2014 12 1 0 82

Intrauterine administration of recombinant human chorionic gonadotropin before embryo transfer on outcome of in vitro fertilization/ intracytoplasmic sperm injection: A randomized clinical trial اثر تزریق داخل رحمی rhCG قبل از انتقال جنین بر نتیجه لقاح آزمایشگاهی/ لقاح از طریق تزریق اسپرم به داخل سیتوپلاسم  2 1 مقدمه: مدارک نشان می­دهند که اینترلوکین یک آلفا و یک بتا و hCG توسط بلاستوسیست ترشح می­شوند و این مواد می­توانند اثر مثبت بر روی اندومتر و گیرنده­های آن داشته باشند. اخیرا نشادن داده شده است که rhCG از رخ دادن آپپتوز در سلول­های استرومایی آندومتر دسیدوال انسانی که در معرض استرس اکسیداتیو قرار گرفته­اند، جلوگیری می­کند. هدف: هدف از انجام این مطالعه ‌ارزیابی اثر تزریق داخل رحمی rhCG قبل از انتقال جنین روی نتایج حاملگی بود. مواد و روش­ها: تعداد 182 بیمار با مشکل نازایی که تاکنون تحت IVF قرار نگرفته­اند، در این طرح کلینیکی کنترل شده پلاسیبوی رندوم شرکت کرده­اند که از آن­ها، تعداد 84 نفر، مقدار μg 250 از داروی rhCG و تعداد 98 نفر، پلاسیبو دریافت کرده­اند. میزان لانه­گزینی و حامگی بین دو گروه، مقایسه شد. نتایج: بیمارانی­که rhCG را قبل از انتقال جنین دریافت کرده بودند، به­طور مشخصی افزایش در لانه­گزینی (0/035=p؛ 36/9% vs. 22/4%) و حاملگی 0/044=p؛ 34/5% .vs 20/4%) و ادامه حاملگی (0/032=p؛ 32/1% vs. 18/4%) نسبت به گروه پلاسیبو داشته­اند. میزان سقط (0/929=p؛ 2/0% vs. 2/4%) و حاملگی خارج رحمی (0/976=p؛ 1/0% vs. 1/2%) بین دوگروه از لحاظ آماری اختلاف معناداری نداشت. نتیجه­گیری: تزریق داخل رحمی مقدار μg 250 از rhCG قبل از انتقال جنین، به­طور قابل ملاحظه­ای میزان لانه­گزینی و حاملگی را در سیکل­های IVF/ICSI بهبود می دهد. 2 Background: The direct effect of hCG on the human endometrium was studied several times. Objective: The objectives of this study were to evaluate the effectiveness of intrauterine injection of recombinant human chorionic gonadotropin (rhCG) before embryo transfer (ET). Materials and Methods: In this randomized placebo-controlled clinical trial, a total number of 182 infertile patients undergoing their first in vitro fertilization/ intracytoplasmic sperm injection (IVF-ICSI) cycles were randomly assigned to receive 250μg intrauterine rhCG (n=84) or placebo (n=98) before ET. The implantation and pregnancy rates were compared between groups. Results: Patients who received intrauterine rhCG before ET had significantly higher implantation (36.9% vs. 22.4%; p=0.035), clinical pregnancy rates (34.5% vs. 20.4%; p=0.044) and ongoing pregnancy rate (32.1% vs. 18.4%; p=0.032) when compared to those who received placebo. The abortion (2.4% vs. 2.0%; p=0.929) and ectopic pregnancy rates (1.2% vs. 1.0%; p=0.976) were comparable between groups of rhCG and placebo, respectively. Conclusion: Intrauterine injection of 250μg of rhCG before ET significantly improves the implantation and pregnancy rates in IVF/ICSI cycles 1 6 2017/10/1 1396/7/9 2018/01/28 1396/11/8 افسون زارعی Afsoon Zarei Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ایران younesi.dr@gmail.com محمد ابراهیم پارسانژاد Mohammad Ebrahim Parsanezhad Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran ایران معصومه یونسی Masoumeh Younesi Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran ایران younesi.dr@gmail.com سعید البرزی Saeed Alborzi Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ایران ژاله ذوالقدری Jaleh Zolghadri Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ایران عالمتاج صمصامی Alamtaj Samsami Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ایران صدیقه عمویی Sedigheh Amooee Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ایران شهین تاج آرامش Shahintaj Aramesh Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ایران Recombinant human chorionic gonadotropin (rhCG) Intracytoplasmic sperm injection (ICSI) In vitro fertilization (IVF) Implantation rate Pregnancy rate. گنادوتروپین جفتی انسانی ریکامبیننت تزریق داخل سیتوپلاسمی اسپرم باروری داخل آزمایشگاهی میزان لانه گزینی میزان حاملگی. Koot YE, Teklenburg G, Salker MS, Brosens JJ, Macklon NS. Molecular aspects of implantation failure. Biochim Biophys Acta 2012; 1822: 1943-1950.##Norwitz ER, Schust DJ, Fisher SJ. Implantation and the survival of early pregnancy. N Engl J Med 2001; 345: 1400-1408.##Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Implantation, Embryogenesis, and Placental Development: Secretory or Postovulatory Endometrial Phase. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. USA, McGraw-Hill; 2010: 42-43.##Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Implantation, Embryogenesis, and Placental Development: Secretory or Postovulatory Endometrial Phase. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. USA, McGraw-Hill; 2010: 48.##Tsampalas M, Gridelet V, Berndt S, Foidart JM, Geenen V, Perrier d'Hauterive S. Human chorionic gonadotropin: a hormone with immunological and angiogenic properties. J Reprod Immunol 2010; 85: 93-98.##Kajihara T, Tochigi H, Uchino S, Itakura A, Brosens JJ, Ishihara O. Differential effects of urinary and recombinant chorionic gonadotropin on oxidative stress responses in decidualizing human endometrial stromal cells. Placenta 2011; 32: 592-597.##Licht P, Losch A, Dittrich R, Neuwinger J, Siebzehnrubl E, Wildt L. Novel insights into human endometrial paracrinology and embryo-maternal communication by intrauterine microdialysis. Hum Reprod Update 1998; 4: 532-538.##Mansour R, Tawab N, Kamal O, El-Faissal Y, Serour A, Aboulghar M, et al. Intrauterine injection of human chorionic gonadotropin before embryo transfer significantly improves the implantation and pregnancy rates in in vitro fertilization/ intracytoplasmic sperm injection: a prospective randomized study. Fertil Steril 2011; 96: 1370-1374.##Salha OH, Lamb VK, Balen AH. A postal survey of embryo transfer practice in the UK. Hum Reprod 2001; 16: 686-690.##Mansour RT, Aboulghar MA, Serour GI, Fahmi I, Ramzy AM, Amin Y. Intracytoplasmic sperm injection using microsurgically retrieved epididymal and testicular sperm. Fertil Steril 1996; 65: 566-572.##Mansour R, Fahmy I, Tawab NA, Kamal A, El-Demery Y, Aboulghar M, et al. Electrical activation of oocytes after intracytoplasmic sperm injection: a controlled randomized study. Fertil Steril 2009; 91: 133-139.##Bourdiec A, Bédard D, Rao CV, Akoum A. Human Chorionic Gonadotropin Regulates Endothelial Cell Responsiveness to Interleukin 1 and Amplifies the Cytokine-Mediated Effect on Cell Proliferation, Migration and the Release of Angiogenic Factors. Am J Reprod Immunol 2013; 70: 127-138.##Hoshina M, Boothby M, Hussa R, Pattillo R, Camel HM, Boime I. Linkage of human chorionic gonadotrophin and placental lactogen biosynthesis to trophoblast differentiation and tumorigenesis. Placenta 1985; 6: 163-172.##Bonduelle ML, Dodd R, Liebaers I, Van Steirteghem A, Williamson R, Akhurst R. Chorionic gonadotrophin-beta mRNA, a trophoblast marker, is expressed in human 8-cell embryos derived from tripronucleate zygotes. Hum Reprod 1988; 3: 909-914.##Lopata A, Hay DL. The potential of early human embryos to form blastocysts, hatch from their zona and secrete HCG in culture. Hum Reprod 1989; 4 (Suppl.): 87-94.##Ertzeid G, Tanbo T, Dale PO, Storeng R, Mørkrid L, Abyholm T. Human chorionic gonadotropin levels in successful implantations after assisted reproduction techniques. Gynecol Endocrinol 2000; 14: 258-263.##Tsampalas M, Gridelet V, Berndt S, Foidart JM, Geenen V, Perrier d'Hauterive S. Human chorionic gonadotropin: a hormone with immunological and angiogenic properties. J Reprod Immunol 2010; 85: 93-98.##Zeke J, Kanyó K, Zeke H, Cseh A, Vásárhelyi B, Szilágyi A, et al. Pregnancy rates with recombinant versus urinary human chorionic gonadotropin in in vitro fertilization: an observational study. Sci World J 2011; 11: 1781-1787.##Al-Inany H, Aboulghar MA, Mansour RT, Proctor M. Recombinant versus urinary gonadotrophins for triggering ovulation in assisted conception. Hum Reprod 2005; 20: 2061-2073.##Sugihara K, Kabir-Salmani M, Byrne J, Wolf DP, Lessey B, Iwashita M, et al. Induction of trophinin in human endometrial surface epithelia by CGbeta and IL-1beta. FEBS Lett 2008; 582: 197-202.##Wan H, Versnel MA, Cheung WY, Leenen PJ, Khan NA, Benner R, et al. Chorionic gonadotropin can enhance innate immunity by stimulating macrophage function. J Leukoc Biol 2007; 82: 926-933.##Schumacher A, Brachwitz N, Sohr S, Engeland K, Langwisch S, Dolaptchieva M, et al. Human chorionic gonadotropin attracts regulatory T cells into the fetal-maternal interface during early human pregnancy. J Immunol 2009; 182: 5488-5497.##Kornyei JL, Lei ZM, Rao CV. Human myometrial smooth muscle cells are novel targets of direct regulation by human chorionic gonadotropin. Biol Reprod 1993; 49: 1149-1157.## ##

Comparison effect of physiotherapy with surgery on sexual function in patients with pelvic floor disorder: A randomized clinical trial مقایسه اثر درمانی فیزیوتراپی و جراحی بر عملکرد جنسی در زنان با اختلالات کف لگن 2 1 مقدمه: اختلالات عملکرد جنسی مشکل شایع در کل جمعیت و خصوصا زنان و بیماران یوروژنیکولوژی می­باشد که منجر به کاهش کیفیت زندگی و ارتباطات خانوادگی می­گردد. هدف: در این مطالعه تأثیر روش­های جراحی و فیزیوتراپی کف لگن در بهبود اختلالات جنسی بررسی و با یکدیگر مقایسه شده است. مواد و روش­ها: کارآزمایی بالینی به صورت تصادفی در 2 گروه و از سال 2007 تا 2009 بر روی 90 بیمار با پرولاپس لگنی درجه 1و2 وسنین 25-55 سال با سابقه زایمان قبلی و اختلال عملکرد جنسی در بیماران درمانگاه  یوروگاینکولوژی  انجام شد. گروه A (45 = n نفر) درمان­های استاندارد جراحی ( ترمیم رکتوسل و پرینورافی ) و گروه B (45=n نفر) فیزیوتراپی به مدت 8 هفته و 2 بار در هفته (تحریک الکتریکی، تمرینات کگل) دریافت نمودند. متغیرهای تمایل جنسی، تهییج جنسی، ارگاسم و درد موقع نزدیکی در دو گروه قبل و پس از مداخله  بر اساس پرسشنامه FSFI با معیارهای اغلب خوب، بعضی وقت­ها خوب، خیلی زیاد و بی نهایت سنجیده و مقایسه شد. نتایج: تمایل و تهییج جنسی در هر دو گروه جراحی و فیزیوتراپی با درمان انجام شده بهبودی یافت (0/007=p و 0/001=p) ولی درمقایسه دو گروه تفاوت معنی­داری مشاهده نشد (0/3=p). ارگاسم، تحریک­پذیری و درد موقع نزدیکی بهبودی بیشتری در روش فیزیوتراپی نسبت به روش جراحی داشت (0/001=p). نتیجه­گیری: به نظر می­رسد فیزیوتراپی روش مناسبی برای درمان مشکلات جنسی در اختلالات کف لگن است. 2 Background: Female sexual dysfunction is a common problem among general population, especially in urogynecological patient, and can lead to a decrease in quality of life and affect martial relationship. Objective: This study was compared the effect of surgical methods versus physiotherapy on sexual function in pelvic floor disorder. Materials and Methods: This randomized controlled trial (RCT) was performed in Urogynecology clinic since August 2007 to December 2009 on 90 patients aged from 25-55 years with previous delivery, positive history of sexual dysfunction with stage <3 of pelvic organ prolapsed and divided in two groups. Group A (n=45) received standard rectocele repair and prineorrhaphy, group B (n=45) received physiotherapy for eight weeks twice a week (electrical stimulation, Kegel exercises). The female sexual function index (FSFI) used to evaluate the sexual function in cases before and after intervention. Frequency of variable scores (libido, orgasm, dysparunia) included without disorder, frequently good, sometimes good, very much and extreme were compared between two groups. Results: Libido and arousal were improved in both groups (p=0.007, p=0.001 respectively). Orgasm and dyspareunia were improved in group B (p=0.001). Dysparunia was more painful in group A. There was significant difference between two groups (improvement of orgasm and dysparunia in group B) (p=0.001). Conclusion: It seems that physiotherapy is an appropriate method for treatment of sexual disorder in pelvic floor disorder. 