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Closer look at circulating nitric oxide levels and their association with polycystic ovary syndrome: A meta-analytical exploration نگاهی دقیق‌تر به نیتریک‌اکسید در گردش و ارتباط آن با سندرم تخمدان پلی‌کیستیک: یک بررسی متاآنالیز 2 1 مقدمه: سندرم تخمدان پلی­کیستیک (PCOS) سایه گسترده­ای بر سلامت باروری میلیون­ها زن، در سراسر جهان می­اندازد و به عنوان یکی از پیچیده­ترین و چندوجهی­ترین اختلالات غدد درون­ریز ظاهر می­شود. علاوه بر این، نیتریک اکسید (NO) به عنوان یک مولکول سیگنال محوری برجسته است که مجموعه­ای از فرآیندهای فیزیولوژیکی را تنظیم می­کند. هدف: این متاآنالیز با هدف روشن کردن ارتباط بین سطوح NO و اختلال PCOS در زنان شکل گرفته است، این مطالعه بررسی پتانسیل NO را به عنوان یک نشانگر زیستی برای تشخیص PCOS و ارزیابی اهمیت بالینی آن نشان می‌دهد. مواد و روش­ ها: جستجوی سیستماتیک در چندین پایگاه داده الکترونیکی از جمله PubMed، Web of Science، Cochrane Library، Scopus، EMBASE و Google Scholar برای شناسایی مطالعات مرتبط منتشر شده تا ژانویه 2024 انجام شد. تفاوت میانگین استاندارد شده (SMD) و CI %95 با استفاده از یک مدل اثرات تصادفی برای ارزیابی اندازه اثر کلی محاسبه شد. متارگرسیون و تجزیه و تحلیل زیر گروهی برای بررسی منابع ناهمگنی انجام شد. نتایج: متاآنالیز 14 مطالعه با 1171 شرکت‌کننده نشان داد که سطوح NO در گروه PCOS به طور معنی‌داری کمتر از گروه کنترل بود. تجزیه و تحلیل ادغام شده یک تفاوت میانگین استاندارد (SMD) از 482/0- را به همراه داشت (027/0 = p، 056/0- تا 908/0- = CI %95). تجزیه و تحلیل­های زیرگروهی تغییرات بیشتری را در سطوح NO بین فنوتیپ­های مختلف PCOS و در رابطه با پارامترهای متابولیک نشان داد. نتیجه­ گیری: این متاآنالیز شواهدی را برای ارتباط بین PCOS و سطوح متفاوتی از NO ارائه می‌کند و نقش بالقوه NO را به عنوان یک نشانگر زیستی در تشخیص و پاتوژنز PCOS نشان می‌دهد. 2 Background:  Polycystic ovary syndrome (PCOS) casts a wide shadow over the reproductive health of millions of women worldwide, emerging as one of the most complex and multifaceted endocrine disorders. In addition, nitric oxide (NO) stands out as a pivotal signaling molecule, orchestrating a symphony of physiological processes. Objective: This meta-analysis aims to elucidate the association between NO levels and PCOS, investigate the potential of NO as a biomarker for PCOS diagnosis, and evaluate its clinical significance. Materials and Methods: A systematic review was conducted in several electronic databases, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and Google Scholar, to identify relevant studies published up to January 2024. Standardized mean difference and 95% CI were calculated using a random effects model to assess the overall effect size. Meta-regressions and subgroup analysis were performed to investigate sources of heterogeneity. Results: A meta-analysis of 14 studies with 1171 participants showed that NO levels were significantly lower in the PCOS group than in the control group. The pooled analysis yielded a standardized mean difference of -0.482; 95% CI: -0.908 to -0.056; p = 0.027. Subgroup analyses further demonstrated variations in NO levels between different PCOS phenotypes and in relation to metabolic parameters. Conclusion: This meta-analysis provides evidence for an association between PCOS and dysregulated NO levels and suggests a potential role of NO as a biomarker in the diagnosis and pathogenesis of PCOS.   Registration ID in PROSPERO: CRD42024507048 943 962 2024/05/21 1403/3/1 2024/11/28 1403/9/8 Seyed Sobhan Bahreiny Seyed Sobhan Bahreiny Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران bahreiny.s@ajums.ac.ir Akram Ahangarpour Akram Ahangarpour Medical Basic Sciences Research Institute, Physiology Research Center, Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران akramahangarpour@gmail.com Elnaz Harooni Elnaz Harooni Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران elnazharooni@gmail.com Mahdi Amraei Mahdi Amraei Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران mahdiamraei1996@gmail.com Mojtaba Aghaei Mojtaba Aghaei Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ایران mojtabaaghaei745@gmail.com Reza Mohammadpour Fard Reza Mohammadpour Fard Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ایران rezamohammadpour1377@gmail.com Polycystic ovary syndrome Nitric oxide Oxidative stress Meta-analysis. سندرم تخمدان پلی‌کیستیک نیتریک اکسید استرس اکسیداتیو متاآنالیز. 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An online intervention relationship enhancement couple therapy program versus systematic desensitization on sexual performance anxiety in women undergoing infertility treatment with timed intercourse: An RCT مداخله آنلاین برنامه زوج درمانی بهبود رابطه در مقایسه با حساسیت‌زدایی منظم بر اضطراب عملکرد جنسی در زنان تحت درمان ناباروری با مقاربت زمانبندی شده: یک کارآزمایی بالینی تصادفی شده 2 1 مقدمه: اضطراب عملکرد جنسی در درمان­های ناباروری رایج است. مداخلات روانشناختی گزینه‌هایی برای زوج‌های مبتلا به ناباروری هستند که داروهای روان‌پزشکی را تحمل نمی‌کنند یا  تمایل به استفاده از روان­‌درمانی در کنار دارو­درمانی دارند. هدف: این مطالعه با هدف مقایسه اثربخشی زوج درمانی بهبود رابطه (RECT) با حساسیت­زدایی سیستماتیک (SD) بر اضطراب جنسی انجام شد. مواد و روش ­ها: یک کارآزمایی بالینی تصادفی موازی در سال 1400 بر 68 زن مبتلا به ناباروری در شهرکرد انجام شد. آنها به طور تصادفی به 8 جلسه  دریافت­کننده مداخله آنلاین هفتگی RECT یا SD (کنترل) اختصاص یافتند. متغیر پیامد اصلی اضطراب عملکرد جنسی از طریق پرسشنامه دیویس در ابتدا، بعد از مداخله (هفته 8) و در پیگیری (هفته 12) ارزیابی شد. رضایت همسر متغیر پیامد ثانویه (هفته­های 8 و 12، از طریق مقیاس دیداری) ارزیابی شد. داده­های 29 زن در هر گروه آنالیز شد. نتایج: مقایسه درون­گروهی RECT و SD کاهش معنی­داری در خط پایه اضطراب جنسی در مقایسه با هفته 12 نشان داد، (001/0 = p، RECT)،     (001/0 = p، SD). تفاوت معنی­داری بین دو گروه RECT و SD در شروع مطالعه نسبت به هفته 12 مشاهده نشد (149/0 = p). اثر متقابل گروه زمانی رضایت همسر تفاوت معنی­داری را بین RECT و SD نشان داد (010/0 = p). نتیجه ­گیری: هر دو RECT و SD تقریباً به یک اندازه در کاهش اضطراب جنسی مؤثر بودند. RECT (متمرکز بر رابطه زوج) با توانمندسازی در مهارت­های ده­گانه بین فردی و SD (فرد محور)، با یاد دادن گام به گام که چگونه می­توان پاسخ جنگ یا گریز را با پاسخ آرام­سازی جایگزین نمود، به زنان کمک می­کند تا رفتارهای سازگارانه­تری را در اضطراب جنسی انجام دهند. RECT رضایت همسر را به طور قابل توجهی در مقایسه با SD افزایش داد که نشان می­دهد مردان نیاز به مشارکت در ایجاد تغییرات مثبت در رابطه دارند. نتایج می­تواند توسط درمانگران و سیاست­گذاران سلامت مورد استفاده قرار گیرد. 2 Background: Sexual performance anxiety is common among infertility treatments. Psychological interventions are options for couples who do not tolerate psychiatric medications or like psychotherapy with pharmacotherapy. Objective: This study aimed to compare the effectiveness of relationship enhancement couple therapy program (RECT) vs. systematic desensitization (SD) on