Comparing the advantages, disadvantages and diagnostic power of different non-invasive pre-implantation genetic testing: A literature review مقایسه مزایا و معایب و قدرت انواع روش‌های تشخیص ژنتیکی غیرتهاجمی پیش از کاشت: مروری بر متون 2 1 به منظور بهبود میزان موفقیت انتقال جنین و افزایش شانس تولد زنده در روشهای کمکباروری، تقاضای فزایندهای برای استفاده از تستهای تشخیص ژنتیکی قبل از لانهگزینی (PGT) وجود دارد. با این حال، رویکردهای تهاجمی مورد استفاده در PGT منجر به شکست لقاح خارج رحمی و سقط جنین و در نتیجه افزایش سطح اضطراب برای والدین شده است. برای رفع این مشکل، روش‌های غیرتهاجمی PGT مانند تشخیص DNA در مایع بلاستوکول بلاستوسیست‌ها و محیط‌های کشت مصرف‌شده (SCM) معرفی شده‌اند. این روشها ثابت کردهاند که در تشخیص آنوپلوئیدی در کروموزومهای جنین انسان کمتهاجمی و مؤثر هستند. هدف این مقاله، بررسی رویکردهای مختلف تشخیص قبل از کاشت، از جمله روش‌های تهاجمی و غیرتهاجمی، با تمرکز ویژه بر niPGT است. استراتژی جستجو شامل جمعآوری دادهها از پایگاههای علمی مانند PubMed، Google Scholar و Science Direct با استفاده از کلمات کلیدی مرتبط بود. جستجو تا ژانویه 2023 انجام شد. در مجموع، 22 مطالعه با موفقیت تشخیص و تکثیر DNA بدون سلول در SCM جنینی را گزارش کردند. توجه به این نکته مهم است که niPGT دارای محدودیتهایی است که ناشی از تفاوت در شاخصهایی مانند نرخ تکثیر DNA بدون سلول، تطابق، سطح آلودگی DNA مادری، حساسیت و ویژگی بین نمونههای SCM و سلولهای بیوپسی شده است. بنابراین، تحقیقات گسترده‌تر و دقیق‌تری برای درک کامل پتانسیل niPGT برای کاربردهای بالینی مورد نیاز است. 2 To improve embryo transfer success and increase the chances of live birth in assisted reproductive methods, there is a growing demand for the use of pre-implantation genetic testing (PGT). However, the invasive approaches used in PGT have led to in vitro fertilization failure and abortions, increasing anxiety levels for parents. To address this, non-invasive PGT methods have been introduced, such as the detection of DNA in blastocoel fluid of blastocysts and spent culture media (SCM). These methods have proven to be minimally invasive and effective in detecting aneuploidy in the chromosomes of human embryos. This review aims to explore the different approaches to pre-implantation diagnosis, including invasive and non-invasive methods, with a particular focus on non-invasive PGT (niPGT). The search strategy involved gathering data from scientific databases such as PubMed, Google Scholar, and Science Direct using relevant keywords. The search was conducted until January 2023. In total, 22 studies have successfully reported the detection and amplification of cell-free DNA in the embryonic SCM. It is important to note that niPGT has some limitations, which include differences in indicators such as cell-free DNA amplification rate, concordance, level of maternal DNA contamination, sensitivity, and specificity between SCM samples and biopsied cells. Therefore, more extensive and detailed research is needed to fully understand niPGT's potential for clinical applications. 177 190 2023/08/16 1402/5/25 2024/03/3 1402/12/13 Noorodin Karami Noorodin Karami Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Noorodin.karami@yahoo.com Farzaneh Iravani Farzaneh Iravani Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Farzaneh.baroon@gmail.com Sareh Bakhshandeh Bavarsad Sareh Bakhshandeh Bavarsad Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران S.bakhshandeh27@gmail.com Samira Asadollahi Samira Asadollahi Department of Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Sasadullahi@yahoo.com Seyed Mehdi Hoseini Seyed Mehdi Hoseini Biotechnology Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Science, Yazd, Iran. ایران sm_hoseini@outlook.com Fateme Montazeri Fateme Montazeri Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران f_montazeri@outlook.com Seyed Mehdi Kalantar Seyed Mehdi Kalantar Abortion Research Centre, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران smkyzd@gmail.com Spent culture media Non-invasive pre-implantation genetic testing Biopsy methods Cell-free embryonic DNA. محیط‌ کشت مصرف‌شده تست‌های ژنتیکی قبل از کاشت روش‌های بیوپسی DNA بدون سلول جنین. Cheng W-L, Hsiao Ch-H, Tseng H-W, Lee T-P. Noninvasive prenatal diagnosis. 