7 14 2017/10/12017/10/1 1396/7/9 2018/01/282018/01/28 1396/11/8 طاهره افتخار Tahereh Eftekhar Institute for Family Health, Vali-e-Asr Reproductive Health Research Center, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran ایران مریم سهرابی Maryam Sohrabi Gynecology Ward, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran ایران فدیه حق اللهی Fedyeh Haghollahi Institute for Family Health, Vali-e-Asr Reproductive Health Research Center, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran ایران fedyeh_hagh@yahoo.com مامک شریعت Mamak Shariat Institute for Family Health, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran ایران الهه میری Elahe Miri Gynecology Ward, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran ایران Pelvic floor FSFI Sexual dysfunction Physiotherapy Physical Therapy Pelvic surgery. کف لگن پرسشنامه اختلال عملکرد جنسی عملکرد جنسی فیزیوتراپی جراحی کف لگن. Stoker J. The anatomy of the pelvic floor and sphincters. In: Bartram CI, Delancey JO, eds. Imaging pelvic floor disorder. New York, springer-verlag PP; 2002: 1-26.##Persu C, Chapple CR, Cauni V, Gutue S, Geavlete P. Pelvic Organ Prolapse Quantification System (POP-Q)- a new era in pelvic prolapse staging. J Med Life 2011; 4: 75-81.##Brandner S, Monga A, Mueller MD, Herrmann G, Kuhn A. Sexual function after rectocele repair. J Sex Med 2011; 8: 583-588.##Achtari C, Dwyer PL. Sexual function and pelvic floor disorders. Best Pract Res Clin Obstet Gynecol 2005; 19: 993-1008.##Knoepp LR, Shippey SH, Chen CCG, Cundiff GW, derogatis LR, Handa VL. Sexual complaints, pelvic floor symptoms, and sexual distress in women over. J Sex Med 2010; 7: 3675-3682.##Gil KM, Somerville AM, Cichowski S, Savitski JL. Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence. Health Qual Life Outcomes 2009; 7: 8.##Field SM, Hilton P. The prevalence of sexual problems in women attending for urodynamic investigation. Int Urogynecol J 1993; 4: 212-215.##Kammerer-Doak D. Assessment of sexual function in women with pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20 (Suppl.): S45-50.##Di Benedetto P. Female urinary rehabilitation. Minerva Ginecol 2004; 56: 353-369.##Hay-Smith EJ, Dumoulin C. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 2010; 1: CD005654.##Nancy A. Phillip S. Femal sexual dysfunction Evaluation and treatment. Am Fam Physician 2000; 62: 127-136.##Kuhn A, Brunnmayr G, Stadlmayr W, Kuhn P, Mueller MD. Male and female sexual function after surgical repair of female organ. J Sex Med 2009; 6: 1324-1334.##Ferreira M, Santos P. [Pelvic floor muscle training programmes: a systematic review]. Acta Med Port 2011; 24: 309-318. (In Portuguese)##Geiss M, Umek WH, Dungl A, Sam C, Riss P, Hanzal E. Prevalence of female sexual dysfunction in gynecologic and urogynecologic patients according to the international consensus classification. Urology 2003; 62: 514-518.##Pauls RN, Segal JL, Silva WA, Kleeman SD, Karram MM. Sexual function in patients presenting to a urogynecology practice. Int Urogynecol J Pelvic Floor Dysfunct 2006; 17: 576-580.##Handa VL, Harvey L, Cundiff GW, Siddique SA, Kjerulff KH. Sexual function among women with urinary incontinence and pelvic organ prolapsed. Am J Obstet Gynecol 2004; 191: 751-756.##Rogers RG, Kammerer-Doak D, Darrow A, Murray K, Olsen A, Barber M. et al. Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study. Am J Obstet Gynecol 2006; 195: 1-4.##Pauls RN, Silva WA, Rooney CM, Siddighi S, Kleeman SD, Dryfhout V, et al. Sexual function after vaginal surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 2007; 197: 622-627.##Azar M, Noohi S, Radfar S, Radfar MH. Sexual function in women after surgery for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 53-57.##Komesu YM, Rogers RG, Kammerer-Doak DN, Barber MD, Olsen AL. Posterior repair and sexual function. Am J Obstet Gynecol 2007; 197: 101.##Kizilkaya NB, Yalicin O, Erkan HA. The effect of pelvic floor training on sexual function of treateel patients. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14: 234-238.##Wurn LJ, Wurn BF, Roscow AS. Increasing orgasm anal decreasing dyspareunia by a manual physical therapy technique. Med Gen Med 2004; 6: 47-58.##Liebergall-Wischnitzer M, Paltiel O, Hochner Celnikier D, Lavy Y, Manor O, Woloski Wruble AC. Sexual function and quality of life of women with stress urinary incontinence: a randomized controlled trial comparing the Paula method (circular muscle exercises) to pelvic floor muscle training (PFMT) exercises. J Sex Med 2012; 9: 1613-1623.##di Benedetto P, Coidessa A, Floris S. Rationale for pelvic floor muscles training in women with urinary incontinence. Minerva Ginecol 2008; 60: 529-541.##Haase P, Skibsted L. Influence of operations for stress incontinence and/or genital descensus on sexual life. Acta Obstet Gynecol Scand 1988; 67: 659-661.##Weber AM, Walters MD, Schover LR, Mitchinson A. Sexual function in women with uterovaginal prolapse and urinary incontinence. Obstet Gynecol 1995; 85: 483-487.##Helström L, Nilsson B. Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet Gynecol Scand 2005; 84: 79-84.##Rogers RG, Kammerer-Doak D, Villarreal A, Coates K, Qualls C. A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse. Am J Obstet Gynecol 2001; 184: 552-558.##Rogers RG, Rockwood TH, Constantine ML, Thakar R, Kammerer-Doak DN, Pauls RN, et al. A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Int Urogynecol J 2013; 24: 1091- 1103.##Khademi A, Alleyassin A, Amini M, Ghaemi M. Evaluation of sexual dysfunction prevalence in infertile couples. J Sex Med 2008; 5: 1402-1410.## ##

Effect of human T-cell lymphotrophic virus type 1 (HTLV-1) in seropositive infertile women on intracytoplasmic sperm injection (ICSI) outcome اثرویروس T سلول لنفوتروپیک انسانی نوع 1 (HTLV-1) در زنان نابارور دارای سرم مثبت برروی نتیجه تزریق درون سیتوپلاسمی اسپرم (ICSI)   2 1 مقدمه: ویروس سلول T لنفوتروپیک انسانی نوع اول (HTLV-1) بیش از ۲۰ میلیون نفر در سراسر جهان را آلوده کرده است. مشهد مرکز استان خراسان رضوی در شمال شرقی ایران برایHTLV-1  با شیوع 3% از کل جمعیت اندمیک محسوب می­شود. هدف: ما نتایج ICSI را دربرنامه مان برای HTLV-1 در زوجین سرودیسکوردنت با زنان آلوده درمقایسه با گروه کنترل مورد بررسی قرار داده شد. مواد و روش­ها: این مطالعه  مقطعی برروی زوجینی که در بین سال­های 2007 تا 2011 به مرکز ناباروری نوین مشهد مراجعه نموده بودند انجام شد. ما 32 زن آلوده به ویروس HTLV-1 در سیکل ICSI را در مقایسه با 62 نفر به عنوان گروه کنترل که ازنظر سنی هم با یکدیگر مشابه بودند مورد آزمایش قرار دادیم. مقایسه نتایج ICSI در خصوص میزان باروری، پارامترهای کیفیت جنینی، میزان القاء، میزان حاملگی کلینیکی و میزان سقط انجام شد. نتایج: میزان باروری، میزان القاء یا لانه گزینی و میزان حاملگی در بین دو گروه با یکدیگر از نظر آماری اختلاف معناداری نداشتند. هیچ اختلاف معناداری در خصوص تعداد جنین، روز انتقال آن­ها، جنین­های فریز شده، حاملگی چندقلویی و میزان سقط در بین دو گروه وجود نداشت. نتیجه­گیری: یافته­های ما نشان دادند که کیفیت جنین و نتایج ICSI تحت تأثیر عفونت با ویروس HTLV-1 در زوجین سرودیسکوردنت نیستند. عمده   یافته­های ما در این مطالعه درنتایج ICSI در بیماران آلوده به HTLV-1 و سرونگاتیو کنترل مشابه هستند. 2 Background: Human T-cell Lymphotrophic virus type 1 (HTLV-1) has infected more than 20 million people worldwide. Northeast of Iran, Mashhad, the capital of Razavi Khorasan Province, is endemic for HTLV-1 with a prevalence of 3% among general population. Objective: We evaluated the ICSI outcome in our program for (HTLV-1) serodiscordant couples (SDCs) with the female infected in comparison with control group. Materials and Methods: This study was performed between 2007 and 2011 in Novin Infertility Treatment Center (Mashhad, Iran). We examined 32 ICSI cycles of HTLV-1 infected women in comparison with an age matched control group (n=62). ICSI outcome was compared regarding fertilization rate (FR), embryo quality parameters, implantation rate (IR), clinical pregnancy rate (PR), and abortion rate (AR). Results: Fertilization (p=0.15), implantation (p=0.33), and pregnancy rate (p=0.12) were similar between the groups. No difference was found regarding the number of transferred embryos (on day 2 or 3) and cryopreserved embryos, multiple pregnancies, or abortion rates between the groups. Conclusion: Our results suggest that the embryo quality and ICSI outcome are not affected by HTLV-1 infection in serodiscordant couples. The major finding of this study is that the outcome of ICSI in HIV-I-infected patients and seronegative controls is similar. 15 18 2017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/28 1396/11/8 مهناز منصوری ترشیزی Mahnaz Mansouri Torshizi Novin Infertility Treatment Center, Mashhad, Iran ایران امیررضا خلیقی Amir Reza Khalighi Mashhad University of Medical Sciences, Mashhad, Iran ایران مهلا فدوی اسلام Mahla Fadavi Islam Novin Infertility Treatment Center, Mashhad, Iran ایران mahlafadavi@gmail.com راحله آرام Rahele Aram Novin Infertility Treatment Center, Mashhad, Iran ایران الهام صبوری Elham Sabouri Novin Infertility Treatment Center, Mashhad, Iran ایران حکمت خلیلی فر Hekmat Khalilifar Novin Infertility Treatment Center, Mashhad, Iran ایران حسام روستایی Hesam Roustaee Novin Infertility Treatment Center, Mashhad, Iran ایران HTLV-1 ICSI outcome Seropositive Infertile HTLV-1 نتایج ICSI سروپوزیتیو نابارور. Gotuzzo E, Verdonck K. HTLV-1: clinical impact of a chronic infection. The infectious etiology of chronic diseases: defining the relationship, enhancing the research, and mitigating the effects: workshop summary book. 2004.##Proietti FA, Carneiro-Proietti AB, Catalan-Soares BC, Murphy EL. Global epidemiology of HTLV-1 infectionand associated diseases. Oncogene 2005; 24: 6058-6068.##Vrielink H, Reesink HW. HTLV-I/II prevalence in different geographic locations. Transfus Med Rev 2004; 18: 46-57.##Hedayati-Moghaddam MR, Fathimoghadam F, Eftekharzadeh Mashhadi I, Soghandi L, Bidkhori HR. Epidemiology of HTLV-1 in Neyshabour, Northeast of Iran. Iran Red Crescent Med J 2011; 13: 424-427.##Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, et al. Harrison's principles of internal medicine. 17th Ed. New York: McGraw-Hill Medical Publishing Division; 2008.##Mandell GL, Bennett JE, Dolin R. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th Ed. 2010.##Safai B, Huang JL, Boeri E, Farid R, Raffat J, Schutzer P, et al. Prevalence of HTLV type I infection in Iran: a serological and genetic study. AIDS Res Hum Retroviruses 1996; 12: 1185-1190.##Lal RB, Brodine SK, Coligan JE, Roberts CR. Differential antibody responsiveness to p19 gag results in serological discrimination between human T-lymphotropic virus type I and type II. J Med Virol 1991; 35: 232-236.##Chen YM, Lee TH, Wiktor SZ, Shaw GM, Murphy EL, Blattner WA, et al. Type-specific antigens for serological discrimination of HTLV-I and HTLV-II infection. Lancet 1990; 336: 1153-1155.##Beilke MA, Traina-Dorge V, England JD, Blanchard JL. Polymyositis, arthritis, and uveitis in a macaque experimentally infected with human T lymphotropic virus type I. Arthritis Rheum 1996; 39: 610-615.