Rozen Genia Rozen Reproductive Services Unit, Royal Women’s Hospital, Melbourne, VIC, Australia. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia. Melbourne IVF, Melbourne, VIC, Australia. استرالیا genia.rozen@mivf.com.au Daniel Lantsberg Daniel Lantsberg Reproductive Services Unit, Royal Women’s Hospital, Melbourne, VIC, Australia. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia. Melbourne IVF, Melbourne, VIC, Australia. استرالیا daniel.lantsberg@mivf.com.au Catharyn Stern Catharyn Stern Reproductive Services Unit, Royal Women’s Hospital, Melbourne, VIC, Australia. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia. Melbourne IVF, Melbourne, VIC, Australia. استرالیا kate.stern@mivf.com.au Wan Tinn The Wan Tinn The Reproductive Services Unit, Royal Women’s Hospital, Melbourne, VIC, Australia. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia. Melbourne IVF, Melbourne, VIC, Australia. استرالیا wantinn.teh@mivf.com.au Blastocyst Live birth In vitro techniques Pregnancy rate Vitrification Reproduction. بلاستوسیست تولد زنده تکنیکهای آزمایشگاهی میزان بارداری انجماد تولیدمثل. Newman JE, Paul RC, Chambers GM. Assisted reproductive technology in Australia and New Zealand 2019. Sydney: University of New South Wales; 2021.##Harris K, Fitzgerald O, Paul RC, Macaldowie A, Lee E, Chambers GM. Assisted reproductive technology in Australia and New Zealand 2014. Sydney: National Perinatal Epidemiology and Statistics Unit, the University of New South Wales; 2016.##Wyns C, Bergh C, Calhaz-Jorge C, De Geyter C, Kupka MS, Motrenko T, et al. ART in Europe, 2016: Results generated from European registries by ESHRE. Hum Reprod Open 2020; 2020: hoaa032.##CDC Centers for Disease Control and Prevention. 2016 Assisted Reproductive Technology National Summary Report. Atlanta (GA): US Dept of Health and Human Services; 2018.##Ishihara O, Jwa SC, Kuwahara A, Ishikawa T, Kugu K, Sawa R, et al. Assisted reproductive technology in Japan: A summary report for 2016 by the Ethics Committee of the Japan Society of Obstetrics and Gynecology. Reprod Med Biol 2018; 18: 7-16.##Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, et al. Oocyte, embryo and blastocyst cryopreservation in ART: Systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update 2017; 23: 139-155.##Kolibianakis E, Bourgain C, Albano C, Osmanagaoglu K, Smitz J, Van Steirteghem A, et al. Effect of ovarian stimulation with recombinant follicle-stimulating hormone, gonadotropin releasing hormone antagonists, and human chorionic gonadotropin on endometrial maturation on the day of oocyte pick-up. Fertil Steril 2002; 78: 1025-1029.##Mirkin S, Nikas G, Hsiu JG, Diaz J, Oehninger S. 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Determination of serum anti-Mullerian hormone levels in a low-prognosis women treated in-vitro fertilization/intracytoplasmic sperm injection: A cohort study تعیین سطح سرمی آنتی مولرین هورمون در زنان با پیش آگهی پایین تحت درمان لقاح آزمایشگاهی/تزریق داخل سیتوپلاسمی اسپرم: یک مطالعه کوهورت 2 1 مقدمه: پیش‌بینی نتیجه درمان افراد تحت درمان با لقاح آزمایشگاهی یا تزریق داخل سیتوپلاسمی اسپرم (IVF/ICSI) با استفاده از غلظت هورمون آنتیمولرین (AMH) به طور گستردهای مورد استفاده قرار گرفته است. با توجه به راهبردهای بیمار محور که شامل تعریف تعداد تخمک فردی (POSEIDON) است، پاسخدهندگان ضعیف یا poor معیار بولونیا به افراد با پیشآگهی پایین تغییر کردهاند. این معیار پیش آگهی پایین را به 4 گروه تقسیم میکند. هدف: هدف از این مطالعه بررسی سطح AMH خون در گروه زنان تحت درمان با IVF/ICSI بود که به نظر میرسید که پیش‌آگهی پایینی داشته باشند. مواد و روش ها: یک مطالعه کوهورت گذشته‌نگر بین 252 شرکت‌کننده مشکوک به قرار گرفتن در گروه با پیش آگهی پایین از ژانویه 2016 تا دسامبر 2019 در Morula IVF، بیمارستان ملی، سورابایا، اندونزی انجام شد. سطوح سرمی AMH و میزان بارداری مشاهده شده در بین 4 زیر گروه مقایسه شد. نتایج: مقدار cutoff AMH با حساسیت 7/86% و اختصاصیت 70%، ng/ml 7/1 برای تشخیص زنان با پیشآگهی پایین با استفاده از معیارهای POSEIDON بود. تفاوتی در میزان بارداری بین تمام گروهها وجود نداشت (05/0 < p). نتیجه