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The categorization of opaque pathologies outside of contrast media in hysterosalpingography which facilitate interpretation: A pictorial review طبقه بندی پاتولوژی های دنس خارج از نواحی حاجب در هیستروسالپینگوگرافی که تفسیر را تسهیل می کند: یک بررسی تصویری 2 1 عکس رنگی رحم یا هیستروسالپینگوگرافی (HSG) یک روش تصویربرداری کاربردی و قابل اعتمادی است که برای بررسی کانال سرویکال، کاویته رحم و لولههای فالوپ میباشد. با استفاده از HSG پاتولوژیهای نواحی حاجب شده و نواحی غیرحاجب که اوپاک باشند، قابل بررسی میباشد. هدف ما از این مقاله تقسیمبندی یافتههای پاتولوژیک اوپاک خارج از نواحی حاجب شده در HSG است. در این مقاله تصاویر جالب و نسبتاً غیرشایع از پاتولوژیهای خارج از منطقه حاجب در HSG که توسط آقای دکتر شهرزاد در طی 50 سال گردآوری گردیده، ارائه شده است. در کلیشه ساده لگن، بافت نرم، ساختمانهای استخوانی، آرتیفکتها یا جسم خارجی دیده میشوند. تقسیمبندی پاتولوژیها میتواند به متخصصین رادیولوژی در تفسیر صحیح HSG کمک نماید. پاتولوژیهای اوپاک خارج از نواحی حاجب شده در HSG به دو گروه پاتولوژیهای وابسته به بافتهای داخل لگنی و اجسام خارجی تقسیم شدند. اجسام خارجی ممکن است در داخل بدن و یا در خارج از بدن قرار گرفته باشند. آشنایی با پاتولوژیهای بافتهای لگن و تفسیر دقیق تصاویر HSG ضروری است. 2 Hysterosalpingography (HSG) is a practical and reliable imaging method to evaluate the cervical canal, uterine isthmus, uterine cavity, and fallopian tubes. Using HSG, opaque pathologies outside of contrast media can be detected as well as pathologies of uterus and fallopian tubes. We aim to present and categorize some uncommon and interesting abnormal findings that are located outside of the contrast areas in HSG. This is a pictorial review that depicts various types of HSG images that include opaque pathologies outside of the contrast areas. Images have been extracted from valuable archives collected over 50 yr by professor Shahrzad. A plain pelvic film contains soft tissues of the pelvis, bony structures, artifacts, or foreign bodies. Categorization might easily help the radiologist to interpret the HSG cliché. Opaque pathologies outside of contrast area in HSG can be categorized into 2 groups: “Pelvic Tissue Related” and “Foreign Bodies”. Pelvic tissue abnormalities might have a gynecologic or non-gynecologic source. Foreign bodies can be located in the pelvis or outside of the body. HSG is a reliable and inexpensive procedure. Familiarity with the pathologies of pelvic tissues and the accurate interpretation of HSG images are important. 191 202 2023/08/162023/10/29 1402/8/7 2024/03/32024/03/11 1402/12/21 Fereshteh Hosseini Fereshteh Hosseini Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. ایران hosseini.f1346@gmail.com Fattaneh Pahlavan Fattaneh Pahlavan Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. ایران midwiferesfahan@gmail.com Firoozeh Ahmadi Firoozeh Ahmadi Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. ایران dr.ahmadi1390@gmail.com Hysterosalpingography Opaque Abnormalities Uterine Fallopian tubes. هیستروسالپینگوگرافی اوپاک ناهنجاری رحم لوله های فالوپ. Luczynska E, Zbigniew K. Diagnostic imaging in gynecology. 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The effect of aqueous extract of orchid root on the structure of ovary and hypothalamic-pituitary-gonadal hormones in polycystic ovary syndrome rat model: An experimental study تأثیر عصاره آبی ریشه ارکیده بر ساختار تخمدان و هورمون‌های هیپوتالاموس-هیپوفیز-گناد در موش های صحرایی مبتلا به سندرم تخمدان پلی کیستیک: یک مطالعه تجربی 2 1 مقدمه: برخی از شرایط پزشکی، از جمله سندرم تخمدان پلیکیستیک (PCOs)، ممکن است منجر به ناباروری شود. عدم تعادل هورمونی در PCOs قابل توجه است. آنتیاکسیدانهای طبیعی دارای مزایای سلامتی بسیاری از جمله اثرات مثبت بر تولید هورمون هستند. هدف: از آنجایی که داروهای گیاهی برای بیماران ایمن‌تر و قابل قبول‌تر هستند، مطالعه حاضر به منظور بررسی اثر عصاره آبی ارکیده (SA) با اثرات آنتیاکسیدانی بر ساختار تخمدان و هورمون‌های محور هیپوتالاموس-هیپوفیز-گناد و تستوسترون آزاد در موش‌های صحرایی PCO طراحی شد. مواد و روش ها: در این مطالعه تجربی، 64 موش صحرایی ماده سالم ویستار (180-200 گرم) به‌طور تصادفی به گروه‌های کنترل 60 و 89 روزه، گروه PCOs و 4 گروه PCO+ SA با دوزهای 40، 80، 160 و 320 میلی‌گرم بر کیلوگرم SA تقسیم شدند. سطوح سرمی GnRH، استروژن، پروژسترون، تستوسترون، هورمون محرک فولیکول و هورمون لوتئینیزهکننده اندازهگیری شد. علاوه بر این، تخمدانها استخراج و مورد بررسی بافتشناسی قرار گرفتند. نتایج: میزان فولیکول‌های نخستین، اولیه، ثانویه و گراف و سطوح سرمی هورمون‌های FSH و پروژسترون در گروه‌های PCO کاهش یافت، در حالی که فولیکول‌های آترتیک و سطوح سرمی GnRH، هورمون محرک فولیکول، استروژن و تستوسترون آزاد افزایش داشت. استفاده از دوزهای مختلف SA عدم تعادل هورمونی و بافتی ناشی از PCO را تنظیم کرد که 320 میلی‌گرم بر کیلوگرم مؤثرترین دوز بود. نتیجه گیری: عصاره آبی ریشه ارکیده می‌تواند تأثیر مثبتی در بهبود PCOs داشته باشد. این اثر را می‌توان با تنظیم سطح هورمون‌های جنسی و اصلاح ناهنجاریهای فولیکولی در بافت تخمدان به دست آورد. 2 Background: Some medical conditions, including polycystic ovarian syndrome (PCOs), may lead to infertility. In PCOs, hormonal imbalance is significant. Antioxidants such as natural antioxidants have many health benefits, including positive effects on hormone production. Objective: Since herbal medicines are more acceptable to people, the present study was designed to evaluate the effect of an aqueous extract of orchid (SA), with antioxidative effects, on the structure of the ovary and the