##Glynn JR, Caraël M, Auvert B, Kahindo M, Chege J, Musonda R, et al. Why do young women have a much higher prevalence of HIV than young men? AIDS 2001; 15: S51-S60.##Terriou P, Auquier V, Chabert-Orsini JM, Chinchole L, Cravello C, Giorgetti P, et al. Outcome of ICSI in HIV-1-infected women. Hum Reprod 2005; 20: 2838-2843.##Barreto Melo MA, Meseguer M, Bellver J, Remoh J, Pellicer A, Garrido N. Human immunodeficiency type-1 virus (HIV-1) infection in serodiscordant couples (SDCs) does not have an impact on embryo quality or intracytoplasmic sperm injection (ICSI) outcome. Fertil Steril 2008; 89: 141-149.##Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HWG, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231-245.##Racowsky C, Stern JE, Gibbons WE, Behr B, Pomeroy KO, Biggers JD. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil Steril 2011; 95: 1985-1989.##Proietti FA, Carneiro-Proietti AB, Catalan-Soares BC, Murphy EL. Global epidemiology of HTLV-1 infection and associated diseases. Oncogene 2005; 24: 6058-6068.##Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Natl Acad Sci USA 1980; 77: 7415-7419.##Manns A, Hisada M, La Grenade L. Human T-lymphotropic virus type I infection. Lancet 1999; 353: 1951-1958.##Fujino T, Nagata Y. HTLV-1 transmission from mother to child. J Reprod Immunol 2000; 47: 197-206.##Ho GYF, Kenrad N, Nomura AMY, Polk BF, Blattner WA. Markers of Health Status in an HTLV-1- Positive Cohort. Am J Epidemiol 1992; 136: 1349-1357.##LaGrenade L, Hanchard B, Fletcher V, Cranston B, Blattner W. Infective dermatitis of Jamaican children: a marker for HTLV-1 infection. Lancet 1990; 336: 1345-1346.##Sabouri AH, Usuku K, Hayashi D, Izumo S, Ohara Y, Osame M, et al. Impaired function of human T-lymphotropic virus type 1 (HTLV-1)- specific CD8+ T cells in HTLV-1-associated neurologic disease. Blood 2008; 112: 2411-2420.##CDC (Centers for Disease Control and Prevention). Recommendations for counseling persons infected with human T-lymphotropic virus, types I and II. Recommendations on prophylaxis and therapy for disseminated Mycobacterium avium complex for adults and adolescents infected with human immunodeficiency virus. MMWR 1993; 42: 1-13.##Benifla JL, Letur-Konïrsch H, Collin G, Devaux A, Kuttenn F, Madelenat P, et al. Safety of cryopreservation straws for human gametes or embryos: a preliminary study with human immunodeficiency virus-1. Hum Reprod 2000; 15: 2186-2189.##Kushnir VA, Lewis W. Human immunodeficiency virus/acquired immunodeficiency syndrome and infertility: emerging problems in the era of highly active antiretrovirals. Fertil Steril 2011; 96: 546-553.##Englert Y, Van Vooren JP, Place I, Liesnard C, Laruelle C, Delbaere A. ART in HIV-infected couples has the time come for a change of attitude? Hum Reprod 2001; 16: 1309-1315.##Savasi V, Mandia L, Laoreti A, Cetin I. Reproductive assistance in HIV serodiscordant couples Hum. Hum Reprod Update 2013; 19: 136-150.##Vandermaelen A, Englert Y. Human immunodeficiency virus serodiscordant couples on highly active antiretroviral therapies with undetectable viral load: conception by unprotected sexual intercourse or by assisted reproduction techniques? Hum Reprod 2010; 25: 374-379.## ##

Association between increased expression of endothelial isoform of nitric oxide synthase in the human fallopian tube and tubal ectopic pregnancy ارتباط بین افزایش بیان ایزوفورم اندوتلیالی آنزیم سنتز کنندۀ نیتریک اکساید در لولۀ فالوپ انسان با حاملگی نابجای لوله ای 2 1 مقدمه: حاملگی نابجای لوله­ای (tEP)، نوع شایع حاملگی خارج رحمی بوده و به عنوان عمده­ترین دلیل مرگ و میر زنان، در سه ماهه اول حاملگی باقی مانده است. نیتریک اکساید (NO)، مولکولی است که در تعداد زیادی از فرایندهای فیزیولوژیکی سیستم تولیدمثل زنان شرکت می­کند. مطالعات جدید، نقش احتمالی ایزوفرم اندوتلیالی آنزیم سنتزکننده نیتریک اکساید (eNOS) را در تنظیم وقایع تولیدمثلی زیادی که در لوله فالوپ اتفاق می­افتد، را نشان داده­اند. هدف: هدف از این مطالعه ارزیابی بیان eNOS در لوله فالوپ زنان مبتلا به حاملگی نابجای لوله­ای بود. مواد و روش­ها: در این مطالعه موردی- شاهدی، تعداد کلی 30 نمونه از لوله­های فالوپ سه گروه از زنان به دست آمد که شامل: 10 نمونه  از زنان مبتلا به حاملگی نابجا، 10 نمونه از زنان غیر حامله در فاز لوتئال از چرخه قاعدگی و 10 نمونه از زنان حامله سالم ترم که تحت عمل سزارین قرار می­گرفتند، بودند. سپس نمونه­ها در فرمالین بافری 10% فیکس شده و مقاطع پارافینی از آن­ها تهیه شد، که مورد ارزیابی ایمونوهیستوشیمی قرار گرفت. نتایج: مکان­یابی eNOS در سلول­های ترشحی و مژه دار اپیتلیوم لومینال و اندوتلیوم عروق لوله فالوپ تمام گروه­ها دیده شد. بهر حال، ما بیان eNOS را در سلول­های عضله صاف هیچ گروهی مشاهده نکردیم. بیان بالای eNOS در اپیتلیوم لومینال زنان با حاملگی نابجا در مقایسه با گروه­های زنان غیر حامله در فاز لوتئال و زنان حامله سالم از لحاظ آماری معنادار بود (0/00=p). اختلاف معناداری در بیان eNOS در اپیتلیوم لومینال لوله فالوپ زنان در گروه های فاز لوتئال و زنان حامله سالم مشاهده نشد(0/78=p). نتیجه­گیری: این مطالعه پیشنهاد می­کند که تغییرات در بیان eNOS در اپیتلیوم لومینال لولۀ فالوپ ممکن است منجر به ایجاد EP شود.   2   Background: Tubal ectopic pregnancy (tEP) is the most common type of extra-uterine pregnancy and the most common cause of maternal mortality. Nitric oxide (NO) is a molecule that incorporates in many physiological processes of female reproductive system. Recent studies have demonstrated the possible role of endothelial isoform of nitric oxide synthase (eNOS) enzyme in the regulation of many reproductive events that occur in the fallopian tube (FT). Objective: The aim of this study was to evaluate the expression of eNOS in the FTs of women with tEP. Materials and Methods: In this case-control study, a total number of 30FTs samples were obtained from three groups including: 10 FTs of women that bearing an EP, 10 FTs from the non-pregnant women at luteal phase of the menstrual cycle, and 10 FTs of healthy pregnant women (n=10). Samples were fixed in 10% buffered formalin and then were evaluated by immunohistochemistry. Results: Localization of eNOS was seen in secretory and ciliated luminal epithelium and vascular endothelium of all groups. However, we did not observed the expression of eNOS in smooth muscle cells of all groups. Expression of eNOS in luminal epithelium of women with EP compared to non-pregnant women at luteal phase of menstrual cycle and healthy pregnant group showed statistically significant increase (p=0.00). Significant difference in expression of eNOS was not observed in luminal epithelium of FTs of women at luteal phase compared to healthy pregnant groups (p=0.78). Conclusion: This study indicates that changes in expression of eNOS in luminal epithelium of FT may lead to development of EP. 19 28 2017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/29 1396/11/9 لیلا فتح بیاتی Leyla Fath Bayati Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران معرفت غفاری نوین Marefat Ghaffari Novin Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران mghaffarin@yahoo.com فاطمه فدایی فتح آبادی Fatemeh Fadaei Fathabadi Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران عباس پیریایی Abbas Piryaei Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران محمد حسن حیدری Mohammad Hasan Heidari Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران مژگان بنده پور Mozhgan Bandehpour Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران محسن نوروزیان Mohsen Norouzian Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران مهدی علیزاده پرهیزگار Mahdi Alizadeh Parhizgar Department of Pathology, Kamkar Arab-Niya Hospital, Qom University of Medical Sciences, Qom, Iran ایران محمود شکوریان فرد Mahmood Shakooriyan Fard Department of Pathology, Kamkar Arab-Niya Hospital, Qom University of Medical Sciences, Qom, Iran ایران Ectopic pregnancy Nitric oxide Immunohistochemistry Fallopian tube حاملگی نابجا نیتریک اکساید ایمونوهستوشیمی لوله فالوپ. Seeber BE, Barnhart KT. Suspected Ectopic Pregnancy. Obstet Gynecol 2006; 107: 399- 413.##Al Azemi M, Refaat B, Aplin J, Ledger W. The expression of MUC1 in human Fallopian tube during the menstrual cycle and in ectopic pregnancy. Hum Reprod 2009; 24: 2582-2587.##Brown JK, Horne AW. Laboratory models for studying ectopic pregnancy. Curr Opin Obstet Gynecol 2011; 23: 221-226.##Shaw JL, Fitch P, Cartwright J, Entrican G, Schwarze J, Critchley HO, et al. Lymphoid and myeloid cell populations in the non-pregnant human Fallopian tube and in ectopic pregnancy. J Reprod Immunol 2011; 89: 84-91.##Barnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med 2009; 361: 379-387.##Refaat B, Amer S, Ola B, Chapman N, Ledger W. The expression of activin-beta A- and -beta B-subunits, follistatin, and activin type ll receptors in Fallopian tubes bearing an ectopic pregnancy. J Clin Endocrinol Metab 2008; 93: 293-299.##Pisarska MD, Carson SA, Buster JE. Ectopic pregnancy. Lancet 1998; 351: 1115-1120.##Tay JI, Moore J, Walker JJ. Ectopic pregnancy. BMJ 2000; 320: 916-919.##Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case control, population-based study in France. Am J Epidemiol 2003; 157: 185-194.##Varma R, Gupta J. Tubal ectopic pregnancy. Clin Evid (Online) 2009; Pii: 1406.##Shao R. Understanding the mechanisms of human tubal ectopic pregnancies: new evidence from knockout mouse models. Hum Reprod 2010; 25: 584-587.##Shaw JL, Dey SK, Critchley HO, Horne AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update 2010; 16: 432- 444.##Lyons RA, Saridogan E, Djahanbakhch O. The reproductive significance of human Fallopian tube cilia. Hum Reprod Update 2006; 12: 363-372.##Ziganshin AU, Vafina ZR, Fatkullin IF. Pharmacological characterization of P2-receptors in human fallopian tubes. Bull Exp Biol Med 2004; 137: 242-245.##Wanggren K, Lalitkumar PG, Stavreus-Evers A, Stabi B, Gemzell-Danielsson K. Prostaglandin E2 and F2alpha receptors in the human Fallopian tube before and after mifepristone treatment. Mol Hum Reprod 2006; 12: 577-585.##Wanggren K, Stavreus-Evers A, Olsson C, Andersson E, Gemzell-Danielsson K. Regulation of muscular contractions in the human Fallopian tube through prostaglandins and progestagens. Hum Reprod 2008; 23: 2359-2368.##Ekerhovd E, Brannstrom M, Alexandersson M, Norstrom A. Evidence for nitric oxide mediation of contractile activity in isolated strips of the human Fallopian tube. Hum Reprod 1997; 12: 301-305.##Ekerhovd E, Norstrom A. Involvement of a nitric oxide-cyclic guanosinemonophosphate pathway in control of fallopian tube contractility. Gynecol Endocrinol 2004; 19: 239-246.##Arbab F, Goldsby J, Matijevic-Aleksic N, Huang G, Ruan KH, Huang JC. Prostacyclin is an autocrine regulator in the contraction of oviductal smooth muscle. Hum Reprod 2002; 17: 3053-3059.##Lindblom B, Hamberger L, Ljung B. Contractile patterns of isolated oviductal smooth muscle under different hormonal conditions. Fertil Steril 1980; 33: 283-287.##Lindblom B, Hamberger L, Wiqvist N. Differentiated contractile effects of prostaglandins E and F on the isolated circular and longitudinal smooth muscle of the human oviduct. Fertil Steril 1978; 30: 553-559.##Jansen RP. Endocrine response in the fallopian tube. Endocr Rev 1984; 5: 525-551.##Paltieli Y, Eibschitz I, Ziskind G, Ohel G, Silbermann M, Weichselbaum A. High progesterone levels and ciliary dysfunction-a possible cause of ectopic pregnancy. J Assist Reprod Genet 2000; 17: 103-106.