گیری: سطوح AMH مطابق با دستورالعمل‌های POSEIDON ممکن است نشان‌دهنده پیش آگهی ضعیف برای زنانی که IVF/ICSI دارند، باشد. برای پیش‌بینی پیش‌آگهی بد در زنان، مقدار cutoff باید مشخص شود. 2 Background: Outcome prediction of participants treated with in-vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) using anti-Mullerian hormone (AMH) concentration has been widely used. According to the patient-oriented strategies encompassing individualized oocyte number (POSEIDON) definition, low prognosis Bologna responders have changed from poor. This definition divides low prognosis into 4 groups. Objective: The purpose of this study was to assess blood AMH levels in the group of women treated with IVF/ICSI who were thought to have a low prognosis. Materials and Methods: A retrospective cohort study among 252 suspected low-prognosis group participants was assessed between January 2016 and December 2019 at Morula IVF, National hospital, Surabaya, Indonesia. Observed AMH serum levels and pregnancy rates were compared among 4 subgroups. Results: The AMH cutoff value was 1.7 ng/mL with a sensitivity of 86.7 percent and a specificity of 70% for diagnosing low-prognosis women using POSEIDON criteria. There was no difference in the pregnancy rate between those groups (p > 0.05). Conclusion: AMH levels may indicate a poor prognosis for women having IVF/ICSI in accordance with POSEIDON guidelines. To predict the poor prognosis in women, the cutoff value must be identified. 255 262 2022/07/252022/10/252022/08/312021/08/132021/08/192022/07/102021/11/11 1400/8/20 2023/01/212023/01/212023/01/232023/02/12023/01/232023/02/142023/02/14 1401/11/25 Ferdy Royland Marpaung Ferdy Royland Marpaung Department of Clinical Pathology, Faculty of Medicine, Dr Soetomo Academic Hospital, Universitas Airlangga, Surabaya, Indonesia. اندونزی ferdyoke@gmail.com Amang Surya Priyanto Amang Surya Priyanto IVF Morula Clinic, National Hospital Surabaya, Indonesia. اندونزی amangsuryap2@gmail.com Fitri Ayu Kusumawati Fitri Ayu Kusumawati IVF Morula Clinic, National Hospital Surabaya, Indonesia. اندونزی fitriayukusumawati2@gmail.com Sidarti Soehita Sidarti Soehita Department of Clinical Pathology, Faculty of Medicine, Dr Soetomo Academic Hospital, Universitas Airlangga, Surabaya, Indonesia. اندونزی r-sidarti-s-s@fk.unair.ac.id Aryati Aryati Aryati Aryati Department of Clinical Pathology, Faculty of Medicine, Dr Soetomo Academic Hospital, Universitas Airlangga, Surabaya, Indonesia. اندونزی aryati@fk.unair.ac.id Prognosis Assisted reproductive technics Gonadal hormone Fertilization in vitro Reproductive health. پیش آگهی تکنیکهای کمک باروری هورمون غدد جنسی لقاح آزمایشگاهی سلامت باروری. Kresna A, Lestari TD, Kasman AM, Luqman EM. Calcium ionophore as oocyte activator to fertilization rate and cleavage level on kacang goat post intracytoplasmic sperm injection (ICSI). Teikyo Med J 2021; 44: 1031-1037.##Rahayu FK, Dwiningsih SR, Sa'adi A, Herawati L. Effects of different intensities of exercise on folliculogenesis in mice: Which is better? Clin Exp Reprod Med 2021; 48: 43-49.##Mohammadzadeh M, Fesahat F, Khoradmehr A, Khalili MA. Influential effect of age on oocyte morphometry, fertilization rate and embryo development following IVF in mice. Middle East Fertil Soc J 2018; 23: 117-120.##Leijdekkers JA, Eijkemans MJC, van Tilborg TC, Oudshoorn SC, van Golde RJT, Hoek A, et al. Cumulative live birth rates in low-prognosis women. Hum Reprod 2019; 34: 1030-1041.##Lukaszuk K, Liss J, Kunicki M, Jakiel G, Wasniewski T, Woclawek-Potocka I, et al. Anti-Müllerian hormone (AMH) is a strong predictor of live birth in women undergoing assisted reproductive technology. Reprod Biol 2014; 14: 176-181.##Alanazi H, Bushaqer N, Ayyoub H, Dayoub N, Hassan S. Antimullerian hormone (AMH) level and IVF/ICSI cycle outcome in expected poor responders. Middle East Fertil Soc J 2018; 23: 246-250.##Ferraretti AP, Gianaroli L. The Bologna criteria for the definition of poor ovarian responders: Is there a need for revision? Hum Reprod 2014; 29: 1842-1845.