sexual anxiety. Materials and Methods: A parallel randomized clinical trial was conducted on 68 women with infertility in Shahrekord, Iran, in January 2022. They were randomly allocated to 8 weekly online interventions RECT or SD (control). The main outcome variable, sexual performance anxiety, was assessed via Davis's questionnaire at baseline, completion of the intervention (week 8), and follow-up (week 12). The secondary outcome variable spouse's satisfaction was assessed (weeks 8 and 12, via visual analog scale). Data from 29 women were analyzed in each group. Results: Intra-group comparison RECT and SD showed a significant decrease of sexual anxiety baseline compared to week 12 (p = 0.001, 0.001 for RECT and SD, respectively). No significant difference was observed between the 2 groups in baseline compared to week 12 (RECT vs. SD, p = 0.149). Time-group interaction of spouse's satisfaction showed a significant difference between RECT and SD (p = 0.010). Conclusion: Both RECT and SD were almost equally effective in decreasing sexual anxiety. RECT (couple relationship-centered) by empowering 10 interpersonal skills, and SD (personal-oriented) by learning step-by-step how fight-or-flight response is replaced by relaxation response, helping women perform more adaptive behaviors regarding sexual anxiety. RECT increased spouse satisfaction significantly compared to SD, indicating that males need to participate in positive relationship changes. The results may be applied by therapists and health policymakers.   This article has been extracted from M.Sc. Thesis. (Maryam Afzal Dehkordi) Registration ID in IRCT: IRCT20211127053188N1 963 974 2024/05/212024/06/14 1403/3/25 2024/11/282024/12/18 1403/9/28 Maryam Afzal Dehkordi Maryam Afzal Dehkordi Student Research Committee of Nursing and Midwifery School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران afzal.midwife@gmail.com Tahmineh Farajkhoda Tahmineh Farajkhoda Research Center for Nursing and Midwifery Care, Non-Communicable Diseases Research Institute, Department of Midwifery, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران farajkhoda_t@yahoo.com Mahdi Khanabadi Mahdi Khanabadi Department of Counseling, School of Education Sciences and Psychology, Allameh Tabataba'i University, Tehran, Iran. ایران mehdikhanabadi@gmail.com Farimah Shamsi Farimah Shamsi Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ایران farimahshamssi@gmail.com Psychological interventions Sexual health Infertility Women Randomized clinical trial. مداخله روانشناسی سلامت جنسی ناباروری زنان کارآزمایی بالینی تصادفی. 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(in Persian)##Habibi N, Fathi E, Hatami Varzaneh A, Aghajani S. The effectiveness of prevention and relationship enhancement program on the quality of life and marital commitment in married women. Iran J Health Sci 2022; 10: 21-30.##Sayari N, Vakilian K, Khalajinia Z, Hejazi SA, Vahedian M. Effectiveness of relationship enrichment program (REP) on sexual dysfunction and satisfaction of females with multiple sclerosis: An educational study. Curr Women's Health Rev 2022; 18: 107-113.##Kleinplatz PJ, Charest M, Paradis N, Ellis M, Rosen L, Ménard AD, et al. Treatment of low sexual desire or frequency using a sexual enhancement group couples therapy approach. J Sex Med 2020; 17: 1288-1296.##Farajkhoda T, Ashrafi F, Bokaie M, Zareei Mahmoodabadi H. Online compared to face-to-face sexual intimacy enhancement training program counseling with cognitive-behavioral approach on sexual intimacy in pregnant women. 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The role of salivary antioxidant level in polycystic ovary syndrome women under assisted reproductive technology treatment: A case-control study نقش سطح آنتی‌اکسیدان بزاقی در زنان با سندرم تخمدان پلی‌کیستیک تحت درمان با تکنولوژی-های کمک‌باروری: یک مطالعه مورد-شاهدی 2 1 مقدمه: ناباروری به عنوان ناتوانی در باردار شدن پس از 12 ماه رابطه جنسی منظم و محافظت نشده تعریف می­شود. تقریباً 85% از زوج­های نابارور علت قابل شناسایی دارند، یکی از شایع­ترین علل ناباروری در بانوان، سندرم تخمدان پلی­کیستیک (PCOS) است. کاهش سطح آنتی­اکسیدان در سرم و مایع فولیکولی در زنان نابارور نسبت به زنان سالم اهمیت مطالعه بیشتر این نشانگرها را نشان می­دهد. هدف: بررسی سطح آنتی­اکسیدان بزاق و سرم در شرکت­کنندگان مبتلا به PCOS تحت درمان با تکنولوژی­های کمک باروری. مواد و روش ­ها: این مطالعه مورد-شاهدی بر روی 80 شرکت‌کننده در دو گروه شرکت­کنندگان نرمال به عنوان کنترل و زنان با PCOS (هر گروه/40 = n) انجام شد، سطوح سرمی و آنتی‌اکسیدانی بزاق مانند سوپراکسید دیسموتاز بزاق، هورمون آنتی‌مولرین بزاق، سوپراکسید دیسموتاز سرم، وضعیت کل اکسیدان سرم و هورمون آنتی‌مولرین سرم اندازه‌گیری شد. نتایج: میانگین سنی شرکت­کنندگان 4/5 ± 6/31 سال بود. هم در بزاق و هم در سرم، سطوح آنتی­اکسیدان به طور قابل توجهی بین PCOS و گروه کنترل متفاوت بود. یافته‌های کلیدی نشان داد که گروه PCOS دارای سطوح آنتی‌اکسیدانی متفاوت و سطوح آنتی­مولرین سرم بالاتری نسبت به گروه کنترل بود که همه تفاوت‌ها از نظر آماری معنی‌دار بودند (05/0 > p). نتیجه­ گیری: یافته ما تأکید کرد که سطوح آنتی­اکسیدان بزاق، به ویژه سوپراکسید دیسموتاز، نشانگر خوبی برای تشخیص PCOS است. زیرا غیرتهاجمی است، می­تواند به راحتی توسط شرکت­کنندگان انجام شود، و می­تواند در تنظیمات مختلف بدون تجهیزات تخصصی جمع­آوری شود.   2 Background: Infertility is defined as the inability to conceive after 12 months of regular unprotected intercourse. Approximately 85% of infertile couples have an identifiable cause, one of the most common causes of infertility is polycystic ovary syndrome (PCOS). The reduction of antioxidant levels in serum and follicular fluid in infertile women compared to healthy women shows the importance of further studying these markers. Objective: To study salivary and serum antioxidant levels in PCOS participants under assisted reproductive technology. Materials and Methods: This case-control study was conducted on 80 women in 2 groups including normal participants as control and PCOS groups (n = 40/each). Serum and salivary antioxidant levels such as saliva superoxide dismutase (SOD), saliva anti-Müllerian hormone (AMH), serum SOD, serum total oxidant status, and serum AMH were measured. Results: The average age of participants was 31.6 ± 5.4 yr. In both the saliva and serum, antioxidant levels differed significantly between the PCOS and control groups. Key findings showed that the PCOS group had different antioxidant levels and higher serum AMH levels compared to the control group, with all differences being statistically significant (p < 0.05). Conclusion: Our finding underscored that saliva antioxidant levels, especially SOD, are a good marker for PCOS diagnosis. It is noninvasive, can easily be performed by the participants, and can be collected in various settings without specialized equipment. This article has been extracted from the