##Papathanasiou A, Djahanbakhch O, Saridogan E, Lyons RA. The effect of interleukin-6 on ciliary beat frequency in the human fallopian tube. Fertil Steril 2008; 90: 391-394.##Lyons RA, Saridogan E, Djahanbakhch O. The reproductive significance of human Fallopian tube cilia. Hum Reprod Update 2006; 12: 363- 372.##Li D, Shirakami G, Zhan X, Johns RA. Regulation of ciliary beat frequency by the nitric oxide-cyclic guanosine monophosphate signaling pathway in rat airway epithelial cells. Am J Respir Cell Mol Biol 2000; 23: 175-181.##Zhan X, Li D, Johns RA. Expression of endothelial nitric oxide synthase in ciliated epithelia of rats. J Histochem Cytochem 2003; 51: 81-87.##Yanagisawa M, Kurihara H, Kimura S, Tomobe Y, Kobayashi M, Mitsui Y, et al. A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 1991; 332: 411-415.##Rosselli M, Imthurn B, Macas E, Keller PJ. Endothelin production by bovine oviduct epithelial cells. J Reprod Fertil 1994a; 101: 27-30.##Rosselli M, Imthurn B, Macas E, Keller PJ, Dubey RK. Endogenous nitricoxide modulates endothelin-1 induced contraction of bovine oviduct. Biochem Biophys Res Commun 1994b; 201: 143-148.##Moncada S, Higgs A. The L-arginine-nitric oxide pathway. N Engl J Med 1993; 329: 2002- 2012.##Griffith OW, Stuehr DJ. Nitric oxide synthase properties and catalytic mechanism. Annu Rev Physiol 1995; 57: 707-736.##Snyder SH. Nitric oxide: NO endothelial NO. Nature 1995; 377: 196-197.##Nussler AK, Billiar TR, Liu ZZ, Morris SM Jr. Coinduction of nitric oxide synthase and arginosuccinate synthetase in a murine macrophage cell line. Implications for regulation of nitric oxide production. J Biol Chem 1994; 269: 1257-1261.##Morris SM Jr, Billiar TR. New insights into the regulation of inducible nitric oxide synthesis. Am J Physiol 1994; 266: E829-E839.##Nathan C, Xie QW. Regulation of biosynthesis of nitric oxide. J Biol Chem 1994; 269: 13275- 13278.##Marletta MA. Nitric oxide: biosynthesis and biological significance. Trends Biochem Sci 1989; 14: 488-492.##Najafi T, Gaffari Novin M, Pakravesh J, Foghi Kh, Fadayi F. Immunohistochemica localization of endothelial nitric oxide synthase in endometrial tissue of women with unexplained infertility. Iran J Reprod Med 2012; 10: 121-126.##Najafi T, Gaffari Novin M, Ghazi R, Khorram O. Altered endometrial expression of endothelial nitric oxide synthase in women with unexplained recurrent miscarriage and infertility. Reprod BioMed Online 2012; 25: 408-414.##Telfer JF, Lyall F, Norman JE, Cameron IT. Identification of nitric oxide synthase in human uterus. Hum Reprod 1995; 10: 19-23.##Shao R, Zhang SX, Weijdegård B, Zou S, Egecioglu E, Norström A, et al. Nitric oxide synthases and tubal ectopic pregnancies induced by Chlamydia infection: basic and clinical insights. Mol Hum Reprod 2000; 16: 907-915.##Ekerhovd E, Brannstrom M, Weijdegard B, Norstrom A. Localization of nitric oxide synthase and effects of nitric oxide donors on the human Fallopian tube. Mol Hum Reprod 1999; 5: 1040-1047.##Refaat B, Simpson H, Britton E, Biswas J, Wells M, Aplin JD, et al. Why does the fallopian tube fail in ectopic pregnancy? The role of activins, inducible nitric oxide synthase, and MUC1 in ectopic implantation. Fertil Steril 2012; 97: 1115-1123.##Al-Azemi M, Refaat B, Amer S, Ola B, Chapman N, Ledger W. The expression of inducible nitric oxide synthase in the human fallopiantube during the menstrual cycle and in ectopic pregnancy. Fertil Steril 2010; 94: 833-840.##Foghi Kh, Gaffari Novin M, Madjd Jabbari Z, Najafi T, Heidari M, Rostampour Yasoori A. Immuno-histochemical localization of endothelial nitric oxide synthase in testicular cells of men with non-obstructive azoospermia. Iran J Reprod Med 2011; 9: 277-280.##Lapointe J, Roy M, St-Pierre I, Kimmins S, Gauvreau D, MacLaren LA, et al. Hormonal and spatial regulation of nitricoxide synthases (NOS) (neuronal NOS, inducible NOS, and endothelial NOS) in the oviducts. Endocrinology 2006; 147: 5600- 5610.##Sikka SC. Relative impact of oxidative stress on male reproductive function. Curr Med Chem 2001; 8: 851-862.##Agarwal A, Gupta S, Sharma RK. Role of oxidative stress in female reproduction. Reprod Biol Endocrinol 2005; 3: 28.##Rosselli M, Dubey RK, Rosselli MA, Macas E, Fink D, Lauper U, et al. Identification of nitric oxide synthase in human and bovine oviduct. Mol Hum Reprod 1996; 2: 607-612.##Gawronska B, Bodek G, Ziecik AJ. Distribution of NADPH-diaphorase and nitric oxidesynthase (NOS) in different regions of porcine oviduct during the estrous cycle. J Histochem Cytochem 2000; 48: 867-875.##Afanas'ev IB. Signaling functions of free radicals superoxide & nitric oxide under physiological & pathological conditions. Mol Biotechnol 2007; 37: 2-4.##Manser RC, Leese HJ, Houghton FD. Effect of inhibiting nitric oxide production on mouse pre-implantation embryo development and metabolism Biol Reprod 2004; 71: 528-533.##Tranguch S, Steuerwald N, Huet-Hudson YM. Nitric oxide synthase production and nitric oxide regulation of preimplantation embryo development. Biol Reprod 2003; 68: 1538-1544.##Chen HW, Jiang WS, Tzeng CR. Nitric oxide as a regulator in pre-implantation embryo development and apoptosis. Fertil Steril 2001; 75: 1163-1171.##Panzica GC, Viglietti-Panzica C, Sica M, Gotti S, Martini M, Pinos H, et al. Effects of gonadal hormones on central nitric oxide producing systems. Neurosci 2006; 138: 987-995.##Moncada S, Higgs EA. Endogenous nitric oxide: physiology, pathology and clinical relevance. Eur J Clin Invest 1991; 21: 361-374.##Moncada S, Palmer RM, Higgs EA. Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev 1991; 43: 109-142.##Perez Martinez S, Viggiano M, Franchi AM, Herrero MB, Ortiz ME, Gimeno MF, et al. Effect of nitric oxide synthase inhibitors on ovum transport and oviductal smooth muscle activity in the rat oviduct. J Reprod Fertil 2000; 118: 111-117.## ##

Rabbit antiserum to mouse embryonic stem cells delays compaction of mouse preimplantation embryos آنتی سرم خرگوش تراکم پیش از لانه گزینی سلول های بنیادی جنینی جنین موش را به تأخیر می اندازد  2 1 مقدمه: سلول­های بنیادی جنینی موش (ES) از توده سلولی داخلی بلاستوسیست (ICM) پیش از لانه­گزینی استخراج می­شود. بنابراین پیشنهاد می­شود که سلول­های ES و ICM باید مولکول­های سطح سلولی مشابه داشته و آنتی­سرم سلول­های ES می­تواند تکوین ICM را مهار کند. هدف: هدف از انجام این مطالعه بررسی اثر آنتی سرم خرگوش در سلول­های ES بر روی تکوین جنین موش پیش از لانه­گزینی و تولید کایمرا بود. مواد و روش­ها: جنین­های 4 سلولی موش در محیط آزمایشگاهی با دمایoC 37/5 مرطوب و 5% CO2 به مدت 36-12 ساعت بالغ شد.جنین­ها در محیط کشت KSOM با یا بدون آنتی­سرم برای 36-12 ساعت کشت داده شدند. نسبت تکوین آزمایشگاهی از بلاستوسیست، تقسیم سلولی، پتانسیل اتصال، فعالیت آلکالن فسفاتاز، تکوین پس از کاشت و تولید کایمرا مورد بررسی و با گروه شاهد مقایسه گردید. 0/05>p معنی­دار در نظر گرفته شد. نتایج: آنتی­سرم خرگوش در سلول­های ES موش باعث تأخیر تراکم جنین و decompaction در مرحله 8 سلولی شد. تکوین جنین­های 4 سلولی در حضور آنتی­سرم برای 36 ساعت باعث کاهش و یا عدم وجود ICM شد. این جنین­ها همچنان فعالیت مثبت فسفاتاز، تقسیم سلولی نرمال، اتصال رویان، شکل­گیری (ICM)، لانه­گزینی و تکوین پس از لانه­گزینی را نشان داد. علاوه بر این decompaction ناشی از آنتی­سرم تولید و انتقال موش germline کایمریک را افزایش نداد. نتیجه­گیری: نتایج نشان داد که آنتی­سرم در سلول­های ES باعث تأخیر تراکم جنین شده وبر روی لانه­گزینی و تکوین جنین بعد از لانه گزینی و تولید کایمرا اثری نداشت. 2 Background: Mouse embryonic stem (ES) cells are derived from the inner cell mass (ICM) of the preimplantation blastocysts. So it is suggested that ES and ICM cells should have similar cellular surface molecules and antiserum to ES cells can inhibit ICM development. Objective: The objective of this study was to evaluate the effect of rabbit antiserum to ES cells on mouse preimplantation embryo development and chimera production. Materials and Methods: Mouse 4-cell embryos were matured in vitro at 37.5oC, in humidified 5% CO2 atmosphere for 12-36 h. The embryos were cultured in KSOM medium with or without antiserum for 12-36 h. The ratios of in vitro embryo development of the blastocysts, cell division, attachment potential, alkaline phosphatase activity, post-implantation development, and chimera production were assessed and compared with the control group. P<0.05 was considered as significant. Results: The rabbit antiserum to mouse ES cells showed delay in embryo compaction and induced decompaction at 8-cell stage. The development of 4-cell embryos in the presence of the antiserum for 36h did not lead to a reduced or absent ICM. These embryos still displayed positive alkaline phosphatase activity, normal cell division, embryo attachment, outgrowth formation, implantation and post-implantation development. In addition, decompaction induced by antiserum did not increase production and germline transmission of chimeric mice. Conclusion: The results showed that antiserum to ES cells delayed embryo compaction and did not affect post-implantation development and chimera production. 29 36 2017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/29 1396/11/9 Yingli Cong Yingli Cong College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, Gansu 730020, China Lifang Cui Lifang Cui College of Animal Science and Technology, Agricultural University of Hebei, Baoding, Hebei 071001, China Zhenhong Zhang Zhenhong Zhang College of Animal Science and Technology, Agricultural University of Hebei, Baoding, Hebei 071001, China Jianzhong Xi Jianzhong Xi College of Animal Science and Technology, Agricultural University of Hebei, Baoding, Hebei 071001, China Mianjuan Wang Mianjuan Wang School Hospital of Agricultural University of Hebei, Baoding, Hebei 071001, China Wangmianjuan@aliyun.com Mouse Embryonic stem cells Immune sera Preimplantation development Chimera. موش سلول های بنیادی جنینی آنتی سرم خرگوش تراکم کایمرا. Dietrich JE, Hiiragi T. Stochastic patterning in the mouse preimplantation embryo. Development 2007; 134: 4219-4231.##Dietrich JE, Hiiragi T. Stochastic processes during mouse blastocyst patterning. Cells Tissues Organs 2008; 188: 46-51.##Eggan K, Akutsu H, Loring J, Jackson-Grusby L, Klemm M, Rideout 3rd WM, et al. Hybrid vigor, fetal overgrowth, and viability of mice derived by nuclear cloning and tetraploid embryo complementation. Proc Natl Acad Sci USA 2001; 98: 6209-6214.##Johnson MH, Chakraborty J, Handyside AH, Willison K, Stern P. The effect of prolonged decompaction on the development of the preimplantation mouse embryo. Embryol Exp Morph 1979; 54: 241-261.##Johnson MH, Maro B, Takeichi M. The role of cell adhesion in the synchronization and orientation of polarization in 8-cell mouse blastomeres. J Embryol Exp Morphol 1986; 93: 239-255.##Johnson MH, McConnell JM. Lineage allocation and cell polarity during mouse embryogenesis. Semin Cell Dev Biol 2004; 15: 583-597.##Li CB, Hu LL, Wang ZD, Zhong SQ, Lei L. Regulation of compaction initiation in mouse embryo. Yi Chuan 2009; 31: 1177-1184.##Lu Y, Su Z, Li Y, Luo J, Tan Z, Ji H, et al. Generation and characterization of rabbit monoclonal antibodies against the native cell surface antigens of embryonic stem cells. J Genet Genomics 2010; 37: 483-492.##Nagy A, Gertsenstein M, Vintersten K, Behringer R. Manipulating the Mouse Embryo: A Laboratory Manual. 3rd Ed. New York, Cold Spring Harbor Laboratory Press; 2003.##Nagy A, Gocza E, Diaz EM, Prideaux V, Ivçnyi E, Markkula M, et al. Embryonic stem cells alone are able to support fetal development in the mouse. Development 1990; 110: 815-821.##Nagy A, Rossant J, Nagy R, Abramow-Newerly W, Roder JC. Derivation of completely cell culture- derived mice from early-passage embryonic stem cells. Proc Natl Acad Sci USA 1993; 90: 8424-8428.##Rossant J, Tam PP. Blastocyst lineage formation, early embryonic asymmetries and axis patterning in the mouse. Development 2009; 136: 701-713.##Shirayoshi Y, Okada TS, Takeichi M. The calcium-dependent cell-cell adhesion system regulates inner cell mass formation and cell surface polarization in early mouse development. Cell 1983; 35: 631-638.##Tan Z, Zhang J, Su Z, Gu B, Jiang X, Luo J, et al. Production of rabbit monoclonal antibodies against mouse embryonic stem cells and identification of pluripotency-associated surface antigens. J Immunol Methods 2011; 365: 149-157.## ##