##Esteves SC, Roque M, Bedoschi GM, Conforti A, Humaidan P, Alviggi C. Defining low prognosis patients undergoing assisted reproductive technology: POSEIDON criteria-the why. Front Endocrinol 2018; 9: 461.##The ESHRE Guideline Group on Ovarian Stimulation, Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, et al. ESHRE guideline: Ovarian stimulation for IVF/ICSI. Hum Reprod Open 2020; 2020: 1-13.##Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P, et al. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: An individual patient data approach. Hum Reprod Update 2013; 19: 26-36.##Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Update 2014; 20: 370-385.##https://doi.org/10.1093/humupd/dmu043##La Marca A, Ferraretti AP, Palermo R, Ubaldi FM. The use of ovarian reserve markers in IVF clinical practice: A national consensus. Gynecol Endocrinol 2016; 32: 1-5.##Clemente Nd, Racine C, Pierre A, Taieb J. Anti-Mullerian hormone in female reproduction. Endocrine Rev 2021; 42: 753-782.##Racoubian E, Aimagambetova G, Finan RR, Almawi WY. Age-dependent changes in anti-Müllerian hormone levels in Lebanese females: Correlation with basal FSH and LH levels and LH/FSH ratio: A cross-sectional study. BMC Women's Health 2020; 20: 134.##Li R, Gong F, Zhu Y, Fang W, Yang J, Liu J, et al. Anti-Müllerian hormone for prediction of ovarian response in Chinese infertile women undergoing IVF/ICSI cycles: A prospective, multi-centre, observational study. Reprod Biomed Online 2016; 33: 506-512.##Iwase A, Osuka S, Goto M, Murase T, Nakamura T, Takikawa S, et al. Clinical application of serum anti-Müllerian hormone as an ovarian reserve marker: A review of recent studies. J Obstet Gynaecol Res 2018; 44: 998-1006.##Zebitay AG, Cetin O, Verit FF, Keskin S, Sakar MN, Karahuseyinoglu S, et al. The role of ovarian reserve markers in prediction of clinical pregnancy. J Obstet Gynaecol 2017; 37: 492-497.##Stracquadanio M, Ciotta L, Palumbo MA. Relationship between serum anti-Mullerian hormone and intrafollicular AMH levels in PCOS women. Gynecol Endocrinol 2018; 34: 223-228.##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.##Tal R, Seifer DB. Potential mechanisms for racial and ethnic differences in anti-Müllerian hormone and ovarian reserve. Int J Endocrinol 2013; 2013: 818912.##Elchuri SV, Patterson BC, Brown MR, Buchanan I, Mertens AC, Meacham LR. Anti-Mullerian hormone levels in American girls by age and race/ethnicity. J Pediatr Endocrinol Metab 2015; 28: 189-193.##Bedenk J, Vrtacnik-Bokal E, Virant-Klun I. The role of anti-Mullerian hormone (AMH) in ovarian disease and infertility. J Assist Reprod Genet 2020; 37: 89-100.##Schuh-Huerta SM, Johnson NA, Rosen MP, Sternfeld B, Cedars MI, Reijo Pera RA. Genetic variants and environmental factors associated with hormonal markers of ovarian reserve in Caucasian and African American women. Hum Reprod 2012; 27: 594-608.##Gleicher N, Weghofer A, Kim A, Barad DH. The impact in older women of ovarian FMR1 genotypes and sub-genotypes on ovarian reserve. PLoS One 2012; 7: e33638.##Schuh-Huerta SM, Johnson NA, Rosen MP, Sternfeld B, Cedars MI, Reijo Pera RA. Genetic markers of ovarian follicle number and menopause in women of multiple ethnicities. Hum Genet 2012; 131: 1709-1724.##Kushnir VA, Seifer DB, Barad DH, Sen A, Gleicher N. Potential therapeutic applications of human anti-Müllerian hormone (AMH) analogues in reproductive medicine. J Assist Reprod Genet 2017; 34: 1105-1113.##Kedem A, Haas J, Geva LL, Yerushalmi G, Gilboa Y, Kanety H, et al. Ongoing pregnancy rates in women with low and extremely low AMH levels. A multivariate analysis of 769 cycles. PLoS One 2013; 8: e81629.##Chinta P, Antonisamy B, Mangalaraj AM, Kunjummen AT, Kamath MS. POSEIDON classification and the proposed treatment options for groups 1 and 2: Time to revisit? A retrospective analysis of 1425 ART cycles. 