D.D.S. Thesis. (Mohadeseh Bahmaee) 975 984 2024/05/212024/06/142024/10/16 1403/7/25 2024/11/282024/12/182024/11/28 1403/9/8 Narges Gholizadeh Narges Gholizadeh Department of Oral and Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. ایران n.gholizadeh@gmail.com Maryam Koopaie Maryam Koopaie Department of Oral and Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. ایران m-koopaie@tums.ac.ir Ashraf Aleyasin Ashraf Aleyasin Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. ایران alyasina@tums.ac.ir Atousa Mortazavi Milani Atousa Mortazavi Milani Clinical Research Development Unit of Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. ایران dr.atousamilani@gmail.com Marziyeh Aghahosseini Marziyeh Aghahosseini Department of Obstetrics and Gynecology and Female Infertility Unit, Tehran University of Medical Sciences, Tehran, Iran. ایران Marzieh.aghahosseini@gmail.com Mohammad Javad Kharrazifard Mohammad Javad Kharrazifard Department of Epidemiology and Biostatistics, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. ایران mohamadjavad.kharazifard@tums.ac.ir Mohadeseh Bahmaee Mohadeseh Bahmaee School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. ایران md.bahmaee@yahoo.com Infertility Saliva Antioxidant Polycystic ovary syndrome Diagnosis. ناباروری بزاق آنتی‌اکسیدان سندرم تخمدان پلی‌کیستیک تشخیص. Carson SA, Kallen AN. Diagnosis and management of infertility: A review. JAMA 2021; 326: 65-76.##Teede H, Deeks A, Moran L. Polycystic ovary syndrome: A complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8: 41.##Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Primers 2016; 2: 16057.##Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2017; 102: 604-612.##Dokras A, Saini S, Gibson-Helm M, Schulkin J, Cooney L, Teede H. Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. Fertil Steril 2017; 107: 1380-1386.##Teede H, Gibson-Helm M, Norman RJ, Boyle J. Polycystic ovary syndrome: Perceptions and attitudes of women and primary health care physicians on features of PCOS and renaming the syndrome. J Clin Endocrinol Metab 2014; 99: E107-E111.##Chang S, Dunaif A. Diagnosis of polycystic ovary syndrome: Which criteria to use and when? Endocrinol Metab Clin North Am 2021; 50: 11-23.##Pizzino G, Irrera N, Cucinotta M, Pallio G, Mannino F, Arcoraci V, et al. Oxidative stress: Harms and benefits for human health. Oxid Med Cell Longev 2017; 2017: 8416763.##Christodoulakos G, Augoulea A, Lambrinoudaki I, Sioulas V, Creatsas G. Pathogenesis of endometriosis: The role of defective 'immunosurveillance'. Eur J Contracept Reprod Health Care 2007; 12: 194-202.##Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: A review. Reprod Biol Endocrinol 2012; 10: 49.##Mohammadi M. Oxidative stress and polycystic ovary syndrome: A brief review. 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Hum Reprod Update 2023; 29: 307-326.##van der Ham K, Laven JS, Tay CT, Mousa A, Teede H, Louwers YV. Anti-Müllerian hormone as a diagnostic biomarker for polycystic ovary syndrome (PCOS) and polycystic ovarian morphology (PCOM): A systematic review and meta-analysis. Fertil Steril 2024; 122: 727-739.##Vagios S, Sacha CR, Hammer KC, Dimitriadis I, James KE, Bormann CL, et al. Response to ovulation induction treatments in women with polycystic ovary syndrome as a function of serum anti-Müllerian hormone levels. J Assist Reprod Genet 2021; 38: 1827-1833.##Bizoń A, Tchórz A, Madej P, Leśniewski M, Wójtowicz M, Piwowar A, et al. The activity of superoxide dismutase, its relationship with the concentration of zinc and copper and the prevalence of rs2070424 superoxide dismutase gene in women with polycystic ovary syndrome- preliminary study. J Clin Med 2022; 11: 2548.##Talat A, Satyanarayana P, Anand P. Association of superoxide dismutase level in women with polycystic ovary syndrome. J Obstet Gynecol India 2022; 72: 6-12.##Pekel A, Gönenç A, Turhan NÖ, Kafalı H. Changes of sFas and sFasL, oxidative stress markers in serum and follicular fluid of patients undergoing IVF. J Assist Reprod Genet 2015; 32: 233-241.##Becatti M, Fucci R, Mannucci A, Barygina V, Mugnaini M, Criscuoli L, et al. A new biochemical approach to detect oxidative stress in infertile women undergoing assisted reproductive technology procedures. Int J Mol Sci 2018; 19: 592.##Miller N, Herzberger EH, Pasternak Y, Klement AH, Shavit T, Yaniv RT, et al. Does stress affect IVF outcomes? A prospective study of physiological and psychological stress in women undergoing IVF. Reprod Biomed Online 2019; 39: 93-101.##Debbarh H, Louanjli N, Aboulmaouahib S, Jamil M, Ahbbas L, Kaarouch I, et al. Antioxidant activities and lipid peroxidation status in human follicular fluid: Age-dependent change. Zygote 2021; 29: 490-494.##Fiers T, Dielen C, Somers S, Kaufman JM, Gerris J. 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Comparing sexual dysfunction in cosmetic rhinoplasty candidates and normal population among married women in Shiraz, Iran: A case-control study مقایسه‌ی اختلال عملکرد جنسی در زنان متأهل متقاضی جراحی زیبایی بینی با گروه شاهد در شیراز، ایران: یک مطالعه‌ی مورد-شاهدی 2 1 مقدمه: اختلال در عزت نفس و خودانگاره ممکن است در افراد دارای اختلال بدریخت انگاری بدن دیده شود و اختلال عملکرد جنسی نیز در بین افراد مبتلا به اختلال بدریخت انگاری بدن شایع­تر است. به نظر می­رسد که وجود نگرانی از تصویر بدنی در کاندیدای عمل­های زیبایی، از جمله جراحی بینی، قابل توجه است. هدف: هدف از این مطالعه با هدف بررسی اختلال عملکرد جنسی در زنان متأهل کاندید جراحی زیبایی بینی و مقایسه آن با گروه شاهد بود انجام شده است. مواد و روش­ ها: این مطالعه­ی مقطعی مورد-شاهدی بر روی 342 زن از آذر 1400 تا آذر 1401 در شیراز، ایران انجام شد. شرکت­کنندگان در گروه کیس شامل 192 داوطلب جراحی زیبایی بینی در گروه جراحی بینی شرکت کردند. و در گروه شاهد شامل 150 زن متأهل غیرکاندید جراحی بینی مراجعه­کننده به درمانگاه سرپایی گوش، حلق و بینی بودند. اطلاعات دموگرافیک، سابقه روانی- اجتماعی و کیفیت زندگی زناشویی به روش مصاحبه حضوری جمع‌آوری شد. برای ارزیابی عملکرد جنسی افراد مورد مطالعه، پرسشنامه­ی شاخص عملکرد جنسی زنان توسط شرکت­کنندگان تکمیل شد. نتایج: تفاوت آماری معناداری بین گروه جراحی بینی و گروه شاهد مشاهده نشد (به ترتیب 6/3 ± 63/23 و 28/4 ± 19/23، 43/0 =p ). شیوع اختلال عملکرد جنسی در بین داوطلبان جراحی زیبایی بینی و گروه شاهد به ترتیب 75% و 76% بود (60/0 = p). تفاوت معنا‌داری در حوزه­های اختلال عملکرد جنسی بین دو گروه مشاهده نشد. نتیجه ­گیری: مطالعه ما نشان‌دهنده اختلال عملکرد جنسی قابل توجهی در جمعیت مورد مطالعه بود؛ اما تفاوت میزان اختلال جنسی در بین دو گروه متقاضی جراحی بینی و کنترل از نظر آماری معنی‌دار نبود. 2 Background: Disturbed self-esteem and self-image can be found in body dysmorphic individuals, and sexual dysfunction is also more frequent among these individuals. Body image concerns may also contribute to the tendency to undergo cosmetic procedures, including rhinoplasty. Objective: This study aimed to compare sexual dysfunction in married women who were candidates for cosmetic rhinoplasty to a control group. Materials and Methods: This case-control study was conducted among 342 married women in Shiraz, Iran, from December 2021-2022. The case group included 192 cosmetic rhinoplasty candidates, and the control group comprised 150 women who were not candidates for cosmetic procedures; they were selected from the ear, nose, and throat outpatient department. Data on demographic features, psycho-social history, and quality of marital life were collected by face-to-face interviews. To evaluate their sexual performance, the participants filled out the female sexual function index questionnaire. Results: No significant difference was observed between rhinoplasty subjects and the control group in the female sexual function index (23.63 ± 3.6 vs. 23.19 ± 4.28, p = 0.43). The prevalence of sexual dysfunction among cosmetic rhinoplasty candidates and the control group was 75% and 76%, respectively (p = 0.60). No significant difference was observed in the sexual dysfunction domains between the groups. Conclusion: Our study indicated a significant sexual dysfunction among the studied population, but the difference was not statistically significant between the rhinoplasty and the control group.   This article has been extracted from M.D. Thesis. (Atoosa Ebrahimi) 985 994 2024/05/212024/06/142024/10/162023/12/16 1402/9/25 2024/11/282024/12/182024/11/282024/12/1 1403/9/11 Ali Sahraian Ali Sahraian Research Center for Psychiatry and Behavioural Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. ایران sahraian@sums.ac.ir Masoud Janipour Masoud Janipour Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran. ایران masood.janipoor@gmail.com Atoosa Ebrahimi Atoosa Ebrahimi Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. ایران Atoosaebrahimi@gmail.com Zohre Zareizadeh Zohre Zareizadeh Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. ایران zohre.zareiz@gmail.com Pardis Habibi Pardis Habibi Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. ایران habibipardis1997@gmail.com Amirhossein Babaei Amirhossein Babaei Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran. ایران Babaei93@yahoo.com Sexual dysfunction Psychological Rhinoplasty Cosmetic Female. اختلالات جنسی روانی جراحی بینی جراحی زیبایی زن. Panahi R, Anbari M, Javanmardi E, Jahangasht Ghoozlu Kh, Dehghankar L. The effect of women's sexual functioning on quality of their sexual life. J Prev Med Hyg 2021; 62: E776-E781.##Bilal A, Rasool S. Marital satisfaction and satisfaction with life: Mediating role of sexual satisfaction in married women. J Psychosexual Health 2020; 2: 77-86.##Miguel I, von Humboldt S, Leal I. Sexual well-being across the lifespan: Is sexual satisfaction related to adjustment to aging? Sex Res Soc Policy 2024; 21: 1-12.##Pious AA, Amaresha AC. Exploring factors of sexual function and sexual satisfaction among nonworking women: A qualitative study. J Psychosexual Health 2023; 5: 208-215.##Narasimhan M, Gilmore K, Murillo R, Allotey P. Sexual health and well-being across the life course: Call for papers. Bull World Health Organ 2023; 101: 750.##Hosseini SE, Ilkhani M, Rohani C, Nikbakht Nasrabadi A, Ghanei Gheshlagh R, Moini A. Prevalence of sexual dysfunction in women with cancer: A systematic review and meta-analysis. Int J Reprod BioMed 2022; 20: 1-12.##Andresen JB, Graugaard C, Andersson M, Bahnsen MK, Frisch M. Sexual inactivity and dysfunction in Denmark: A project SEXUS study. Arch Sex Behav 2022; 51: 3669-3688.##Prabhu SS, Hegde S, Sareen S. Female sexual dysfunction: A potential minefield. Indian J Sex Transm Dis AIDS 2022; 43: 128-134.##Khademi R, Hosseini SH, Sharif Nia H, Khani S. Evaluating co-occurrence of depression and sexual dysfunction and related factors among Iranian rural women: A population-based study. Biomedicine 2020; 10: 33-39.##Ziaei T, Farahmand Rad H, Rezaei Aval M, Roshandel Gh. The relationship between sexual self-concept and sexual function in women of reproductive age referred to health centers in Gorgan, North East of Iran. J Midwifery Reprod Health 2017; 5: 969-977.##Kuck N, Cafitz L, Bürkner P-C, Hoppen L, Wilhelm S, Buhlmann U. Body dysmorphic disorder and self-esteem: A meta-analysis. BMC Psychiatry 2021; 21: 310.##Henn AT, Taube CO, Vocks S, Hartmann AS. Body image as well as eating disorder and body dysmorphic disorder symptoms in heterosexual, homosexual, and bisexual women. Front Psychiatry 2019; 10: 531.##Walker CE, Krumhuber EG, Dayan S, Furnham A. Effects of social media use on desire for cosmetic surgery among young women. Curr Psychol 2021; 40: 3355-3364.##de Souza TSC, Patrial MTCRdO, Meneguetti AFC, de Souza MSC, Meneguetti ME, Rossato VF. Body dysmorphic disorder in rhinoplasty candidates: Prevalence and functional correlations. Aesthetic Plast Surg 2021; 45: 641-648.##Ghazizadeh Hashemi SA, Edalatnoor B, Edalatnoor B, Niksun O. A comparison of body image concern in candidates for rhinoplasty and therapeutic surgery. Electronic Physician 2017; 9: 5363-5368.##Sahraian A, Janipour M, Tarjan A, Zareizadeh Z, Habibi P, Babaei A. Body dysmorphic and narcissistic personality disorder in cosmetic rhinoplasty candidates. Aesthetic Plast Surg 2022; 46: 332-337.##https://doi.org/10.1007/s00266-021-02711-8##Heidarzadeh A, Shahmohammadipour P, Azzizadeh Forouzi M, Dehghan M, Khorasani Z. Body image, self-esteem, and psychological problems among applicants and non-applicants of cosmetic surgery. J Pract Clin Psychol 2019; 7: 33-42.##Fakhri A, Pakpour AH, Burri A, Morshedi H, Mohammadi Zeidi I. The female sexual function index: Translation and validation of an Iranian version. J Sex Med 2012; 9: 514-523.##Jafarzadeh Esfehani R, Fazel N, Dashti S, Moshkani S, Haghighi Hasanabad F, Foji S, et al. Female sexual dysfunction and its associated risk factors: An epidemiological study in the North-East of Iran. J Midwifery Reprod Health 2016; 4: 498-505.##Mohammadian S, Dolatshahi B. Sexual problems in Tehran: Prevalence and associated factors. J Educ Health Promot 2019; 8: 217.##Lordêlo P, Leal MRD, Brasil CA, Santos JM, Lima MCNPC, Sartori MGF. Radiofrequency in female external genital cosmetics and sexual function: A randomized clinical trial. Int Urogynecol J 2016; 27: 1681-1687.##Ghiasi A, Keramat A. Prevalence of sexual dysfunction among reproductive-age women in Iran: A systematic review and meta-analysis. J Midwifery Reprod Health 2018; 6: 1390-1398.##Mazinani R, Akbari Mehr M, Kaskian A, Kashanian M. [Evaluation of prevalence of sexual dysfunctions and its related factors in women]. Razi Journal of Medical Sciences 2013; 19: 59-66. (in Persian)##Pretorius D, Couper ID, Mlambo MG. Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province. Afr J Prim Health Care Fam Med 2021; 13: e1-e7.