hypothalamic-pituitary-gonadal axis hormones and free testosterone in PCOs rats. Materials and Methods: In this experimental study, 64 healthy female Wistar rats (180-200 gr) were randomly divided into 60 and 89 day control groups, PCOs, and 4 PCOs + SA groups that received 40, 80, 160, and 320 mg/kg of SA. Serum levels of gonadotropin-releasing hormone, estrogen, progesterone, testosterone, follicle-stimulating hormone, and luteinizing hormone were measured. In addition, the ovaries were extracted and examined histologically. Results: The amount of primordial, primary, secondary, and Graafian follicles and serum levels of follicle-stimulating hormone and progesterone hormones decreased in PCOs groups, while atretic follicles and the serum levels of gonadotropin-releasing hormone, luteinizing hormone, estrogen, and free testosterone were increased. SA at different doses regulated hormonal and histological imbalances caused by PCOs, and 320 mg/kg was the most effective. Conclusion: The aqueous extract of orchids root can have a positive effect on the improvement of polycystic ovary syndrome. This effect can be achieved by regulating the level of sex hormones and correcting follicular abnormalities in the ovarian tissue. 203 210 2023/08/162023/10/292023/07/19 1402/4/28 2024/03/32024/03/112024/02/24 1402/12/5 Hassanali Abedi Hassanali Abedi Research Center for Noncommunicable Disease, Jahrom University of Medical Sciences, Jahrom, Iran. ایران hassanaliabedi@yahoo.com Armin Zarrin-Mehr Armin Zarrin-Mehr Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran. ایران A.Z.9303@gmail.com Bahareh Ebrahimi Bahareh Ebrahimi Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ایران ebrahimi_b@sums.ac.ir Hoda Haghshenas Hoda Haghshenas Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran. ایران hoda76h@gmail.com Negar Parvin Negar Parvin Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran. ایران n.parvin98@gmail.com Hossein Kargar Jahromi Hossein Kargar Jahromi Research Center for Noncommunicable Disease, Jahrom University of Medical Sciences, Jahrom, Iran. ایران h.kargar@jums.ac.ir PCOS Orchid Ovary GnRH LH FSH. 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Evidence summaries and recommendations from the international evidence‐based guideline for the assessment and management of polycystic ovary syndrome: Lifestyle management. Obes Rev 2020; 21: e13046.##Khashchenko E, Vysokikh M, Uvarova E, Krechetova L, Vtorushina V, Ivanets T, et al. Activation of systemic inflammation and oxidative stress in adolescent girls with polycystic ovary syndrome in combination with metabolic disorders and excessive body weight. J Clin Med 2020; 9: 1399.##Enechukwu CI, Onuegbu AJ, Olisekodiaka MJ, Eleje GU, Ikechebelu JI, Ugboaja JO, et al. Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital. Obstet Gynecol Sci 2019; 62: 335-343.##Kargar Jahromi H, Solhjoo E, Hassannezhad A, Pourahmadi M, Sahraei R, Abedi H, et al. [Comparison of aqueous extract of Salepâ s root (Dactylorhiza maculate) with ibuprofen on pain sensory thresholds using the formalin test in adult male rats]. 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Epiphytic acampe ochracea orchid relieves paracetamol-induced hepatotoxicity by inhibiting oxidative stress and upregulating antioxidant genes in in vivo and virtual screening. Biomed Pharmacother 2021; 143: 112215.##Barragán-Zarate GS, Lagunez-Rivera L, Solano R, Pineda-Peña EA, Landa-Juárez AY, Chávez-Piña AE, et al. Prosthechea karwinskii, an orchid used as traditional medicine, exerts anti-inflammatory activity and inhibits ROS. J Ethnopharmacol 2020; 253: 112632.##Amini L, Tehranian N, Movahedin M, Ramezani Tehrani F, Soltanghoraee H. Polycystic ovary morphology (PCOM) in estradiol valerate treated mouse model. Int J Women's Health Reprod Sci 2016; 4: 13-17.##Venegas B, De León Gordillo LY, Rosas G, Espinoza JA, Morán C, Domínguez R, et al. In rats with estradiol valerate-induced polycystic ovary syndrome, the acute blockade of ovarian β-adrenoreceptors improve ovulation. 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Herbs as a source for the treatment of polycystic ovarian syndrome: A systematic review. BioTech 2023; 12: 4.##Shahzad H, Giribabu N, Muniandy S, Salleh N. Quercetin induces morphological and proliferative changes of rat's uteri under estrogen and progesterone influences. Int J Clin Exp Pathol 2014; 7: 5484.##Han B, Jiang P, Jiang L, Li X, Ye X. Three phytosterols from sweet potato inhibit MCF7-xenograft-tumor growth through modulating gut microbiota homeostasis and SCFAs secretion. Food Res Int 2021; 141: 110147.##Matsuda F, Ohkura S, Magata F, Munetomo A, Chen J, Sato M, et al. Role of kisspeptin neurons as a GnRH surge generator: Comparative aspects in rodents and non‐rodent mammals. J Obstet Gynaecol Res 2019; 45: 2318-2329.