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A successful twin healthy live birth achieved from eggs with a rare perivitelline space abnormality: A case report یک تولد زنده سالم و موفق دوقلو حاصل از تخمک های با ناهنجاری نادر فضای پری‌ویتلین: گزارش مورد 2 1 مقدمه: مشاهده بدشکلی فنوتیپی در تخمک انسان به‌ ویژه در فضای پری‌ویتلین گاهی اتفاق میافتد که از مهم‌ترین انحرافات جزء اضافی سیتوپلاسمی است. مورد: مورد زنی 30 ساله بدون بارداری قبلی بود که برای اولین بار اقدام به درمان لقاح آزمایشگاهی میکرد. با توجه به مقدار بسیار زیاد ذرات گرانولار موجود در فضای پری‌ویتلین، که پس از عمل جداسازی قابل مشاهده بود، امکان تعیین حضور و موقعیت اولین جسم قطبی برای درک درست بلوغ تخمک وجود نداشت (متافاز 2). با این وجود، در تمام تخمکها تزریق داخل سیتوپلاسمی اسپرم انجام شد. برای انجام کل مراحل کشت از دستگاه انکوباتور تایم لپس استفاده شد. از این رو، فیلم 6 روزه کشت ضبط شد. تنها 2 تخمک توانستند به درستی بارور شوند و در روز 6 به مرحله بلاستوسیست برسند. جنینها منجمد شدند و متعاقباً به عنوان انتقال جنین منجمد پس از سیکل قاعدگی بعدی منتقل شدند. نتیجه گیری: به نظر می‌رسد وجود استثنایی ذرات گرانولار در فضای پری‌ویتلین که جنبه‌ها و رفتار سلول‌های گرانولوزا را به ما یادآوری می‌کند، بر لقاح تأثیر می‌گذارد اما بر کیفیت بلاستوسیست تأثیر نمی‌گذارد. در واقع این زن پس از انتقال جنین موفق به تولد دوقلو شد. 2 Background: Phenotypic dysmorphism is not rare to be found in the human oocyte, especially in the perivitelline space, which are among the most important aberration of the extra cytoplasmic component. Case Presentation: The case is of a 30-yr-old woman with no previous pregnancy, attempting an in vitro fertilization treatment for the first time. Given the extraordinary quantity of granular particles found in the perivitelline space, visible after the stripping procedure, it was not possible to establish the presence and position of the first polar body to appreciate the correct oocyte maturation (metaphase 2). Nevertheless, all the eggs were injected by the intracytoplasmic sperm injection. A time lapse incubator was used to perform the entire culture. Hence, a record of 6 days culture video was obtained. Only 2 eggs could fertilize correctly and reach the blastocyst stage on day 6. The embryos were frozen and subsequently transferred as frozen embryo transfer following the next menstrual cycle. Conclusion: The exceptional presence of granular particles in the perivitelline space, which reminds us for aspects and behavior the granulosa cells, seems to affected the fertilization but not the blastocysts quality. As a matter of fact the woman, after the embryo transfer, achieved a successful twin live birth. 263 267 2022/07/252022/10/252022/08/312021/08/132021/08/192022/07/102021/11/112022/06/30 1401/4/9 2023/01/212023/01/212023/01/232023/02/12023/01/232023/02/142023/02/142023/01/15 1401/10/25 Daniele Ferri Daniele Ferri Momo Fertilife Clinic, Via Cala Dell’Arciprete 2C, Bisceglie, Italy. ایتالیا danieleferrimomo@gmail.com Domenico Baldini Domenico Baldini Momo Fertilife Clinic, Via Cala Dell’Arciprete 2C, Bisceglie, Italy. ایتالیا dbaldini@libero.it Giorgio Maria Baldini Giorgio Maria Baldini Momo Fertilife Clinic, Via Cala Dell’Arciprete 2C, Bisceglie, Italy. ایتالیا gbaldini97@gmail.com Oocyte Granulosa cell Intracytoplasmic sperm injection Perivitelline space Case report. تخمک سلول گرانولوزا تزریق داخل سیتوپلاسمی اسپرم فضای پریویتلین گزارش مورد. Sousa M, Teixeira da Silva J, Silva J, Cunha M, Viana P, Oliveira E, et al. Embryological, clinical and ultrastructural study of human oocytes presenting indented zona pellucida. Zygote 2015; 23: 145-157.##Nikiforov D, Grøndahl ML, Hreinsson J, Andersen CY. Human oocyte morphology and outcomes of infertility treatment: A systematic review. Reprod Sci 2022; 29: 2768-2785.##Jansen R, Mortimer D. Toward reproductive certainty: Fertility and genetics beyond, the plenary proceedings of the 10th world congress. London: CRC Press; 1999.##Gupta SK. The human egg's zona pellucida. Curr Top Dev Biol 2018; 130: 379-411.##Turathum B, Gao EM, Chian RC. The function of cumulus cells in oocyte growth and maturation and in subsequent ovulation and fertilization. Cells 2021; 10: 2292.## ##