##Logan S, Thu WPP, Ho K, Cauley JA, Kramer MS, Yong E-L. Sexual inactivity and sexual dysfunction in midlife Singaporean women: A prospective cross-sectional study of prevalence and risk factors. Maturitas 2021; 152: 1-9.##Singh N, Sharma P, Mishra N. Female sexual dysfunction: Indian perspective and role of Indian gynecologists. Indian J Community Med 2020; 45: 333-337.##Amanelahi A, Refahi N, Rajabi Gh. [Predicting sexual dysfunction based on sexual self-esteem and intimacy with spouse among female college students with and without sexual dysfunction disorder]. Iranian Journal of Psychiatric Nursing 2017; 5: 18-24. (in Persian)##Merghati Khoei E, Moeini B, Barati M, Soltanian AR, Shahpiri E, Ghaleiha A, et al. A qualitative inquiry of sexuality in Iranian couples using the information-motivation-behavioral skills paradigm. J Egypt Public Health Assoc 2019; 94: 27.##Clayton AH, Valladares Juarez EM. Female sexual dysfunction. 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The effect of dienogest and gonadotropin-releasing hormone agonist on pelvic pain after laparoscopic surgery for endometriosis: An RCT بررسی اثربخشی داینوژست وآگونیست هورمون آزادکننده گنادوتروپین بر درد لگن پس از جراحی لاپاراسکوپی در اندومتریوز: یک مطالعه کارآزمایی بالینی تصادفی 2 1 مقدمه: اندومتریوز یک بیماری التهابی مزمن است که به دلیل درد شدید و ناتوان­کننده، زندگی بیماران را تحت تأثیر قرار می­دهد. داروهای متعددی برای کاهش درد و ناراحتی مرتبط با این بیماری معرفی شده است. آگونیست­های هورمون آزادکننده گنادوتروپین و داینوژست از داروهای مهم در این زمینه هستند. هدف: مطالعه حاضر به بررسی اثربخشی آگونیست هورمون آزادکننده گنادوتروپین و داینوژست بر کاهش درد لگنی و همچنین عوارض ناخواسته آنها پس از جراحی لاپاراسکوپی در اندومتریوز می­پردازد. مواد و روش ­ها: این مطالعه کارآزمایی بالینی تصادفی شده شامل 104 زن مبتلا به اندومتریوز مراجعه­کننده به بخش تولید­مثل بیمارستان یاس، دانشگاه علوم پزشکی تهران، تهران، بین آوریل 2022 تا مارچ 2023 می­باشد. پس از جراحی لاپاراسکوپی، شرکت­کنندگان به طور تصادفی به دو گروه (تعداد = 52/هر گروه) تقسیم شدند: گروهی که برای آنها داینوژست تجویز می‌شد و گروهی که آگونیست هورمون آزادکننده گنادوتروپین (GnRH) دریافت می‌کردند. شرکت­کنندگان به مدت سه ماه پیگیری شدند و درد لگن با استفاده از visual analog scale اندازه­گیری شد. درد لگن و عوارض جانبی بین دو گروه مقایسه شد. نتایج: درد لگن در هر دو گروه درمانی به طور قابل توجهی بهبود یافت (0001/0 ˂ p). تفاوت معنی­داری بین گروه­های آگونیست GnRH و داینوژست در گرگرفتگی و میزان درد مفاصل مشاهده نشد. با این حال، تفاوت معنی­داری در خشکی واژن (03/0 = p) و کاهش میزان میل جنسی (02/0 = p) بین دو گروه مشاهده شد. استفاده از آگونیست­های GnRH و داینوژست باعث کاهش خونریزی نامنظم واژینال شد. نتیجه­ گیری: نتایج نشان می‌دهد که اثربخشی آگونیست‌های GnRH و داینوژست در بهبود درد لگنی بیماران آندومتریوز پس از یک دوره درمانی سه ماهه یکسان است. با این حال، این دو دارو عوارض جانبی متفاوتی ایجاد کردند. 2 Background: Endometriosis is a chronic inflammatory condition associated with debilitating chronic pelvic pain that affects women's quality of life. Several drugs have been used to reduce pain and psychological distress associated with this disease. Currently, gonadotropin-releasing hormone (GnRH) agonists and dienogest are the most widely used medical therapies for endometriosis. Objective: This study aimed to investigate the efficacy of dienogest and GnRH agonists in improving pelvic pain after laparoscopic surgery for endometriosis. Materials and Methods: In this randomized clinical trial study, 104 women with endometriosis who were referred to the Department of Reproductive Medicine of Yas hospital, Tehran, Iran, between April 2022 and March 2023 were studied. After laparoscopic surgery, individuals were randomly assigned into 2 groups (n = 52/each): the dienogest-administered group and the GnRH agonist-administered group. Participants were followed up at 3 months and pelvic pain was measured using the visual analog scale. Pelvic pain and adverse effects of drugs were compared between the groups. Results: Pelvic pain significantly improved in both treatment groups (p < 0.0001). No significant difference was observed in hot flashes and joint pain between the dienogest and GnRH agonist groups. However, a significant difference was found in vaginal dryness (p = 0.03) and decreased libido (p = 0.02). GnRH agonists and dienogest reduced irregular vaginal bleeding. Conclusion: Our results suggested that the effect of GnRH agonists and dienogest in improving pelvic pain for endometriosis is the same after a 3-month treatment period. However, these 2 drugs caused different adverse effects.   Registration ID in IRCT: IRCT20091012002576N25 995 1002 2024/05/212024/06/142024/10/162023/12/162023/11/28 1402/9/7 2024/11/282024/12/182024/11/282024/12/12024/12/29 1403/10/9 Fatemeh Davari Tanha Fatemeh Davari Tanha Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran. ایران Fatedavtanha@gmail.com Azam Rasti Azam Rasti Non-Communicable Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. ایران rasti_azam@yahoo.com Hamideh Pakniat Hamideh Pakniat Non-Communicable Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. ایران pakniat110@yahoo.com; hpakniat@qums.ac.ir Shohreh Salimi Setudeh Shohreh Salimi Setudeh Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran. ایران shsalimi98@yahoo.com Endometriosis Gonadotropin-releasing hormone Dienogest Pelvic pain. آندومتریوز آگونیست هورمون آزادکننده گنادوتروپین داینوژست درد لگن. Ebrahimi M, Akbari Asbagh F, Davari Tanha F, Pakniat H, Feizabad E, Rasouli Y. Co-treatment of gonadotropin and letrozole in infertile women with endometriosis: A double-blind randomized clinical trial. Int J Reprod BioMed 2022; 20: 483-490.##Vannuccini S, Clemenza S, Rossi M, Petraglia F. Hormonal treatments for endometriosis: The endocrine background. Rev Endocr Metab Disord 2022; 23: 333-355.##Khashchenko EP, Uvarova EV, Chuprynin VD, Pustynnikova MY, Fatkhudinov TK, Elchaninov AV, et al. Pelvic pain, mental health and quality of life in adolescents with endometriosis after surgery and dienogest treatment. J Clin Med 2023; 12: 2400.##Sutrisno S, Firdaus WA. Efficacy of dienogest on pelvic pain and dyspareunia: Comprehensive meta-analysis and systematic review. Asian J Health Res 2023; 2: 89-95.##Lamceva J, Uljanovs R, Strumfa I. The main theories on the pathogenesis of endometriosis. Int J Mol Sci 2023; 24: 4254.##Wang P-H, Yang S-T, Chang W-H, Liu C-H, Lee F-K, Lee W-L. Endometriosis: Part I. Basic concept. Taiwan J Obstet Gynecol 2022; 61: 927-934.##Carneiro MM. Deciding on the appropriate pharmacotherapy for the treatment of endometriosis. Exp Opin Pharmacother 2023; 24: 1-5.##Kalaitzopoulos DR, Samartzis N, Kolovos GN, Mareti E, Samartzis EP, Eberhard M, et al. Treatment of endometriosis: A review with comparison of 8 guidelines. BMC Women's Health 2021; 21: 397.