Derivation of ES-like cell from neonatal mouse testis cells in autologous sertoli cells co-culture system جداسازی، تکثیرو غنی سازی سلول های بنیادی اسپرماتوگونی موش نوزاد در روش هم کشتی با سلول های سرتولی با منبع یکسان 2 1 مقدمه: سلول­های بنیادی اسپرماتوگونی (SSCs) یک جمعیت خودنوزا از سلول­های بنیادی جنس مذکر هستند. SSC ها همانند سلول­های بنیادی جنینی دارای پتانسیل تمایزی هستند. این سلول­های بنیادی شبه­جنینی می­توانند منبع بالقوه­ای برای سلول­های پرتوان جهت درمان بر پایه سلول بنیادی باشند. هدف: ارائه یک سیستم هم کشتی ساده و مقرون به صرفه برای تولید سلول­های بنیادی شبه جنینی از بیضه موش نوزاد. مواد و روش­ها: سلول­های جدا شده از بیضه در محیط DMEM/F12 کشت داده شدند. ماهیت سلول­های جداسازی شده و سلول­های بنیادی شبه جنینی به دست آمده با روش ایمنوسیتوشیمی و از طریق ارزیابی وجود پروتئین­های PLZF، Vimentin، Oct4 و Nanog تأیید شد و بیان ژن­های اختصاصی سلول ژرم و پرتوانی با استفاده از تکنیک qPCR، به ترتیب در کلونی­های بنیادی شبه جنینی وSSCها مورد ارزیابی قرار گرفت. نتایج: نتایج حاصل از qPCR نشان داد که بیان ژن­های پرتوانی در سلول­های بنیادی شبه جنینی افزایش و بیان ژن­های اختصاصی سلول ژرم کاهش معنی­دار پیدا می­کنند به­علاوه شاخص­های پرتوانی درسلول­های بنیادی شبه جنینی مثبت بودند. یافته­های این مطالعه نشان داد که با این روش تولید سلول­های بنیادی شبه جنینی از SSC ها، ساده تر از روش­های شناخته شده است. نتیجه­گیری: ما یک راه ساده و عملی را برای برای به دست آوردن سلول­های بنیادی شبه جنینی از SSC ها در محیط کشت معرفی کرده ایم. در واقع یک سیستم کشت کارآمد می­تواند یک روش با ارزش برای مطالعه سیستم­های خود تجدید در SSC ها و تولید سلول­های شبه بنیادی باشد.   2 Background: Spermatogonial stem cell (SSC) is a self-renewing population of male adult stem cell. SSCs have a differentiation potential which are similar to embryonic stem cells. These Embryonic stem like (ES-like) cells can be a potential source for pluripotent cells for stem cell-based therapy. Objective: This study presents an economical and simple co-culture system for pluripotent stem cells generation from neonatal mouse testis Materials and Methods: Isolated testicular cells were cultured in DMEM/F12. Characteristics of the isolated cells and obtained ES-like cell were immune-cytochemically confirmed by examining the presence of PLZF, vimentin, Oct4 and Nanog protein. Expression of the pluripotency and germ-cell specific genes was analyzed by qPCR in derived ES-like colony and SSCs respectively. Results: The experiment results indicated that our method of obtaining pluripotent ES-like cells from spermatogonial cells (SCs) is simpler than the described methods. ES-like cells were immunopositive for pluripotency markers. ES-like cell qPCR results indicated significant increase in pluripotency genes expression and significant decrease in germ cell-specific genes expression. Conclusion: The results indicated that ES-like cell with pluripotency characteristic were generated from freshly isolated spermatogonial cells. The pluripotent stem cells provide a cellular reservoir usable for regenerative medicine instead of embryonic stem cells.  37 46 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/292018/01/29 1396/11/9 محمد حسین اسدی Mohammad Hossein Asadi Department of Anatomical Sciences, Faculty of Medical Sciences, Baqiyatallah University of Medical Sciences, Tehran, Iran ایران ستاره جوانمردی Setareh Javanmardi Department of Anatomical Sciences, Faculty of Medical Sciences, Baqiyatallah University of Medical Sciences, Tehran, Iran ایران setareh_javanmardy@yahoo.com منصوره موحدین Mansoureh Movahedin Department of Anatomical Sciences, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran ایران Spermatogonial stem cells Embryonic stem like cell Pluripotent stem cells Co-culture. سلول های بنیادی اسپرماتوگونی سلول بنیادی شبه جنینی پرتوانی هم کشتی. Caires K, Broady J, McLean D. Maintaining the male germline: regulation of spermatogonial stem cells. J Endocrinol 2010; 205: 133-145.##Meistrich ML, Van Beek M. Spermatogonial stem cells: Cell and molecular biology of the testis. New York, Oxford University Press; 1993.##de Rooij DG, Russell LD. All you wanted to know about spermatogonia but were afraid to ask. J Androl 2000; 21: 776.##Ning L, Goossens E, Geens M, Saen DV, Tournaye H. Spermatogonial stem cells as a source for regenerative medicine. Mid East Fertil Soc J 2012; 17: 1-7.##Kanatsu-Shinohara M, Lee J, Inoue K, Ogonuki N, Miki H, Toyokuni S, et al. Pluripotency of a single spermatogonial stem cell in mice. Biol Reprod 2008; 78: 681-687.##Golestaneh N, Kokkinaki M, Pant D, Jiang J, DeStefano D, Fernandez-Bueno C, et al. Pluripotent stem cells derived from adult human testes. Stem Cells Dev 2009; 18: 1115-1125.##Ning L, Goossens E, Geens M, Van Saen D, Van Riet I, He D, et al. Mouse spermatogonial stem cells obtain morphologic and functional characteristics of hematopoietic cells in vivo. Hum Reprod 2010; 25: 3101-3109.##Simon L, Hess RA, Cooke PS. Spermatogonial stem cells, in vivo transdifferentiation and human regenerative medicine. Expert Opin Biol Ther 2010; 10: 519-530.##Kanatsu-Shinohara M, Inoue K, Lee J, Yoshimoto M, Ogonuki N, Miki H, et al. Generation of pluripotent stem cells from neonatal mouse testis. Cell 2004; 119: 1001-1012.##Simon L, Ekman GC, Kostereva N, Zhang Z, Hess RA, Hofmann MC, et al. Direct transdifferentiation of stem/progenitor spermatogonia into reproductive and nonreproductive tissues of all germ layers. Stem Cells 2009; 27: 1666-1675.##Guan K, Nayernia K, Maier LS, Wagner S, Dressel R, Lee JH, et al. Pluripotency of spermatogonial stem cells from adult mouse testis. Nature 2006; 440: 1199-1203.##Glaser T, Opitz T, Kischlat T, Konang R, Sasse P, Fleischmann BK, et al. Adult germ line stem cells as a source of functional neurons and glia. Stem Cells 2008; 26: 2434-2443.##Izadyar F, Pau F, Marh J, Slepko N, Wang T, Gonzalez R, et al. Generation of multipotent cell lines from a distinct population of male germ line stem cells. Reproduction 2008; 135: 771-784.##Seandel M, James D, Shmelkov SV, Falciatori I, Kim J, Chavala S, et al. Generation of functional multipotent adult stem cells from GPR125+ germline progenitors. Nature 2007; 449: 346-350.##Im JE, Song SH, Kim JY, Kim KL, Baek SH, Lee DR, et al. Vascular differentiation of multipotent spermatogonial stem cells derived from neonatal mouse testis. Exp Mol Med 2012; 44: 303-309.##Kanatsu-Shinohara M, Ogonuki N, Inoue K, Miki H, Ogura A, Toyokuni S, et al. Long-term proliferation in culture and germline transmission of mouse male germline stem cells. Biol Reprod 2003; 69: 612-616.##Kubota H, Avarbock MR, Brinster RL. Growth factors essential for self-renewal and expansion of mouse spermatogonial stem cells. Proc Natl Acad Sci USA 2004; 101: 16489-16494.##Meng X, Lindahl M, Hyvönen ME, Parvinen M, de Rooij DG, Hess MW, et al. Regulation of cell fate decision of undifferentiated spermatogonia by GDNF. Science 2000; 287: 1489-1493.##Naughton CK, Jain S, Strickland AM, Gupta A, Milbrandt J. Glial cell-line derived neurotrophic factor-mediated RET signaling regulates spermatogonial stem cell fate. Biol Reprod 2006; 74: 314-321.##Hess R, França LR, Skinner M, Griswold M. Structure of the Sertoli cell. In: Skinner MK, Grinswold MD (Eds). Sertoli Cell Biology. California, Elsevier Academic Press; 2005: 19-40.##Huleihel M, Lunenfeld E. Regulation of spermatogenesis by paracrine/autocrine testicular factors. Asian J Androl 2004; 6: 259-268.##Parks J, Lee D, Huang S, Kaproth M. Prospects for spermatogenesis in vitro. Theriogenology 2003; 59: 73-86.##Roser JF. Regulation of testicular function in the stallion: an intricate network of endocrine, paracrine and autocrine systems. Anim Reprod Sci 2008; 107: 179-196.##Merhi RA, Guillaud L, Delouis C, Cotinot C. Establishment and characterization of immortalized ovine Sertoli cell lines. In Vitro Cell Dev Biol Anim 2001; 37: 581-588.##https://doi.org/10.1290/1071-2690(2001)037<0581:EACOIO>2.0.CO;2##Pognan F, Masson MT, Lagelle F, Charuel C. Establishment of a rat Sertoli cell line that displays the morphological and some of the functional characteristics of the native cell. Cell Biol Toxicol 1997; 13: 453-463.##Zhang D, He D, Wei G, Song XF, Li XL, In T. Long-term Coxculture of Spermatogonial Stem Cells on Sertoli Cells Feeder Layer in vitro. Sichuan Da Xue Xue Bao Yi Xue Ban 2008; 39: 6.##Liu S, Tang Z, Xiong T, Tang W. Isolation and characterization of human spermatogonial stem cells. Reprod Biol Endocrinol 2011; 9: 141.##Mohamadi S, Movahedin M, Koruji S, Jafarabadi MA, Makoolati Z. Comparison of colony formation in adult mouse spermatogonial stem cells developed in Sertoli and STO coculture systems. Andrologia 2011; 44: 431-437.##Simon L, Hofmann MC, Cooke PS. Spermatogonial Stem Cells: An Alternate Source of Pluripotent Stem Cells for Regenerative Medicine. Expert Opin Biol Ther 2010; 10: 519-530.##Nagano M, Brinster CJ, Orwig KE, Ryu BY, Avarbock MR, Brinster RL. Transgenic mice produced by retroviral transduction of male germ-line stem cells. Proc Natl Acad Sci USA 2001; 98: 13090-13095.##Ryu BY, Kubota H, Avarbock MR, Brinster RL. Conservation of spermatogonial stem cell self-renewal signaling between mouse and rat. Proc Natl Acad Sci USA 2005; 102: 14302-14307.##Nagano MC, Yeh JR. The Cluster-Forming Activity Assay: A Short-Term In Vitro Method to Analyze the Activity of Mouse Spermatogonial Stem Cells. In: Orwing KE, Hermann BP (Eds). Male Germline Stem Cells: Developmental and Regenerative Potential. New York, Humana Press; 2011: 125-134.##Kossack N, Meneses J, Shefi S, Nguyen HN, Chavez S, Nicholas C, et al. Isolation and Characterization of Pluripotent Human Spermatogonial Stem Cell‐Derived Cells. Stem Cells 2009; 27: 138-149.##Hamra FK, Chapman KM, Nguyen DM, Williams-Stephens AA, Hammer RE, Garbers DL. Self renewal, expansion, and transfection of rat spermatogonial stem cells in culture. Proc Natl Acad Sci USA 2005; 102: 17430-17435.##Tadokoro Y, Yomogida K, Ohta H, Tohda A, Nishimune Y. Homeostatic regulation of germinal stem cell proliferation by the GDNF/FSH pathway. Mech Dev 2002; 113: 29-39.##Kurita K, Sakai N. Functionally distinctive testicular cell lines of zebrafish to support male germ cell development. Mol Reprod Dev 2004; 67: 430-438.## ##