##Watanabe M, Fukuda A, Nabekura J. The role of GABA in the regulation of GnRH neurons. Front Neurosci 2014; 8: 387.##Hajiani M, Kargar Jahromi H, Kargar Jahromi Z, Khabbaz Kherameh Z. 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Letrozole and ovarian hyperstimulation syndrome: Retrospective cross-sectional study لتروزول و سندرم تحریک بیش از حد تخمدان: یک مطالعه مقطعی گذشته نگر 2 1 مقدمه: اخیرا لتروزول به علت اثر کاهشدهنده استروژن و افزایشدهنده آندروژن بر تخمدانها و در نتیجه اثر بر سلولهای گرانولوزا و کاهش تولید فاکتور رشد اندوتلیال عروقی (VEGF) در پیشگیری از سندرم تحریک بیش از حد تخمدان (OHSS) متوسط تا شدید در تکنولوژی کمک باروری (ART) مورد توجه واقع شده است. هدف: هدف ما از این مطالعه بررسی اثر مصرف لتروزول در پیشگیری از بروز OHSS در زنان نابارور با تشخیص سندرم تخمدان پلیکیستیک در سیکل ART میباشد. مواد و روش ها: در این مطالعه مقطعی، از بین 1743 پرونده پزشکی زنان نابارور که در برنامه برگشت تخمک مرکز تحقیقاتی درمانی ناباروری یزد قرار داشتند، اطلاعات 343 زن مبتلا به سندرم تخمدان پلیکیستیک و در معرض خطر OHSS از فروردین تا اسفند 1401 بررسی شد. تحریک تخمدان با پروتکل GnRH آنتاگونیست انعطافپذیر انجام شده بود. بیماران براساس دریافت یا عدم دریافت لتروزول به دو گروه تقسم شدند. در گروه لتروزول از روز تریگر 5/2 میلیگرم لتروزول دوبار در روز ادامه یافت و گروه کنترل لتروزول دریافت نکرد. متغیرهای شدت OHSS و میزان بستری شدن و نیاز به تجویز آلبومین بین دو گروه آنالیز شد. نتایج: 89 زن در گروه لتروزول و 254 زن در گروه کنترل بررسی شد. از نظر سن و وزن، بین دو گروه اختلاف آماری معنیداری وجود نداشت ولی از نظر AMH گروه لتروزول AMH بالاتری از لحاظ آماری نسبت به گروه کنترل داشت (61/4 ± 53/7 در برابر 63/3 ± 47/5 و 001/0 < p). از نظر پارامترهای شدت OHSS و میزان بستری شدن و نیاز به تجویز آلبومین بین دو گروه تفاوت معنیدار آماری وجود نداشت. نتیجه گیری: بر اساس مطالعه اخیر، اضافه کردن لتروزول به درمان GnRH آنتاگونیست و کابرگولین، باعث کاهش شدت OHSS نمیشود. 2 Background: Recently, letrozole has been used to prevent moderate to severe ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technology cycles due to its estrogen-reducing and androgen-increasing effects on the ovaries, affecting granulosa cells, and reducing vascular endothelial growth factor production. Objective: This study aimed to investigate the impact of letrozole consumption in preventing OHSS in infertile women with polycystic ovarian syndrome undergoing in vitro fertilization. Materials and Methods: In this cross-sectional study, among 1743 medical records of infertile women who were scheduled for oocyte retrieval at Research and Clinical Center for Infertility, Yazd, Iran. Data of 343 women with polycystic ovarian syndrome diagnosis and at risk of OHSS was extracted from March 2022-2023. The stimulation was carried out using a flexible gonadotropin releasing hormone antagonist protocol. Women were divided into 2 groups based on whether they received letrozole or not. In the letrozole group, 2.5 mg letrozole twice daily was continued from the trigger day, while in the control group, women did not receive letrozole. The parameters of OHSS severity, hospitalization rates, and the need for albumin prescription were analyzed. Results: 89 women in the letrozole and 254 women in the control group were examined. There was no statistically significant difference between groups in terms of age and body mass index; however, anti-Mullerian hormone was significantly higher than control group (7.53 ± 4.61 vs. 5.47 ± 3.63, p < 0.001). The parameters of OHSS severity, hospitalization rates, and the need for albumin prescription showed no significant differences between the groups. Conclusion: Recent study indicates that incorporating letrozole into the treatment of gonadotropinreleasing hormone antagonists and cabergoline does not reduce the OHSS severity. 211 218 2023/08/162023/10/292023/07/192023/12/30 1402/10/9 2024/03/32024/03/112024/02/242024/02/28 1402/12/9 Elham Nikfarjam Elham Nikfarjam Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران elhamnikfarjam2022@yahoo.com Maryam Eftekhar Maryam Eftekhar Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران eftekharmaryam1351@gmail.com Hanieh Fatehi Hanieh Fatehi Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران dr.fatehi435@gmail.com Sahereh Arabian Sahereh Arabian Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Research Center for Abnormal Uterine Bleeding, Semnan University of Medical Sciences, Semnan, Iran. ایران sahereh_arabian@yahoo.com Letrozole Polycystic ovary syndrome Ovarian hyperstimulation syndrome Assisted reproductive technologies. لتروزول سندرم تخمدان پلی کیستیک سندرم تحریک بیش از حد تخمدان تکنولوژی کمک باروری Du D-F, Li M-F, Li X-L. Ovarian hyperstimulation syndrome: A clinical retrospective study on 565 inpatients. Gynecol Endocrinol 2020; 36: 313-317.