##Mariani LL, Mancarella M, Fuso L, Baino S, Biglia N, Menato G. Endometrial thickness in the evaluation of clinical response to medical treatment for deep infiltrating endometriosis: A retrospective study. Arch Gynecol Obstet 2021; 303: 161-168.##Surrey ES. GnRH agonists in the treatment of symptomatic endometriosis: A review. F S Rep 2023; 4 (Suppl.): 40-45.##Veth VB, van de Kar MM, Duffy JM, van Wely M, Mijatovic V, Maas JW. Gonadotropin‐releasing hormone analogues for endometriosis. Cochrane Database Syst Rev 2023; 6: CD014788.##Bizzarri N, Remorgida V, Leone Roberti Maggiore U, Scala C, Tafi E, Ghirardi V, et al. Dienogest in the treatment of endometriosis. Exp Opin Pharmacother 2014; 15: 1889-1902.##Moehner S, Becker K, Lange JA, von Stockum S, Serrani M, Heinemann K. Long-term treatment of endometriosis with dienogest: Real-world results from the VIPOS study. J Endometriosis Pelvic Pain Disord 2021; 13: 104-110.##Granese R, Perino A, Calagna G, Saitta S, De Franciscis P, Colacurci N, et al. Gonadotrophin‐releasing hormone analogue or dienogest plus estradiol valerate to prevent pain recurrence after laparoscopic surgery for endometriosis: A multi‐center randomized trial. Acta Obstet Gynecol Scand 2015; 94: 637-645.##Murji A, Biberoğlu K, Leng J, Mueller MD, Römer T, Vignali M, et al. Use of dienogest in endometriosis: A narrative literature review and expert commentary. Curr Med Res Opin 2020; 36: 895-907.##Takaesu Y, Nishi H, Kojima J, Sasaki T, Nagamitsu Y, Kato R, et al. Dienogest compared with gonadotropin‐releasing hormone agonist after conservative surgery for endometriosis. J Obstet Gynaecol Res 2016; 42: 1152-1158.##Techatraisak K, Hestiantoro A, Soon R, Banal-Silao MJ, Kim M-R, Seong SJ, et al. Impact of long-term dienogest therapy on quality of life in Asian women with endometriosis: The prospective non-interventional study ENVISIOeN. Reprod Sci 2022; 29: 1157-1169.##Yu EH, Joo JK. Commentary on the new 2022 European Society of Human Reproduction and Embryology (ESHRE) endometriosis guidelines. Clin Exp Reprod Med 2022; 49: 219.##Li R-R, Xi Q, Tao L, Sheng W, Zhao C-C, Wu Y-J. A systematic review and bayesian analysis of the adverse effects of dienogest. BMC Pharmacol Toxicol 2024; 25: 43.##Wu H, Liu J-J, Ye S-T, Liu J, Li N. Efficacy and safety of dienogest in the treatment of deep infiltrating endometriosis: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 297: 40-49.##Osuga Y, Hayashi K, Kanda S. Long‐term use of dienogest for the treatment of primary and secondary dysmenorrhea. J Obstet Gynaecol Res 2020; 46: 606-617.##Huang Y, Zhang D, Zhang L, Zhou Y, Peng C. Clinical efficacy of dienogest against endometriomas with a maximum diameter of ≥ 4 cm. Ann Med 2024; 56: 2402942.##Muzii L, Di Tucci C, Galati G, Carbone F, Palaia I, Bogani G, et al. The efficacy of dienogest in reducing disease and pain recurrence after endometriosis surgery: A systematic review and meta-analysis. Reprod Sci 2023; 30: 3135-3143.##Ozaki R, Kumakiri J, Jinushi M, Ikuma S, Murakami K, Kawasaki Y, et al. Comparison of effect of preoperative dienogest and gonadotropin-releasing hormone agonist administration on laparoscopic cystectomy for ovarian endometriomas. Arch Gynecol Obstet 2020; 302: 969-976.##Barra F, Scala C, Leone Roberti Maggiore U, Ferrero S. Long-term administration of dienogest for the treatment of pain and intestinal symptoms in patients with rectosigmoid endometriosis. J Clin Med 2020; 9: 154.##Seo Y-S, Yuk J-S, Cho Y-K, Shin J-Y. Dienogest and the risk of reoperation in endometriosis. J Pers Med 2021; 11: 924.## ##

Decreased expression of miRNA-200a and miRNA-223-3p in endometriosis cases during the secretory phase of the menstrual cycle: insights from a comprehensive case-control study with analysis of molecular biomarkers and their potential role in disease-induced infertility. کاهش بیان miRNA-200a و miRNA-223-3p در اندومتریوز در طول مرحله ترشحی چرخه قاعدگی: بینش از یک مطالعه مورد-شاهدی در مورد نشانگرهای زیستی مولکولی و ناباروری مرتبط با بیماری 2 1 مقدمه: اندومتریوز وضعیتی است که با کاهش پذیرش رحم، منجر به ناباروری می‌شود. گزارش شده است که این بیماری حدود 20 تا 25 درصد از زنان نابارور را تحت تأثیر قرار می­دهد که برخی از نشانگرهای ژنتیکی نقش مهمی در پاتوژنز و ناباروری دارند. هدف: هدف از این مطالعه بررسی نقش miR200a و miR223-3p در لانه­گزینی جنین و ارتباط آنها با ناباروری مرتبط با بیماری اندومتریوز است. مواد و روش­ ها: در این مطالعه مورد-شاهدی، 36 زن مراجعه­کننده به مرکز تحقیقات بهداشت باروری و ناباروری دانشگاه علوم پزشکی بابل و مرکز درمان تخصصی ناباروری فاطمه الزهرا (س) بابل در فاصله خرداد 1391 تا تیرماه 1392 مورد بررسی قرار گرفتند. آنها به دو گروه آندومتریوز و کنترل (18 = n) تقسیم شدند. نمونه­های آندومتر از شرکت‌کنندگان بین روزهای 17 تا 24 سیکل قاعدگی جمع­آوری شد. بررسی هیستوپاتولوژیک برای تأیید مرحله ترشحی نمونه­ها صورت گرفت و میزان بیان miR200a و miR223-3P با واکنش زنجیره­ای پلیمراز رونوشت معکوس کمی مورد تجزیه و تحلیل قرار گرفتند. نتایج: تجزیه و تحلیل نتایج بافت­شناسی تأیید کرد که هر دو گروه در مرحله ترشح هستند. علاوه بر این، نتایج بیان miRNA کاهش قابل توجهی در سطح بیان miR200a و miR223-3p در گروه اندومتریوز نسبت به گروه کنترل نشان داد. سطح بیان miR223-3p و miR200a در بافت آندومتر اوتوپیک زنان مبتلا به اندومتریوز به طور قابل توجهی کمتر از گروه کنترل بود. نتیجه ­گیری: نتایج ما نشان می‌دهد که miR200a و miR223-3p در پاتوژنز بیماری آندومتریوز نقش ایفا می­کنند، در حالی که سایر ژن‌ها و مسیرهای سیگنالینگ احتمالاً در شکست کاشت لانه­گزینی ناشی از این بیماری نقش دارند. 2 Background: Endometriosis (EM) is a condition that causes infertility with decreasing uterine receptivity. It is reported that it affects about 20-25% of all infertile women. Some genetic markers play a crucial role in pathogenesis and infertility. Objective: This study investigates the role of miR-200a and miR-223-3p in embryo implantation and their association with EM-related infertility. Materials and Methods: In this case-control study, 36 women who referred to the Center for Research on Reproductive Health and Infertility of Babol University of Medical Sciences and Fatemeh Al-Zahra Infertility Specialized Treatment Center in Babol, Iran between June 2022 and July 2023 were evaluated. Participants were divided into 2 EM and control groups (n = 18/each). Endometrial samples were collected from participants between 17th and 24th days of their menstrual cycle. Histopathological examination (hematoxylin and eosin and periodic acid schiff) was performed to confirm the secretory stage, and miR-200a and miR-223-3p expressions were analyzed by quantitative reverse transcriptase-polymerase chain reaction. Results: Histological analysis confirmed that both groups were in the secretory stage. Additionally, miRNA expression results showed a significant decrease in the miR-200a and miR-223-3p expression levels in EM group compared to control group. The expression level of miR-223-3p and miR-200a in the eutopic endometrial tissue of women with EM was notably lower than those in the control group. Conclusion: Our results suggest that miR-200a and miR-223-3p are involved in the EM pathogenesis, while other genes and signaling pathways are probably involved in the implantation failure.   