Prevalence and risk factors associated with preterm birth in Ardabil, Iran شیوع زایمان زودرس و عوامل خطر مرتبط با آن در شهرستان اردبیل، ایران 2 1 مقدمه: زایمان زودرس از مهمترین عوامل مرگ و میر و ناتوانی بلند مدت نوزادان است. هدف: این مطالعه با هدف تعیین شیوع زایمان زودرس و عوامل خطر مرتبط با آن در شهرستان اردبیل، ایران انجام شد. مواد و روش­ها: در این مطالعه مورد شاهدی که در فاصله آذر ماه 1389 تا مرداد ماه 1390 انجام شد. کلیه نوزادان متولد شده در بیمارستان­های شهرستان اردبیل وارد مطالعه شدند. در مجموع 6705 کودک در مدت مطالعه در سه بیمارستان مجهز به اتاق زایمان شهرستان اردبیل متولد شدند که از میان آن­ها 346 نوزاد سن زیر 37 هفته داشتند و به عنوان گروه مورد انتخاب شدند، 589 نفر نوزاد ترم به عنوان گروه شاهد در نظر گرفته شد. اطلاعات مورد نیاز، از طریق بررسی اطلاعات ثبت شده در پرونده بهداشتی زنان باردار جمع آوری شد. بررسی ارتباط متغیرهای مستقل با تولد زودرس با استفاده از آزمون رگرسیون تک متغییره و چند متغیره انجام شد. نتایج: شیوع زایمان زودرس 1/5% بود و سابقه زایمان زودرس (0/000=p و3/9-40/4:OR=12/7, CI)، فشار خون بالا (0/002=p و OR=7/3,CI:2/1-25/4)، الگوهیدرآمنیوس (0/002=p وOR=3/9, CI:1/6-9/5 )، همسرآزاری (0/024=p وOR=3/7, CI:1/1-11/8 )، پره اکلامسی (0/014=p و OR=3/6, CI:1/3-10/3 )، پارگی زودرس کیسه آب (0/000=p و OR=3/1,CI:1/9-4/9)، خونریزی یا لکه بینی در بارداری (0/037=p وOR=2/0,CI:1/0-3/8 )، استفراغ شدید بارداری (0/015=p وOR=2/0,CI:1/1-3/8 )، ابتلا به عفونت ادراری در هفته 32-26 بارداری (0/044=p وOR=1/8,CI:1/0-3/2 )، طبقه اجتماعی متوسط و پائین (0/021=p و OR=1/6,CI:1/0-2/3)، هاپیوتانسیون دیاستولیک (فشارخون دیاستولیک کمتر از 60 میلی متر جیوه) (0/049=p و OR=1/5,CI:0/99-2/3) به ترتیب مهمترین عوامل خطر زایمان زودرس شناخته شد. نتیجه­گیری: این مطالعه زنان ایرانی در معرض خطر زایمان زودرس را شناسایی کرد. توجه ویژه به این گروه از زنان و انجام مراقبت بهداشتی با هدف پیشگیری از وقوع زایمان زودرس می تواند نقش موثری در کاهش شیوع زایمان زودرس و عوارض نوزادی مرتبط با آن در جامعه مورد مطالعه ما داشته باشد.   2 Background: Preterm birth is a leading cause of perinatal mortality and long-term morbidity as well as the long-term health consequences and cognitive outcomes. Objective: Present study was conducted to determine prevalence and risk factors associated with preterm birth in Ardabil, Iran. Materials and Methods: A case control study was conducted between Nov 2010 and July 2011 in all three maternal hospitals in Ardabil. All the live newborns during the study period were investigated. Of 6705 live births during the study period 346 births occurred in <37 weeks were taken as a case and 589 term neonates were taken as a control group. Data were obtained through review of prenatal and hospital delivery records. Univariate and multivariate logistic regression analysis were applied to obtain magnitude of association between independent variables and preterm birth. Results: The prevalence rate of preterm birth was 5.1%. History of previous preterm birth (OR=12.7,CI: 3.9-40.4, p<0.001), hypertension (OR=7.3, CI:2.1-25.4, p=0.002), Oligohydramnios (OR=3.9, CI:1.6-9.5, p=0.002), spouse abuse (OR=3.7, CI:1.1-11.8, p=0.024), preeclampsia (OR=3.6, CI:1.3-10.3, p=0.014), premature rupture of membrane (OR=3.1, CI:1.9-4.9, p=0.000), bleeding or spotting during pregnancy (OR=2.0, CI:1.0-3.8, p=0.037), Hyperemesis Gravid arum (OR=2.0, CI: 1.1-3.8, p=0.015), urinary tract infection in 26-30 weeks , (OR=1. 8 CI:1.0-3.2, p=0.04), diastolic blood pressure ≤60 mmg (OR=1.5, CI: 0.99-2.2, p=0.049) were determined as significant risk factors for preterm birth. Conclusion: Early detection and treatment of diseases or disorders among pregnant women especially hypertension, Oligohydramnios, preeclampsia, bleeding or spotting, Hyperemesis Gravid arum, urinary tract infection, and low diastolic blood pressure as well as the improving health care quality delivered to pregnant women may reduce preterm prevalence rate.  47 56 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/292018/01/292018/01/29 1396/11/9 راحله عالی جهان Rahele Alijahan Province Heath Center, Ardabil University of Medical Science, Ardabil, Iran. ایران صادق حضرتی Sadegh Hazrati School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran ایران S.hazrati@Arums.ac.ir مهرداد میرزارحیمی Mehrdad Mirzarahimi Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran ایران فرهاد پورفرضی Farhad Pourfarzi Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran ایران پیمانه احمدی هادی Peymaneh Ahmadi Hadi District Health Center, Ardabil University of Medical Science, Ardabil, Iran ایران Prevalence Preterm birth Risk factors زایمان زودرس عوامل خطر مادری عوامل خطر جنینی. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ 2010; 88: 31-38.##Sonkusare S, Rai L, Naik P. preterm birth: mode of delivery and neonatal outcome. Med J Malaysia 2009; 64: 303-306.##Modarres SZ, Amooian B, Movahed SB, Mohamadi M. periodontal health in mothers of preterm and term infants. Taiwan J Obstet Gynecol 2007; 46: 157-161.##Goldenberg RL, Culhane JF, Jams JD, Rometo R. epidemiology and cause of preterm birth. Lancet 2008; 371: 75-83.##Renzo GCD, Giardina I, Rosati A, Clerici G, Torricelli M, Petraglia F, maternal risk factors for preterm birth: a country-based population analysis. Eur J Obstet Gynecol 2011; 3: 1-5.##Mirzaie F, Mohammad-Alizadeh S. Contributing Factors of preterm delivery in parturient in a university hospital in Iran. Saudi Med J 2007; 28: 400-404.##Mahmoodi Z, Hoseini F, Sadeghi Avval Shahr H, Ghodsi Z, Amini L. The Association between Maternal Factors and Preterm Birth and Premature Rapture of Membranes. J Fam Reprod Health 2010; 4: 135-139.##Nabavizadeh SH, Malekzadeh M, Mousavizadeh A, Ghaffarian Shirazi HR, Ghaffari P, Karshenas N, et al. Retrospective study of Factors related to preterm labor in Yasuj, Iran. Int J Gen Med 2012: 2012: 1013-1017.##Raisanen S, Gissler M, Saari J, Kramer M, Heinonen S, Contribution of risk factors to Extremely, Very and Moderately Preterm Birts-Register-Based Analysis of 1,390.742 Singleton Births. PLOS One 2013; 8: 1-7.##Passini R, Tedesco R, Marba S, Cecatti J, Guinsburg R, Martinez F, et al. Brazilian multicenter study on prevalence of preterm birth and associated factors. BMC Pregnancy Childbirth 2010; 10: 1-7.##Murphy D. Epidemiology and environmental factors in preterm labor. Clin Obstet Gynecol 2007; 21: 773-789.##Chin LO C, Hsu JJ, Hsieh CC, Hsieh TT, Hung T. Risk factors for spontaneous preterm delivery before 34 weeks of gestation among Taiwanese women. Taiwan J Obstet Gynecol 2007; 46: 389-393.##Dolatian M, Mirabzadeh A, Forouzan AS, Sajjadi H, Alavi Majd H, Moafi F. Preterm Delivery and Psycho-Social Determinants of Health Based on World Health Organization Model in Iran: A Narrative Review. Glob J Health Sci 2013; 5: 52-64.##Cunningham FG, Leveno KJ, Hauth JC, edithors. Williams obstetrics. 23th Ed. New York, McGraw Hill; 2010.##Jafari F, Eftekhar H, Pourreza A, Mousavi J. Sosio-economic and medical determination of low birth weight in iran: 20 years after establishment of a primary health care network. Public Health 2010; 124: 153-157.##Vallandares E, Ellsberg M, Pena R, Hogberg U, Persson LA. Physical partner abuse during pregnancy: a risk factor for low birth weight in Nicaragua. Obstet Gynecol 2002; 100: 700-704.##Vahdaninia M, Sadat S, Montazeri A. Correlation of low birth weight in term pregnancies: are Prospective study from Iran. BMC pregnancy childbirth 2008; 8: 1-5.##Warland J, MCcutcheon, Baghurst P. Maternal blood pressure in pregnancy and still birth: a case control study of third trimester still birth. AM J Perinatal 2008; 25: 311-317##Tan PC, Jacob R, Quek KF, Omar SZ. Pregnancy outcome in hyperemesis Gravidarum and the effect of laboratory clinical indicators of hyperemesis severity. J Obstet Gynacol 2007; 33: 457-464.##Nguyen N, Savitz DA, Thorp JM. Risk factors for preterm birth in Vietnam. Int J Gynaecol Obstet 2004; 86: 70-78.##Khalajinia Z, Jandaghi G. Maternal risk factors for preterm birth: a country-based population analysis. Eur J Obstet Gynecol Reprod Biol 2012; 159: 342-346.##Bernabe JV, Soriano T, Albaladejo R, Juarranz M, Calle ME, Martinez D, et al. Risk factors for low birth weight: a review. Eur J Obstet Gynecol Reprod Biol 2004; 116: 3-15.##Coker AL, Sanderson M, Dong B, Partner violence during pregnancy and pregnancy outcomes. Paediatr Perinat Epidemiol 2004; 18: 260-290.##Rodrigues T, Rocha L, Barros H. Physical abuse during pregnancy and preterm delivery. AM J Obstet Gynecol 2008; 198: 1-6.##Yost NP, Bloom SL, McIntire DD, Leveno KJ. A Prospective observational study of domestic violence during pregnancy. Obstet Gynecol 2005; 106: 61-65.##Schoeman J, Grové DV, Odendaal HJ. Are domestic violence and the excessive use of alcohol risk factors for preterm birth. J Trop Pediatr 2005; 51: 49-50.##Grimstad H, Schei B, Backe B, Jacobsen G. Physical abuse and low birth weight: a case-control study. J Obstet Gynecol 1997; 104: 1281-1287.##Cokkinides VE, Coker AL, Sanderson M, Addy C, Bethea L. Physical violence during pregnancy: maternal complications and birth outcomes. Obstet Gynecol 1999; 93: 661-666.##Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis Gravidarum. Obstet Gynecol 2006; 107: 285-292.##Hallak M, Tsalamandris K, Dombrowski MP, Isada NB, Pryde PG, Evans MI. Hyperemesis Gravidarum: effect on fetal outcome. J Repord Med 1996; 41: 871-874.##Roseboom TJ, Ravelli AC, van der Post JA, Painter RC. Maternal characteristics largely explain poor pregnancy outcome after hyperemesis Gravidarum. Eur J Obstet Gynecol Reprod Biol 2011; 156: 56-59.##Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. Consequences of hyperemesis Gravidarum for offspring: a systematic review and meta-analysis. BJOG 2011; 118: 1302-1313.##De Sutter P, Bontinck J, Schutysers V, Van der Elst J, Gerris J, Dhont M. First trimester bleeding and pregnancy outcome in singletons after assisted reproduction. Hum Reprod 2006; 21: 1907-1911.##Strobino B, Pantel-Silverman J. Gestational vaginal bleeding and pregnancy outcome. Am J Epidemiol 1989; 129: 806-815.##Schieve L, Handler A, Hershow R, Persky V, Davis F. Urinary tract infection during pregnancy: its association with maternal morbidity and perinatal outcome. Am J Public Health 1994; 84: 806-815.##Zeitlin JA, Ancel PY, Saurel-Cubizolles MJ, Papiernik E. Are risk factors the same for small for gestational age versus other preterm birth. Am J Obstet Gynecol 2001; 185: 208-215.##Krymko H, Bashiri A, Smolin A, Sheiner E, Bar-David J, Shoham-Vardi I, et al. Risk factors for recurrent preterm delivery. Eur J Obstet Gynecol Reprod Biol 2004; 113: 160-163.##Wildschut HI, Nas T, Golding J. Are socio-demographic factors predictive of preterm birth? A reappraisal of the 1958 British perinatal mortality survey. Br J Obstet Gynaecol 1997; 104: 57-63.##Chen A, Basso O. Does low maternal blood pressure during pregnancy increase the risk of perinatal death? Epidemiology 2007; 18: 619-622.##Zhang J, Klebanoff MA. Low blood pressure during pregnancy and poor perinatal outcomes: an obstetric paradox. Am J Epidemiol 2001; 153: 642-646.##Klosa W, Wilhelm C, Schillinger H, Hillemanns HG.Therapy of hypotension in pregnancy using norfenorfrine hydrochloride with special reference to the effects on fetal circulation-initial observation. Z Geburtshilfe Perinatol 1992; 196: 21-25.## ##