##Palomba S, Costanzi F, Nelson SM, Caserta D, Humaidan P. Interventions to prevent or reduce the incidence and severity of ovarian hyperstimulation syndrome: A systematic umbrella review of the best clinical evidence. Reprod Biol Endocrinol 2023; 21: 67.##Choudhary RA, Vora PH, Darade KK, Pandey S, Ganla KN. A prospective randomised comparative clinical trial study of luteal phase letrozole versus ganirelix acetate administration to prevent severity of early onset OHSS in ARTs. Int J Fertil Steril 2021; 15: 263-268.##Di Guardo F, Lello Ch, Incognito GG, Bruno MT, Palumbo M. Letrozole and ovarian hyperstimulation syndrome (OHSS): A promising prevention strategy. J Clin Med 2023; 12: 614.##Namvar Jahromi B, Parsanezhad ME, Shomali Z, Bakhshai P, Alborzi M, Moin Vaziri N, et al. Ovarian hyperstimulation syndrome: A narrative review of its pathophysiology, risk factors, prevention, classification, and management. Iran J Med Sci 2018; 43: 248-260.##Pellicer N, Pellicer A. Pathogenesis and management in OHSS. In: Dahan MH, Fatemi HM, Polyzos NP, Garcia-Velasco JA. Handbook of current and novel protocols for the treatment of infertility. UK: Academic Press, Elsevier; 2024.##El-Khayat W, Elsadek M. Calcium infusion for the prevention of ovarian hyperstimulation syndrome: A double-blind randomized controlled trial. Fertil Steril 2015; 103: 101-105.##Zhang Q, Ma Y, Bu X, Jia C, Liu Y, Wang S. Comparison of bromocriptine and hydroxyethyl starch in the prevention of ovarian hyperstimulation syndrome. Int J Gynecol Obstet 2022; 159: 944-950.##Zhao J, Xu B, Huang X, Yan Y, Li Y. Whether letrozole could reduce the incidence of early ovary hyperstimulation syndrome after assisted reproductive technology? A systematic review and meta-analysis. Reprod Health 2020; 17: 181.##Attalla W, Abd Elhamidb T. Aromatase inhibitors versus cabergoline for the prevention of ovarian hyperstimulation syndrome: A prospective, randomized, double-blind study. Evid Based Women's Health J 2017; 7: 22-29.##Agarwal S, Krishna D, Rao KA. Prevention and management of ovarian hyperstimulation syndrome. Int J Infertil Fetal Med 2019; 10: 46-51.##Minami T, Yamana H, Shigemi D, Matsui H, Fushimi K, Yasunaga H. Artificial colloids versus human albumin for the treatment of ovarian hyperstimulation syndrome: A retrospective cohort study. Int J Reprod BioMed 2019; 17: 709.##Fouda UM, Elshaer HS, Youssef GG, Hanafy A, Mehrem WM, Youssef MA, et al. Cabergoline versus calcium infusion in the prevention of ovarian hyperstimulation syndrome: A randomised controlled study. J Obstet Gynaecol 2022; 42: 122-126.##Mohammadi Yeganeh L, Moini A, Shiva M, Mirghavam N, Bagheri Lankarani N. Methylprednisolone for prevention of ovarian hyperstimulation syndrome in patients with polycystic ovarian syndrome undergoing in-vitro fertilisation: A randomised controlled trial. J Obstet Gynaecol 2018; 38: 241-246.##Eftekhar M, Saeed L. Effect of adding letrozole to gonadotropin on in vitro fertilization outcomes: An RCT. Int J Reprod BioMed 2020; 18: 287-294.##Mangal S. Current knowledge on the use of letrozole in ovarian stimulation. Int J Infertil Fetal Med 2021; 11: 48-53.##Qi Q, Xia Y, Luo J, Wang Y, Xie Q. Cocktail treatment by GnRH-antagonist, letrozole, and mifepristone for the prevention of ovarian hyperstimulation syndrome: A prospective randomized trial. Gynecol Endocrinol 2023; 39: 2269281.##Chen Y, Yang T, Hao C, Zhao J. A retrospective study of letrozole treatment prior to human chorionic gonadotropin in women with polycystic ovary syndrome undergoing in vitro fertilization at risk of ovarian hyperstimulation syndrome. Med Sci Monit 2018; 24: 4248-4253.##Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25.##Yanagihara Y, Tanaka A, Nagayoshi M, Tanaka I, Ohno M, Itakura A. Combined use of letrozole, cabergoline and GnRH antagonist eliminates ovarian hyperstimulation syndrome (OHSS) in polycystic ovarian syndrome (PCOS). Evid Based Women's Health J 2022; 12: 262-269.##Ghasemi Tehrani H, Aasasi K, Mardanian F, Mehrabian F, Movahedi M, Naghshineh E. Evaluation of the effect of letrozole in the ovarian hyperstimulation syndrome prevention in participants at risk of treatment with ovulation-stimulating drugs: A randomized controlled trial. Rep Biochem Mol Biol 2022; 11: 386-393.## ##