This article has been extracted from M.Sc. Thesis. (Yasaman Nazari Hagh) 1003 1014 2024/05/212024/06/142024/10/162023/12/162023/11/282024/01/13 1402/10/23 2024/11/282024/12/182024/11/282024/12/12024/12/292024/12/14 1403/9/24 Yasaman Nazari Hagh Yasaman Nazari Hagh School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran. ایران y.nazari273@gmail.com Mohamadreza Ahmadifard Mohamadreza Ahmadifard Department of Medical Genetics, School of Medicine, Babol University of Medical Sciences, Babol, Iran. ایران mr.ahmadifard@gmail.com Sedigheh Esmaelzadeh Sedigheh Esmaelzadeh Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. ایران sesmael2010@gmail.com Soheila abbaszadeh Soheila abbaszadeh Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. ایران ds.abbaszadeh@gmail.com Naser Shokrzadeh Naser Shokrzadeh Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran. ایران shokrzadeh.n@umsu.ac.ir Endometriosis miRNA Implantation Signaling pathways Biomarkers Infertility Menstrual cycle. اندومتریوزیس miRNA لانه‌گزینی مسیرهای سیگنالینگ بیومارکرها ناباروری سیکل قاعدگی. Cousins FL, McKinnon BD, Mortlock S, Fitzgerald HC, Zhang C, Montgomery GW, et al. New concepts on the etiology of endometriosis. J Obstet Gynaecol Res 2023; 49: 1090-1105.##Marquardt RM, Tran DN, Lessey BA, Rahman MS, Jeong J-W. Epigenetic dysregulation in endometriosis: Implications for pathophysiology and therapeutics. Endoc Rev 2023; 44: 1074-1095.##Balalau DO, Ciupitu IA, Bogheanu D-M, Ghiocel-Zariosu A-I, Balalau C, Ples L, et al. Management of pelvic pain caused by endometriosis. J Mind Med Sci 2023; 10: 79-84.##Da Broi MG, Ferriani RA, Navarro PA. Ethiopathogenic mechanisms of endometriosis-related infertility. JBRA Assist Reprod 2019; 23: 273-280.##Lee D, Kim SK, Lee JR, Jee BC. Management of endometriosis-related infertility: Considerations and treatment options. Clin Exp Reprod Med 2020; 47: 1-11.##https://doi.org/10.5653/cerm.2020.47.1.1.e1##Patel BG, Rudnicki M, Yu J, Shu Y, Taylor RN. Progesterone resistance in endometriosis: Origins, consequences and interventions. 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IL-6-174 G/C transversion might decrease male infertility risk: A case-control study ترانسورژن IL-6 -174 G/C ممکن است خطر ناباروری مردان را کاهش دهد: یک مطالعه مورد شاهدی 2 1 مقدمه: استعدادهای ژنتیکی به‌عنوان عوامل مهم در ناباروری مردان شناسایی شده‌اند. در میان بسیاری از ژن‌های مرتبط با عملکرد تولید­مثل مردان،    اینترلوکین 6 (IL-6) به‌عنوان یک عامل کلیدی مطرح شده است. با وجود شناخت فزاینده عوامل ژنتیکی در ناباروری مردان، ارتباط خاص بین پلی‌مورفیسم ژنتیکی IL-6-174 G/C و ناباروری مردان همچنان حوزه‌ای است که نیاز به تحقیقات بیشتر دارد. هدف: این تحقیق به بررسی همبستگی بین ترانسورژن IL-6-174 G/C و ناباروری مردان می‌پردازد. مواد و روش ­ها: در یک مطالعه مورد-شاهدی، تعداد 314 مرد که به مرکز ناباروری کاشان (بیمارستان شهید بهشتی کاشان، ایران) مراجعه کرده بودند، برای تحلیل پلی‌مورفیسم IL-6-174 G/C وارد مطالعه شدند. مطالعه شامل 163 شرکت‌کننده نابارور به‌عنوان گروه مورد و 151 مرد بارور به ‌عنوان گروه شاهد بود. پس از غربالگری، 2 میلی‌لیتر خون کامل از هر شرکت‌کننده جمع‌آوری شد. افراد نابارور به 3 زیرگروه بر اساس معیارهای سازمان جهانی بهداشت تقسیم شدند: 1- آزواسپرمی غیرانسدادی (42 = n)، 2- اولیگوزواسپرمی (61 = n)، و 3- آستنوزواسپرمی (60 = n). پس از استخراج DNA، ژنوتیپ‌های نمونه‌ها در    لوکوس -174 G/C (rs1800795) با استفاده از واکنش زنجیره‌ای پلیمراز-پلی‌مورفیسم طول قطعات محدودکننده تعیین شدند. نتایج: بررسی ژنتیکی ما ارتباط معنی­داری بین ژنوتیپ GC و ناباروری مردان را نشان داد. علاوه بر این، بین ژنوتیپ هتروزیگوت GC و کاهش خطر الیگوزواسپرمی و آستنوسپرمی همبستگی مشاهده شد. علاوه بر این، آلل C با کاهش خطر ناباروری و زیرگروه­های خاص مانند اولیگوزواسپرمی و آستنواسپرمی مرتبط بود. نتیجه­ گیری: یافته­های ما نشان می­دهد که ترانسورژن IL-6 -174 G/C می­تواند به طور بالقوه به عنوان یک عامل ژنتیکی محافظتی در برابر ناباروری مردان عمل کند. 2 Background: Genetic predispositions have been identified as important factors in male infertility. Among the many genes related to male reproductive function, interleukin 6 (IL-6) has emerged as a key player. Despite the growing recognition of genetic factors in male infertility, the specific association between the IL-6-174 G/C genetic polymorphism and male infertility remains an area that needs further investigation. Objective: This investigation explores the correlation between the IL-6-174 G/C transversion and male infertility. Materials and Methods: In a case-control study, a total of 314 men who referred to the Kashan Infertility Centre, Shahid Beheshti hospital, Kashan, Iran, were enrolled for IL-6-174 G/C polymorphism analysis. The study comprised 163 infertile participants as the case group and 151 fertile men as the control group. Following the screening, 2 ml of whole blood was collected from each participant. Cases were categorized into 3 subgroups based on World Health Organization criteria: (i) nonobstructive azoospermia (n = 42), (ii) oligozoospermia (n = 61), and (iii) asthenozoospermia (n = 60). After DNA extraction, genotypes of the samples at the -174 G/C (rs1800795) locus were determined using the polymerase chain reaction-restriction fragment length polymorphism method. Results: Our genetic investigation demonstrated a significant association between the GC genotype and male infertility. Furthermore, a correlation was observed between the heterozygous GC genotype and reduced risk of oligozoospermia and asthenospermia. Additionally, the C allele was correlated with a decreased risk of infertility and specific subgroups such as oligozoospermia and asthenospermia. Conclusion: Our findings suggest that the IL-6-174 G/C transversion could potentially serve as a protective genetic factor against male infertility. 1015 1024 2024/05/212024/06/142024/10/162023/12/162023/11/282024/01/132023/08/27 1402/6/5 2024/11/282024/12/182024/11/282024/12/12024/12/292024/12/142024/12/14 1403/9/24 Tayyebeh Zamani-Badi Tayyebeh Zamani-Badi Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran. ایران t.zamani@yahoo.com Mohammad Karimian Mohammad Karimian Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran. ایران mdkarimian@gmail.com Javad Amini Mahabadi Javad Amini Mahabadi Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran. ایران j.mahabadi64@gmail.com Atieh Rafatmanesh Atieh Rafatmanesh Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran. ایران rafatmaneshatieh62@gmail.com Hossein Nikzad Hossein Nikzad Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran. ایران hnikzad1343@gmail.com Polymorphism Genetic Interleukin-6 Spermatogenesis Male infertility. پلی‌مورفیسم ژنتیک اینترلوکین 6 اسپرماتوژنزیز ناباروری مردان. 