The impact of alpha lipoic acid on developmental competence of mouse vitrified pre-antral follicles in comparison to those isolated from vitrified ovaries تأثیر آلفا لیپوئیک اسید بر توانائی تکوین فولیکول های پره آنترال منجمد شده موش در مقایسه با گروهی که از تخمدان منجمد جدا شده اند. 2 1 مقدمه: انجماد بافت تخمدان و فولیکول پره آنترال، چشم اندازی امیدبخش برای حفظ باروری زنان است. هدف: هدف از مطالعه حاضر، ارزیابی توانائی تکوین فولیکول پره آنترال منجمد شده موش در مقایسه با فولیکول های پره آنترال جدا شده از تخمدان منجمد شده در حضور آلفا لیپوئیک اسید بود. مواد و روش­ها: فولیکول­های پره آنترال منجمد-ذوب شده و فولیکول­های پره آنترال مشتق شده از تخمدان تازه و تخمدان منجمد- ذوب شده به طور جداگانه­ای با و یا بدون آلفا لیپوئیک اسید کشت داده شدند و سپس با اضافه کردن hCG تخمک­گذاری القاء شد. رشد فولیکول، بلوغ تخمک و تکوین جنین ارزیابی شد. نتایج: اندازه و میزان تکوین فولیکول، بلوغ تخمک و تکوین جنین در گروه­های در مان شده با آلفا لیپوئیک اسید در مقایسه با گروه­های مرتبط درمان نشده به طور معنی­داری بیشتر بود. پارامتر های مذبور به طور معنی­داری در فولیکول­های منجمد-ذوب شده در مقایسه با فولیکول­های جدا شده از تخمدان منجمد-ذوب شده بیشتر بود. نتیجه­گیری: این یافته­ها با توجه به افزایش نرخ پارامترهای تکوین از عملکرد برتر فولیکول­های پره آنترال منجمدشده در مقایسه با زمانی که از تخمدان منجمد شده جدا شوند، حمایت می­کند. بعلاوه آلفا لیپوئیک اسید، بلوغ آزمایشگاهی فولیکول­های پره آنترال را در نمونه­های انجمادی و غیر انجمادی بهبود بخشید. 2 Background: Cryopreservation of ovarian tissues and pre-antral follicles is a promising prospect for preservation of women fertility. Objective: The aim of this study was to evaluate the in vitro developmental competence of mouse vitrified pre-antral follicles in comparison to isolated pre-antral follicles derived from vitrified ovaries in the presence of alpha lipoic acid (ALA). Materials and Methods: Pre-antral follicles derived from fresh, vitrified-warmed ovarian tissues and vitrified–warmed pre-antral follicles were cultured individually with or without ALA, followed by adding hCG to induce ovulation. The follicle growth, oocyte maturation, and embryo development were assessed. Results: The diameter and development of follicles, oocyte maturation and embryo development rates were significantly higher in ALA supplemented groups compared to the respective ALA-free conditions groups. Aforementioned parameters were significantly higher in vitrified-warmed follicles in comparison to follicles derived from vitrified-warmed ovaries. Conclusion: These findings support a superior performance of pre-antral follicles when vitrified rather than when isolated from vitrified ovaries with regard to increasing the rates of developmental parameters. Moreover, ALA improves the in vitro maturation of pre-antral follicles in vitrified and non-vitrified samples.  57 64 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/292018/01/292018/01/292018/01/30 1396/11/10 سحر حاتمی Sahar Hatami School of Biology, Damghan University, Damghan, Iran ایران Zavareh.S@gmail.com سعید زواره Saeed Zavareh School of Biology, Damghan University, Damghan, Iran ایران مژده صالح نیا Mojdeh Salehnia Department of Anatomy, Tarbiat Modares University, Tehran, Iran ایران تقی لشکربلوکی Taghi Lashkarbolouki School of Biology, Damghan University, Damghan, Iran ایران محمدتقی قربانیان Mohammad Taghi Ghorbanian School of Biology, Damghan University, Damghan, Iran ایران اسحاق کریمی Isaac Karimi Laboratory of Molecular and Cellular Biology, Department of Basic Veterinary Sciences, School of Veterinary Medicine, Razi University, Kermanshah, Iran ایران Vitrification Ovary Preantral follicles Alpha Lipoic Acid انجماد تخمدان فولیکول پره آنترال آلفا لیپوئیک اسید. Amorim CA, Goncalves PB, Figueiredo JR. Cryopreservation of oocytes from pre-antral follicles. Hum Reprod Update 2003; 9: 119-129.##Posillico S, Kader A, Falcone T, Agarwal A. Ovarian Tissue Vitrification: Modalities, Challenges and Potentials. Curr Women's Health Rev 2010; 6: 352-366.##Huang L, Mo Y, Wang W, Li Y, Zhang Q, Yang D. Cryopreservation of human ovarian tissue by solid-surface vitrification. Eur J Obstet Gynecol Reprod Biol 2008; 139: 193-198.##Isachenko V, Lapidus I, Isachenko E, Krivokharchenko A, Kreienberg R, Woriedh M, et al. Human ovarian tissue vitrification versus conventional freezing: morphological, endocrinological, and molecular biological evaluation. Reproduction 2009; 138: 319-327.##Liebermann J, Nawroth F, Isachenko V, Isachenko E, Rahimi G, Tucker MJ. Potential importance of vitrification in reproductive medicine. Biol Reprod 2002; 67: 1671-1680.##Zavareh S, Salehnia M, Saberivand A. Comparison of Different Vitrification Procedures on Developmental Competence of Mouse Germinal Vesicle Oocytes in the Presence or Absence of Cumulus Cells. Int J Fertil Steril 2009; 3: 111-118.##Desai N, AbdelHafez F, Ali MY, Sayed EH, Abu-Alhassan AM, Falcone T, et al. Mouse ovarian follicle cryopreservation using vitrification or slow programmed cooling: assessment of in vitro development, maturation, ultra-structure and meiotic spindle organization. J Obstet Gynaecol Res 2011; 37: 1-12.##Amorim CA, Van Langendonckt A, David A, Dolmans MM, Donnez J. Survival of human pre-antral follicles after cryopreservation of ovarian tissue, follicular isolation and in vitro culture in a calcium alginate matrix. Hum Reprod 2009; 24: 92-99.##Abedelahi A, Salehnia M, Allameh AA, Davoodi D. Sodium selenite improves the in vitro follicular development by reducing the reactive oxygen species level and increasing the total antioxidant capacity and glutathione peroxide activity. Hum Reprod 2010; 25: 977-985.##Oktem O, Oktay K. The role of extracellular matrix and activin-A in in vitro growth and survival of murine preantral follicles. Reprod Sci 2007; 14: 358-366.##Liu HC, He Z, Rosenwaks Z. Mouse ovarian tissue cryopreservation has only a minor effect on in vitro follicular maturation and gene expression. J Assist Reprod Genet 2003; 20: 421-431.##Wang AW, Zhang H, Ikemoto I, Anderson DJ, Loughlin KR. Reactive oxygen species generation by seminal cells during cryopreservation. Urology 1997; 49: 921-925.##Rahimi G, Isachenko E, Sauer H, Isachenko V, Wartenberg M, Hescheler J, et al. Effect of different vitrification protocols for human ovarian tissue on reactive oxygen species and apoptosis. Reprod Fertil Dev 2003; 15: 343-349.##Yeoman RR, Williams LE, Abee CR. Low oxygen inhibits but complex high-glucose mediumfacilitates in vitro maturation of squirrel monkey oocyte-granulos a cell complexes. J Assist Reprod Genet 1999; 16: 102-107.##Agarwal A, Said TM, Bedaiwy MA, Banerjee J, Alvarez JG. Oxidative stress in an assisted reproductive techniques setting. Fertil Steril 2006; 86: 503-512.##Agarwal A, Gupta S, Sharma R. Oxidative stress and its implications in female infertility- a clinician's perspective. Reprod Biomed Online 2005; 11: 641-650.##Sajal Gupta, Lucky Sekhon, Kim Y, Ashok Agarwal. The Role of Oxidative Stress and Antioxidants in Assisted Reproduction. Women's Health Rev 2010; 6: 227-238.##Bedaiwy MA, Falcone T, Mohamed MS, Aleem AA, Sharma RK, Worley SE, et al. Differential growth of human embryos in vitro: role of reactive oxygen species. Fertil Steril 2004; 82: 593-600.##Packer L, Witt EH, Tritschler HJ. Alpha-lipoic acid as a biological antioxidant. Free Radic Biol Med 1995; 19: 227-250.##Packer L, Tritschler HJ, Wessel K. Neuroprotection by the metabolic antioxidant alpha-lipoic acid. Free Radic Biol Med 1997; 22: 359-378.##Talebi A, Zavareh S, Kashani MH, Lashgarbluki T, Karimi I. The effect of alpha lipoic acid on the developmental competence of mouse isolated preantral follicles. J Assist Reprod Genet 2012; 29: 175-183.##Zhang H, Wu B, Liu H, Qiu M, Liu J, Zhang Y, et al. Improving development of cloned goat embryos by supplementing alpha-lipoic acid to oocyte in vitro maturation medium. Theriogenology 2013; 80: 228-233.##Kuwayama M, Vajta G, Kato O, Leibo SP. Highly efficient vitrification method for cryopreservation of human oocytes. Reprod Biomed Online 2005; 11: 300-308.##Chen SU, Chien CL, Wu MY, Chen TH, Lai SM, Lin CW, et al. Novel direct cover vitrification for cryopreservation of ovarian tissue increase follicle viability and pregnancy capability in mice. Hum Reprod Update 2006; 21: 2794-2800.##Taghavi A. Comparison of apoptosis, viability and maturation in mouse preantral follicle after slow freezing and cryotop vitrification. Tehran, Tarbiat Modares; 2009.##Bagchi A, Woods EJ, Critser JK. Cryopreservation and vitrification: recent advances in fertility preservation technologies. Exp Rev Med Dev 2008; 5: 359-370.##Courbiere B, Caquant L, Mazoyer C, Franck M, Lornage J, Salle B. Difficulties improving ovarian functional recovery by microvascular transplantation and whole ovary vitrification. Fertil Steril 2009; 91: 2697-2706.##Chen SU, Chien CL, Wu MY, Chen TH, Lai SM, Lin CW, et al. Novel direct cover vitrification for cryopreservation of ovarian tissues increases follicle viability and pregnancy capability in mice. Hum Reprod 2006; 21: 2794-2800.##Salehnia M, Abbasian Moghadam E, Rezazadeh Velojerdi M. Ultrastructure of follicles after vitrification of mouse ovarian tissue. Fertil Steril 2002; 78: 644-645.##Nagai S, Mabuchi T, Hirata S, Shoda T, Kasai T, Yokota S, et al. Correlation of abnormal mitochondrial distribution in mouse oocytes with reduced developmental competence. Tohoku J Exp Med 2006; 210: 137-144.##Combelles CM, Gupta S, Agarwal A. Could oxidative stress influence the in-vitro maturation of oocytes? Reprod Biomed Online 2009; 18: 864-880.##Cakatay U. Pro-oxidant actions of alpha-lipoic acid and dihydrolipoic acid. Med Hypotheses 2006; 66: 110-117.##Byun CH, Koh JM, Kim DK, Park SI, Lee KU, Kim GS. Alpha-lipoic acid inhibits TNF-alpha-induced apoptosis in human bone marrow stromal cells. J Bone Miner Res 2005; 20: 1125-1135.##Fujita H, Shiosaka M, Ogino T, Okimura Y, Utsumi T, Sato EF, et al. Alpha-lipoic acid suppresses 6-hydroxydopamine-induced ROS generation and apoptosis through the stimulation of glutathione synthesis but not by the expression of heme oxygenase-1. Brain Res 2008; 1206: 1-12.##Johnson MT, Freeman EA, Gardner DK, Hunt PA. Oxidative metabolism of pyruvate is required for meiotic maturation of murine oocytes in vivo. Biol Reprod 2007; 77: 2-8.##Voloboueva LA, Liu J, Suh JH, Ames BN, Miller SS. (R)-alpha-lipoic acid protects retinal pigment epithelial cells from oxidative damage. Invest Ophthalmol Vis Sci 2005; 46: 4302-4310.##Akpinar D, Yargicoglu P, Derin N, Aliciguzel Y, Agar A. The effect of lipoic acid on antioxidant status and lipid peroxidation in rats exposed to chronic restraint stress. Physiol Res 2008; 57: 893-901.##Luberda Z. The role of glutathione in mammalian gametes. Reprod Biol 2005; 5: 5-17.##Paszkowski T, Traub AI, Robinson SY, McMaster D. Selenium dependent glutathione peroxidase activity in human follicular fluid. Int J Clin Chem 1995; 236: 173-180.## ##