Naringenin ameliorates cytotoxic effects of bisphenol A on mouse Sertoli cells by suppressing oxidative stress and modulating mitophagy: An experimental study بهبود اثرات سیتوتوکسیک بیسفنل آ بر سلول های سرتولی موش کوچک آزمایشگاهی بوسیله نارینجنین با سرکوب استرس اکسیداتیو و تعدیل میتوفاژی: یک مطالعه تجربی 2 1 مقدمه: بیسفنل آ (BPA)، یک عامل مختلکننده سیستم درونریز، به طور گستردهای به عنوان پلاستیکهای پلیکربنات برای تولید ظروف مواد غذایی استفاده میشود. قرار گرفتن در معرض BPA در غلظتهای موجود در محیط زیست میتواند باعث اختلالات تولیدمثل شود. هدف: اثر نارینجنین (NG) بر سمیت سلولی ایجاد شده در سلولهای سرتولی (رده سلولی TM4) ناشی از BPA و مکانیسم آن در مطالعه حاضر مورد بررسی قرار گرفت. مواد و روشها: در مطالعه تجربی-آزمایشگاهی حاضر، سلولها به مدت 24 ساعت با BPA (8/0 میکرومولار) یا NG در دوزهای 10، 20 و 50 میکروگرم در میلیلیتر تیمار شدند. میزان زنده ماندن سلولها، تولید رادیکالهای آزاد اکسیژن (ROS)، محتوای مالوندی‌آلدئید (MDA)، سطح آنتیاکسیدان‌ها و پتانسیل غشای میتوکندری (MMP) سنجیده شد. بیان ژن‌های مرتبط با میتوفاژی، از جمله Parkin و Pink1 نیز مورد ارزیابی قرار گرفت. نتایج: BPA به طور قابل توجهی زنده ماندن سلولهای سرتولی را کاهش داد (004/0 = p). سطوح Pink1 و Parkin در گروه BPA به طور قابل توجهی افزایش یافت (001/0 < p)، در حالی که MMP به طور قابل توجهی کاهش یافت (001/0 < p). BPA، سطح MDA و ROS را افزایش داد (001/0 < p) و مارکرهای آنتیاکسیدانی را کاهش داد (003/0 = p). NG در غلظتهای 20 و 50 میکروگرم در میلیلیتر میتواند به طور قابل توجهی زنده ماندنی و MMP سلولهای TM4 را افزایش دهد (034/0 = p). درمان با NG به غلظت بستگی دارد و میتواند سطوح Pink1 و Parkin را در مقایسه با گروه BPA کاهش دهد (024/0 = p). NG فاکتورهای آنتیاکسیدانی را افزایش داد، در حالی که سطوح ROS و MDA در سلولهای در معرض BPA کاهش یافت. نتیجهگیری: اثرات مفید NG بر سلول‌های سرتولی در معرض BPA با سرکوب میتوفاژی و کاهش استرس اکسیداتیو مرتبط است. 2 Background: Bisphenol A (BPA), an endocrine-disrupting agent, is widely used as polycarbonate plastics for producing food containers. BPA exposure at environmentally relevant concentrations can cause reproductive disorders. Objective: The effect of Naringenin (NG) on BPA-induced Sertoli cell toxicity and its mechanism was examined in the present study. Materials and Methods: In this experimental-laboratory study, the mouse TM4 cells were treated to BPA (0.8 μM) or NG for 24 hr at concentrations of 10, 20, and 50 μg/ml. Cell viability, reactive oxygen species (ROS) production, malondialdehyde (MDA) content, antioxidant level, and mitochondrial membrane potential (MMP) were examined. The expression of mitophagy-related genes, including Parkin and PTEN-induced putative kinase 1 (Pink1), was also evaluated. Results: BPA significantly lowered the viability of the Sertoli cells (p = 0.004). Pink1 and Parkin levels of the BPA group were significantly increased (p < 0.001), while the MMP was considerably decreased (p < 0.001). BPA raised MDA and ROS levels (p < 0.001) and reduced antioxidant biomarkers (p = 0.003). NG at the 20 and 50 μg/ml concentrations could significantly improve the viability and MMP of TM4 cells (p = 0.034). NG depending on concentration, could decrease Pink1 and Parkin at mRNA and protein levels compared to the BPA group (p = 0.024). NG enhanced antioxidant factors, while ROS and MDA levels were decreased in the BPA-exposed cells. Conclusion: The beneficial impacts of NG on BPA-exposed Sertoli cells are related to the suppression of mitophagy and the reduction of oxidative stress. 219 228 2023/08/162023/10/292023/07/192023/12/302023/11/11 1402/8/20 2024/03/32024/03/112024/02/242024/02/282024/03/5 1402/12/15 Layasadat Khorsandi Layasadat Khorsandi Cellular and Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران khorsandi_cmrc@yahoo.com abbas Heidari-Moghadam abbas Heidari-Moghadam Department of Anatomical Sciences, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran. ایران abbass.heidari@yahoo.com Elham Younesi Elham Younesi Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران elhamyounesi29@yahoo.com Mohammad-Javad Khodayar Mohammad-Javad Khodayar Toxicology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران khodayar-mj@ajums.ac.ir Yousef Asadi-Fard Yousef Asadi-Fard Department of Anatomy, School of Medicine, Arak University of Medical Sciences, Arak, Iran. ایران usef.fard@yahoo.com Mitophagy Naringenin Sertoli cells Bisphenol A Reactive oxygen species Pink1 Parkin. میتوفاژی نارینجنین سلول های سرتولی بیسفنل آ گونه های فعال اکسیژن Pink1 Parkin Manzoor MF, Tariq T, Fatima B, Sahar A, Tariq F, Munir S, et al. 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Naringin reverses high-cholesterol diet-induced vascular dysfunction and oxidative stress in rats via regulating LOX-1 and NADPH oxidase subunit expression. Biomed Res Int 2019; 2019: 3708497.##Li F, Zhan Z, Qian J, Cao C, Yao W, Wang N. Naringin attenuates rat myocardial ischemia/reperfusion injury via PI3K/Akt pathway-mediated inhibition of apoptosis, oxidative stress and autophagy. Exp Ther Med 2021; 22: 811-819.##Hsueh TP, Sheen JM, Pang JH, Bi KW, Huang CC, Wu HT, et al. The anti-atherosclerotic effect of naringin is associated with reduced expressions of cell adhesion molecules and chemokines through NF-κB pathway. Molecules 2016; 21: 195-210.