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Hum Fertil 2017; 22: 111-117.##Alves-Silva T, Freitas GA, Húngaro TGR, Arruda AC, Oyama LM, Avellar MCW, et al. Interleukin-6 deficiency modulates testicular function by increasing the expression of suppressor of cytokine signaling 3 (SOCS3) in mice. Sci Rep 2021; 11: 11456.##Fraczek M, Kurpisz M. Cytokines in the male reproductive tract and their role in infertility disorders. J Reprod Immunol 2015; 108: 98-104.##Li X, Ni M, Xing S, Yu Y, Zhou Y, Yang S, et al. Reactive oxygen species secreted by leukocytes in semen induce self-expression of interleukin-6 and affect sperm quality. Am J Mens Health 2020; 14: 1557988320970053.##Sharma A, Singh K, Biswas A, Ranjan R, Kishor K, Pandey H, et al. Impact of interleukin 6 promoter polymorphisms (-174 G> C,-572 G> C and -597 G> A) on plasma IL-6 levels and their influence on the development of DVT: A study from India. Hematology 2018; 23: 833-838.##Zhang M, Xu J, Bao X, Niu W, Wang L, Du L, et al. Association between genetic polymorphisms in interleukin genes and recurrent pregnancy loss: A systematic review and meta-analysis. PloS One 2017; 12: e0169891.##Ayelign B, Negash M, Andualem H, Wondemagegn T, Kassa E, Shibabaw T, et al. Association of IL-10 (-1082 A/G) and IL-6 (-174 G/C) gene polymorphism with type 2 diabetes mellitus in Ethiopia population. BMC Endocr Disord 2021; 21: 70.##González-Castro TB, Hernández-Díaz Y, Pérez-Hernández N, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narvaez ML, et al. Interleukin 6 (rs1800795) gene polymorphism is associated with cardiovascular diseases: A meta-analysis of 74 studies with 86,229 subjects. EXCLI J 2019; 18: 331-355.##Shukla KK, Agnihotri S, Gupta A, Mahdi AA, Mohamed EA, Sankhwar SN, et al. Significant association of TNFα and IL-6 gene with male infertility--an explorative study in Indian populations of Uttar Pradesh. Immunol Lett 2013; 156: 30-37.##Sobhan MR, Mahdinezhad-Yazdi M, Dastgheib SA, Ahrar H, Aghili K, Neamatzadeh H. 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Assessing psychological health and reproductive function: Depression, anxiety, and stress in infertile men compared to controls: A case-control study مقایسه استرس، اضطراب و افسردگی در بین مردان نابارور: یک مطالعه‌ی مورد-شاهدی 2 1 مقدمه: به دلیل افزایش شیوع ناباروری و همچنین استرس و اضطراب و افسردگی، بررسی ارتباط بین آنها و شناخت فاکتور­های دموگرافیک مؤثر بر استرس، اضطراب و افسردگی در این افراد حائز اهمیت خواهد بود. هدف: هدف از انجام مطالعه مقایسه استرس، اضطراب و افسردگی در بین مردان نابارور و گروه کنترل بود. مواد و روش ­ها: این مطالعه از دی تا بهمن 1401 در مرکز تحقیقات ناباروری میلاد مشهد انجام شد. در این مطالعه مورد شاهدی، تعداد60 نفر از مردان نابارور و 60 نفر مرد بارور از بستگان ایشان وارد مطالعه شدند و اطلاعات دموگرافیک شامل سن، تحصیلات، شغل، مدت زمان ازدواج و مدت زمان ناباروری از ایشان گردآوری شد و به پرسش­نامه -21DASS نیز پاسخ دادند و در انتها یافته­ها مورد تحلیل آماری قرار گرفتند. نتایج: افسردگی، اضطراب و استرس شدید و بسیار شدید به ترتیب 65%، 60% و 4/43% در مردان نابارور و 7/16%، 3/23% و 7/11% در مردان بارور مشاهده شد که به طور قابل توجهی بیشتر از گروه بارور بوده و بین افسردگی (001/0 ≥ p)، اضطراب (001/0 = p)، استرس (001/0 ≥ p) و ناباروری رابطه معنی­داری وجود داشت. همچنین بین طول مدت ناباروری و افسردگی رابطه معناداری مشاهده شد (031/0 = p). نتیجه­ گیری: مطالعه ما نشان داد که مردان نابارور نسبت به گروه کنترل استرس، اضطراب و افسردگی بیشتری داشتند. محدودیت­های ما شامل جمع­آوری  داده­ها بصورت تلفنی و ماهیت غربالگری پرسشنامه DASS-21 بود. همچنین مطالعات آتی بهتر است شامل جمعیت­های بزرگ­تری باشد و وضعیت اقتصادی را به عنوان متغیر مرتبط با سلامت روان در نظر بگیرد. 2 Background: With the increasing prevalence of infertility and its links to depression, anxiety, and stress, it is essential to compare these mental health levels between infertile men and a control group. Objective: This study aimed to compare depression, anxiety, and stress among infertile and fertile men. Also, assessing demographic factors affecting these challenges among both groups. Materials and Methods: This case-control study was conducted on 120 men at Milad Infertility Research Center, Mashhad, Iran from January 2023 to February 2023. Participants were divided into 2 groups: 60 infertile men and 60 healthy men who did not have fertility problems. Demographic information such as age, education, occupation, duration of the marriage, and duration of infertility was collected from their medical records, and they also completed the depression, anxiety, and stress scale 21 questionnaire through a telephonic interview. Finally, the findings were statistically analyzed. Results: Severe and very severe depression, anxiety, and stress were observed in 65%, 60%, and 43.4% of infertile men and 16.7%, 23.3%, and 11.7% of fertile men, respectively. Which was significantly more than the fertile group, and there was a significant relationship between depression (p ≤ 0.001), anxiety (p = 0.001), stress (p ≤ 0.001), and infertility. Also, a significant relationship was observed between the duration of infertility and depression (p = 0.031). Conclusion: Our study found infertile men had higher stress, anxiety, and depression than the control group. Limitations included phone-based data collection and the depression, anxiety, and stress scale 21 questionnaire's screening nature. Future studies should involve larger populations and consider economic status as a variable related to mental health. This article has been extracted from M.D. Thesis. (Maryam Ramezani) 1025 1034 2024/05/212024/06/142024/10/162023/12/162023/11/282024/01/132023/08/272024/08/13 1403/5/23 2024/11/282024/12/182024/11/282024/12/12024/12/292024/12/142024/12/142024/12/21 1403/10/1 Seyedeh Narjes Roubaraki Seyedeh Narjes Roubaraki Department of Psychology, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran. ایران n.rudbaraki@yahoo.com Maryam Ramezani Maryam Ramezani Student Research Committee, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran. ایران Maryamramezani767@gmail.com Bita Saifi Bita Saifi Department of Basic Sciences, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran. ایران bita_saifi@yahoo.com Mostafa Salimi Mostafa Salimi Student Research Committee, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran. ایران salimi.mostafa@iaumshms.ac.ir Massood Issapour Massood Issapour Department of Urology, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran. ایران Massoodissapour@yahoo.com Male infertility Stress Anxiety Depression. ناباروری مردان استرس اضطراب افسردگی. 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