##Mohamed EE, Ahmed OM, Abdel-Moneim A, Zoheir KMA, Elesawy BH, Al Askary A, et al. Protective effects of naringin-dextrin nanoformula against chemically induced hepatocellular carcinoma in Wistar rats: Roles of oxidative stress, inflammation, cell apoptosis, and proliferation. 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Features of the course of severe and critical COVID-19 in pregnant women: A prospective cross-sectional study ویژگی های سیر کووید-19 شدید و بحرانی در زنان باردار: یک مطالعه مقطعی آینده نگر 2 1 مقدمه: با شروع همهگیری بیماری کرونا ویروس 2019 (کووید-19)، مطالعات نشان داد که خطر ابتلا به نوع شدید این بیماری در زنان باردار بیشتر میباشد. هدف: این مطالعه به بررسی ویژگی‌های انواع شدید و بسیار شدید عفونت کووید-19 در زنان باردار می‌پردازد. مواد و روش ها: در این مطالعه مقطعی آینده‌نگر، سوابق پزشکی 120 زن باردار مبتلا به کووید-19 شدید و بسیار شدید با هم مقایسه شد. این زنان در مرکز بیماری‌های عفونی، شیمکنت، قزاقستان از دسامبر 2021 تا مه 2022 تحت درمان قرار گرفته بودند. عواملی مانند زمان بستری در بیمارستان، مدت دوره بستری، بیماریهای همراه با حاملگی مادر، سن، عوارض بارداری و پس از زایمان، پیامدهای بارداری و نوع درمان مورد تجزیه و تحلیل قرار گرفت. نتایج: 87 زن باردار (5/%72) مبتلا به کووید-19 شدید و 33 نفر (5/%27) با نوع بسیار شدید کووید-19 وارد مطالعه شدند. دادههای زیر هنگام مقایسه تعداد حاملگی، بسته به سن حاملگی به دست آمد: در هفتههای 12-1، این شاخص 95/0 ± 75/3 بود. در هفتههای 27-13 شاخص 00/3 (00/00-4/2 :Q1-Q3)، در هفتههای 40-28 شاخص 00/3 (00/4-00/2 :Q1-Q3). نتایج نشاندهنده این بود که عفونت شدید کووید-19 در زنان با بارداری سوم رخ میدهد (00/4-00/2 :Q1-Q3)Me 3.00 ). نتیجه گیری: خطر پیشرفت بیماری به کووید-19 شدید و بسیار شدید در زنان باردار بالای 33 سال و در هفته‌های 40-28 بارداری وجود دارد. ارجاع زودهنگام به پزشک در بیمارستان، بستری شدن به موقع و شروع درمان، خطر تشدید وضعیت بیمار و ایجاد عوارض وحشتناک را کاهش میدهد. 2 Background: At the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, studies showed that the risk of severe disease was higher in pregnant women. Objective: This study investigates the characteristics of severe and critical types of COVID-19 coronavirus infection in pregnant women. Materials and Methods: This prospective cross-sectional study compared the medical records of 120 pregnant women with severe and very severe COVID-19 treated at the Infectious Disease Center, Shymkent, Kazakhstan from December 2021 to May 2022. Factors such as time of hospital admission, hospitalization period, maternal comorbidities, age, pregnancy and postpartum complications, pregnancy outcomes, and treatment type were analyzed. Results: 87 (72.5%) pregnant women with severe and 33 (27.5%) with critical type of COVID-19 were included. The following data were obtained when comparing the pregnancy parity of the subjects, depending on the gestational age: in 1-12 wk, the indicator was 3.75 ± 0.95; in 13-27 wk 3.00 (Q1-Q3: 2.00-4.00), in 28-40 wk 3.00 (Q1-Q3: 2.00-4.00). Severe COVID-19 coronavirus infection occurs in women with more than a third pregnancy (Me 3.00 [Q1-Q3: 2.00-4.00]). Conclusion: There is a risk of disease progression to severe and critical COVID-19 in pregnant women older than 33 yr of age and at 28-40 wk gestation. Early referral to a doctor in hospital, timely hospitalization, and initiated treatment reduces the risk of aggravation of the patient's condition and development of formidable complications. 229 234 2023/08/162023/10/292023/07/192023/12/302023/11/112023/01/2 1401/10/12 2024/03/32024/03/112024/02/242024/02/282024/03/52024/03/7 1402/12/17 Gulbanu Ganikyzy Shaimerdenova Gulbanu Ganikyzy Shaimerdenova South Kazakhstan Medical Academy, Shymkent, Kazakhstan. قزاقستان gulbanu1008@mail.ru Gulzhan Narkenovna Abuova Gulzhan Narkenovna Abuova South Kazakhstan Medical Academy, Shymkent, Kazakhstan. قزاقستان dr.abuova@gmail.com Saltanat Nalibekkyzy Kulbayeva Saltanat Nalibekkyzy Kulbayeva South Kazakhstan Medical Academy, Shymkent, Kazakhstan. قزاقستان saltanatkulbayeva@gmail.com COVID-19 Pregnancy Infection. کووید-19 بارداری عفونت. Hui DS, Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. 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Human Vα7.2-Jα33 mucosal-associated invariant T cells in endometrial ectopic tissues tend to produce interferon-gamma: A new player in endometriosis etiology: A case-control study سلول های T ثابت مرتبط با مخاط V𝜶7.2-J𝜶33 انسان در بافت های نابجای آندومتر تمایل به تولید اینترفرون گاما دارند: بازیگری جدید در علت آندومتریوز: یک مطالعه مورد-شاهدی 2 1 مقدمه: آندومتریوز یک اختلال التهابی مزمن مرتبط با استروژن است که با تکثیر سلولهای آندومتر در مکانی خارج از رحم شناخته میشود. حضور زیاد سلولهای ایمنی در مایع صفاقی زنان مبتلا به اندومتریوز، دخالت سیستم ایمنی در پاتوژنز بیماری را تأیید میکند. سلولهای MAIT با تولید IL-17، IFN-γ و TNF-α، تأثیر غیرقابل انکاری بر ایمنی مخاط ایفا میکنند. عملکرد این سلولها در پاتوژنز اندومتریوز کمتر مورد بررسی قرار گرفته است. هدف: هدف از این مطالعه بررسی نفوذ سلول MAIT با استفاده از تعیین سطح بیان ژن‌های Va7.2-Jα33 در بافت یوتوپیک و اکتوپیک ضایعات آندومتریوز است. مواد و روش ها: در مطالعه مورد-شاهدی، نمونههای مورد آزمایش شامل 20 بافت اوتوپیک و 20 بافت نابجا زنان مبتلا به اندومتریوز و 20 بافت آندومتر رحم زنان در گروه شاهد بود. بیان ژنهای TNF-α، IL-17A، IFN-γ توسط (q-RT-PCR) مورد تجزیه و تحلیل قرار گرفت. نتایج: بر اساس نتایج مطالعه، بیان ژن‌های Va7.2-Jα33 در رحم و بافت‌های یوتوپیک آندومتر در مقایسه با کنترل داخلی ژن و همچنین در بافت‌های نابجا، افزایش قابل ‌توجهی را نشان نداد. تجزیه و تحلیل همبستگی یک رابطه مثبت بین ژنهای بیان Vα7.2-Jα33 و سطوح IFN-γ در بافتهای نابجا تأیید کرد. نتیجه گیری: با توجه به بیان کم ژن اختصاصی سلول‌های MAIT در بافت نابجا، می‌توان نتیجه گرفت که این سلول‌ها به میزان کمی در محیط اندومتریوز حضور دارند و با ترشح IFN-γ احتمال نقش آنها در پیشرفت اندومتریوز وجود دارد. 2 Background: Endometriosis is a chronic estrogen-related inflammatory disorder that is known by proliferating endometrial cells in a place outside the uterus. The high presence of immune cells in the peritoneal fluid of women with endometriosis confirms the involvement of the immune system in the pathogenesis of the disease. Mucosal-associated invariant T (MAIT) cells play an undeniable impact on mucosal immunity by the production of interleukin-17, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha. The function of the cells in the pathogenesis of endometriosis is less investigated. Objective: This study aims to investigate the infiltration of MAIT cells by using the determination levels of Vα7.2-Jα33 gene expression in eutopic and ectopic tissue of endometriosis lesions. Materials and Methods: In this case-control study, the tested samples include 20 eutopic and 20 ectopic tissues of women with endometriosis and 20 uterine endometrial tissues of women in the control group. Expressions of the Vα7.2-Jα33 tumor necrosis factor-alpha, interleukin-17A, and IFN-γ genes were analyzed by quantitative reverse transcriptase-polymerase chain reaction. Results: According to the results, Vα7.2-Jα33 gene expression did not show substantial elevation in the uterine and eutopic endometrial tissues compared to internal gene control as well as in ectopic tissues. Correlation analysis approved a positive relationship between Vα7.2-Jα33 expression genes and IFN-γ levels in ectopic tissues. Conclusion: Considering the low-expression specific gene of MAIT cells in ectopic tissue, it can be concluded that these cells are present in the endometriotic environment to a certain extent, and there is a possibility of their role in the progression of endometriosis by secreting IFN-γ. 235 244 2023/08/162023/10/292023/07/192023/12/302023/11/112023/01/22023/08/27 1402/6/5 2024/03/32024/03/112024/02/242024/02/282024/03/52024/03/72024/03/9 1402/12/19 Maryam Zare Moghaddam Maryam Zare Moghaddam Department of Immunology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران zmary1371@GMAIL.COM Fateme Zare Fateme Zare Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Fatemezare91@gmail.com Reyhane Sandoghsaz Reyhane Sandoghsaz Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Reyhane.sandoghsaz@gmail.com Abbas Khalil Abbas Khalil Department of Pediatrics, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران Email:abbas_khalili_30@yahoo.com Ali Shams Ali Shams Department of Immunology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران alis743@yahoo.com Endometriosis MAIT IFN-γ TNF-α TCR V alpha 7.2-J alpha33 IL-17. آندومتریوزیس MAIT IFN-γ TNF-α TCR V alpha 7.2 J alpha33 IL-17. 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Corrigendum to “The effect of topical endometrial scratching on pregnancy outcome in women with previous failure of intrauterine insemination: A non-randomized clinical trial” [Int J Reprod BioMed 2021; 19: 465-470] 2 2 The publisher has been informed of an error that occurred on page 465 in which the first author affiliation order is incorrect and should be replaced with each other. On behalf of the author, the publisher wishes to apologize for this error. The online version of article has been updated on 30 March 2024. 245 245 2023/08/162023/10/292023/07/192023/12/302023/11/112023/01/22023/08/272024/04/30 1403/2/11 2024/03/32024/03/112024/02/242024/02/282024/03/52024/03/72024/03/92024/03/11 1402/12/21 Farahnaz Farzaneh Farahnaz Farzaneh Endometriosis Research Center, Iran University of medical Sciences, Tehran, Iran. Infectious Disease and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. ایران Farahnaz1826@yahoo.com Farzaneh Khastehfekr Farzaneh Khastehfekr Zahedan University of Medical Science, Zahedan, Iran. ایران pregnancy ## ##