Effect of aqueous and hydro-alcoholic extracts of lettuce (Lactuca sativa) seed on testosterone level and spermatogenesis in NMRI mice بررسی اثر عصاره های آبی و آبی-الکلی تخم کاهو بر تستوسترون و اسپرماتوژنز در موش نژاد NMRI  2 1 مقدمه: یکی از کاربرد­های مهم تخم کاهو در طب سنتی، کاهش مایع منی، اسپرم و تمایلات جنسی بوده است. هدف: مقصود از مطالعه حاضر بررسی اثر عصاره­های آبی و آبی­الکلی تخم کاهو بر تستوسترون و اسپرماتوژنز می­باشد. مواد و روش­ها: در مطالعه تجربی حاضر تعداد 24 موش نژاد NMRI در محدوده وزنی 20-25 گرم خریداری شد. حیوانات به صورت تصادفی به 4 گروه: کنترل، عصاره آبی-الکلی mg/kg200 و عصاره­های آبی (mg/kg100،50) تقسیم شدند. عصاره­ها به مدت 10 روز متوالی، روزی 1 بار به صورت داخل صفاقی تزریق شدند. 2 هفته بعد از آخرین تزریق موش­ها بوسیله اتر بیهوش شده و پس از لاپاراتومی خونگیری از قلب جهت بررسی تستوسترون بوسیله کیت اندازه­گیری الایزا انجام پذیرفت. سپس بیضه و دم اپیدیدیم تمام حیوانات به منظور اندازه­گیری مورفولوژی بیضه و تعداد و میزان حیات اسپرم خارج گردید. نتایج: وزن بیضه در گروه عصاره­های آبی-الکلی و آبی (mg/kg 100(0/001=pو آبی (mg/kg 50 (0/008=pافزایش یافت. میزان حیات اسپرم گروه عصاره­های آبی-الکلی (0/001=p) و آبی (mg/kg 50 (0/026=p و 100 (0/045=p) کاهش پیدا نمود. همچنین نتایج کاهش معنی­داری را در تعداد اسپرم در گروه عصاره آبی-الکلی (0/035=p) و آبی (mg/kg 50 (0/006=p در مقایسه با گروه کنترل نشان داد. همچنین افزایش معنی داری در میزان سطح سرمی تستوسترون در گروه عصاره آبی mg/kg50 در مقایسه با گروه­های کنترل (0/002=p)، عصاره­های آبی­الکلی (0/001=p) و  آبی (mg/kg 100 (0/003=p بوجود آمد. نتیجه­گیری: نتایج این مطالعه نشان داد که عصاره­های آبی-الکلی و آبی mg/kg 50 تخم کاهو اثرات ضد اسپرماتوژنز دارند، همچنین عصاره mg/kg 50 سطح سرمی تستوسترون را در موش­ها افزایش داد. بنابراین می­توان چنین پیشنهاد نمود که تخم کاهو می­تواند به عنوان یک عامل بالقوه ضدبارداری باشد.   2 Background: One of the considerable uses of lettuce (Lactuca sativa) seed in traditional medicine has been to reduce semen, sperm and sexuality. Objective: The aim of this study was to investigate the effects of aqueous and hydro-alcoholic extracts of lettuce seed on testosterone level and spermatogenesis. Materials and Methods: In this experimental study 24 adult male NMRI mice weighing 20-25gr were purchased. Animals were randomly divided into 4 groups: controls, hydro-alcoholic (200 mg/kg) and aqueous extracts (50, 100mg/kg). The extracts were injected intraperitoneally once a day for 10 consecutive days. 2 weeks after the last injection, the mice were anaesthetized by ether and after laparatomy blood was collected from the heart to determine testosterone by ELISA assay kit. Then testis and cauda epididymis of all animals were removed for analyzing testis morphology and sperm count and viability. Results: Testis weight in hydro-alcoholic and aqueous extracts 100 mg/kg (p=0.001) and aqueous extract 50 mg/kg (p=0.008) groups was increased .Sperm viability in hydro-alcoholic (p=0.001) and aqueous extracts 50 (p=0.026), 100 mg/kg (p=0.045) groups was decreased, Also the results showed a significant decrease in sperm count in hydro-alcoholic (p=0.035) and aqueous extracts 50 mg/kg (p=0.006) groups in comparison with control group. Also there was a significant increase in serum level of testosterone in aqueous extract 50 mg/kg group in comparison with control (p=0.002) hydro-alcoholic (p=0.001) and aqueous extracts 100 mg/kg (p=0.003) groups. Conclusion: Present results demonstrated that hydro-alcoholic and aqueous 50 mg/kg extracts of lettuce seed have antispermatogenic effects, also aqueous extract 50 mg/kg increased serum level of testosterone in mice. Therefore we can suggest that lettuce seed could be a potential contraceptive agent. 65 72 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/292018/01/292018/01/292018/01/302018/01/30 1396/11/10 اکرم آهنگرپور Akram Ahangarpour Health Research Institute, Diabetes Research Center, Department of Physiology, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran ایران علی اکبر عروجن Ali Akbar Oroojan Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ایران aliakbar_oroojan@yahoo.com مریم رادان Maryam Radan Department of Physiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ایران Lactuca sativa seed Sperm Testosterone Testis تخم کاهو اسپرم تستوسترون بیضه. Shukla S, Dixit S. In silico identification of drug targets for antifertility from natural products by differential reaction content analysis of metabolic pathways. Malaysia J Med Sci 2011; 18: 13-17.##Shibeshi W, Makonnen E, Zerihun L, Debella A. Effect of Achyranthes aspera L. on fetal abortion, uterine and pituitary weights, serum lipids and hormones. Afr Health Sci 2006; 6: 108-112.##Ettebong EO, Nwafor PA, Ekpo M, Ajibesin KK. Contraceptive, estrogenic and anti-estrogenic potentials of methanolic root extract of Carpolobia lutea in rodents. Pak J Pharm Sci 2011; 24: 445-449.##Maurya R, Srivastava S, Kulshreshta DK, Gupta CM. Traditional remedies for fertility regulation. Curr Med Chem 2004; 11: 1431-1450.##Satyavati GV. Indian plants and plant products with antifertility effect. Anc Sci Life 1984; 3: 193-202.##Mou B. Mutations in lettuce improvement. Int J Plant Genom 2011; 2011: 1-7.##Garg M, Garg C, Mukherjee PK, Suresh B. Antioxidant potential of Lactuca sativa. Anc Sci Life 2004; 24: 6-10.##Sayyah M, Hadidi N, Kamalinejad M. Analgesic and anti-inflammatory activity of Lactuca sativa seed extract in rats. J Ethnopharmacol 2004; 92: 325-329.##Xu F, Zou GA, Liu YQ, Aisa HA. chemical constituents from seeds of Lactuca sativa. Chem Nat Compounds 2012; 48: 574-576.##Molina PE. Endocrine physiology. 3rd Ed. The Mc Graw-Hill companies, USA; 2010: 195-197.##Vasudeva N, Vats M. Anti-spermatogenic activity of ethanol extract of Dalbergia sissoo Roxb. stem bark. J Acupunct Meridian Stud 2011; 4: 116-122.##Owumi SE, Odunola OA, Aliyu M. Co-administration of sodium arsenite and ethanol: Protection by aqueousextract of Aframomum longiscapum seeds. Pharmacognosy Res 2012; 4: 154-160.##Gupta RS, Chaudhary R, Yadav RK, Verma SK, Dobhal MP. Effect of Saponins of Albizia lebbeck (L.) Benth bark on the reproductive system of male albino rats. J Ethnopharmacol 2005; 96: 31-36.##Rajasekaran M, Nair AG, Hellstrom WJ, Sikka SC. Spermicidal activity of an antifungal saponin obtained from the tropical herb Mollugo pentaphylla. Contraception 1993; 47: 401-412.##Avicenna. [The canon 2]. 6th Ed. Iran, Soroush Press; 2005: 341. (In Persian)##Ahangarpour A, Oroojan AA. The effects of Cassia italica leaves aqueous extract on non-pregnant uterus contraction in rats. Iran J Reprod Med 2010; 4: 179-184.##Ahangarpour A, Oroojan AA. [Effect of Crust and Seed's Aqueous Extract and Hydro-Alcoholic Extracts of Crust, Seed and Pulp of Citrullus Colocynthis on Lipid's Factors and Hepatic Enzyme in Fructose-Fed Male Rats]. J Babol Univ Med Sci 2012; 14: 53-60. (In Persian)##Atal S, Agrawal RP, Vyas S, Phadnis P, Rai N. Evaluation of the effect of piperine per se on blood glucose level in alloxan-induced diabetic mice. Acta Pol Pharm 2012; 69: 965-969.##Khan S, Dwivedi C, Parmar V, Srinivasan KK, Shirwaikar A. Methanol extract of dried exudate of Commiphora mukul prevents bone resorption in ovariectomized rats. Pharm Biol 2012; 50: 1330-1336.##Fox JG, Barthold SW, Davisson MT, Newcomer CE, Quimby FW, Smith AL. The Mouse in Biomedical Research. 2nd Ed. American College of Laboratory Animal Medicine Series, USA; 2007: 97.##Izawa H, Kohara M, Aizawa K, Suganuma H, Inakuma T, Watanabe G, et al. Alleviative effects of quercetin and onion on male reproductive toxicity induced by dieselexhaust particles. Biosci Biotech Biochem 2008; 72: 1235-1241.##Courtade M, Lagorce C, Bujan L, Caratero C, Mieusset R. Clinical characteristics and light and transmission electron microscopic sperm defects of infertile men with persistent unexplained asthenozoospermia. Fertil Steril 1998; 70: 297-304.##WHO laboratory manual for the examination and processing of human semen. 5th Ed. Switzerland, WHO Press; 2010.##Raji Y, Akinsomisoye OS, Salman TM. Antispermatogenic activity of Morinda lucida extract in male rats. Asian J Androl 2005; 7: 405-410.##Bormann CL, Smith GD, Padmanabhan V, Lee TM. Prenatal testosterone and dihydrotestosterone exposure disrupts ovine testicular development. Reproduction 2011; 142: 167-173.##Katzung G, Masters B, Trevor J. Basic & Clinical Pharmacology. 12th Ed. USA, Mc Graw Hill; 2012.##Yu WJ, Lee BJ, Nam SY, Ahn B, Hong JT, Do JC, et al. Reproductive disorders in pubertal and adult phase of the male rats exposed to vinclozolin during puberty. J Vet Med Sci 2004; 66: 847-853.##Li J, Wang Z, Shi D, Chen Y. Adult exposure to sasanguasaponin induces spermatogenic cell apoptosis in vivo through increased oxidative stress in male mice. Toxicol Ind Health 2010; 26: 691-700.##Ahmadi R, Abdollahy E. [The effects of salvia officinalis extract on serum level of creatine kinase and alkaline phosphatase in male rats]. Razi J Med Sci 2012; 19: 20-25. (In Persian)##Pourmehdi Rad G, Kesmati M. [Comparison of Anxiolytic Effect of Matricaria Recutita in Male and Female Mice in the Presence and Absence of Gonads]. Zahedan J Res Med Sci 2009; 11: 19-29. (In Persian)## ##

Effectiveness of aspirin compare with heparin plus aspirin in recurrent pregnancy loss treatment: A Quasi experimental study بررسی تأثیر آسپیرین در مقایسه با آسپیرین همراه با هپارین در درمان سقط مکرر: یک مطالعه نیمه تجربی  2 1 مقدمه: مصرف آسپیرین، هپارین و یا هر دو در زنان مبتلا به سقط مکرر با علت ناشناخته می­تواند مفید باشد چراکه این مشکل می­تواند به دلیل ترومبوز در عروق دسی دوآ بوجود آید. هدف: هدف از مطالعه حاضر بررسی همراهی ترومبوفیلیا با سقط مکرر با علت ناشناخته و بررسی تأثیر داروهای ضد انعقادی در درمان آن بود. مواد و روش­ها: در این مطالعه quasi experiment (مشابه کارآزمایی بالینی) 520 زن مبتلا به سقط مکرر را بررسی نموده ایم. 250 زن با سقط مکرر با علت ناشناخته در دو گروه مورد بررسی قرار گرفتند. یکی از آنها آسپیرین (mg 80 روزانه) از 2 ماه قبل از حاملگی و در طی حاملگی تا هفته  36 دریافت نمود. گروه دوم آسپیرین به روش قبل همراه با هپارین (5000 واحد دو بار در روز) زیرجلدی از شروع حاملگی دریافت نمودند که این درمان تا 4 هفته بعد از زایمان نیز ادامه داشت. نوع درمان برای هر بیمار بر اساس سن و تعداد سقط انتخاب شد. نتایج: تعداد تولد زنده در دو گروه تفاوت معنی دار نداشت. زنانیکه آسپیرین همراه با هپارین دریافت نموده بودند 74/5 درصد نوزاد زنده به دنیا آورده بودند. در حالیکه زنانیکه تنها آسپیرین مصرف نموده بودند 79/8 درصد نوزادان زنده به دنیا آورده بودند. نتیجه­گیری: تعداد تولد زنده در دو گروه مصرف کننده دارو بدون تفاوت معنی دار بود. استفاده از آسپیرین و یا آسپیرین به اضافه هپارین در درمان سقط مکرر با علت ناشناخته باید مورد به مورد انتخاب شود. 2 Background: Using aspirin, heparin, or both in women with unexplained recurrent miscarriage could be useful, because this problem might be initiated by thrombosis in decidual vessels. Objective: To investigate the association between thrombophilia and unexplained recurrent miscarriage and to evaluate the efficacy of anticoagulant treatment. Materials and Methods: In this quasi experimental, we enrolled 520 women, who had a history of recurrent miscarriage. Two hundred fifty two women with unexplained recurrent miscarriage were assigned to receive aspirin (80 mg daily) for two month before pregnancy and after confirmation of a viable pregnancy until 36 weeks of gestation or receive aspirin, as the same, plus heparin (5000 unit twice a day) subcutaneously after confirmation of viable pregnancy until 4 weeks after delivery. Type of medication was chosen for each woman according to number of abortion and age. Results: Live-birth rates did not different significantly among the two study groups. The proportions of women who gave birth to a live normal infant were 74.5% in the group receiving aspirin plus heparin (combination-therapy group) and 79.8% in the aspirin group. Conclusion: Live-birth rates did not different significantly among the two study groups. So, using aspirin or aspirin plus heparin did not change pregnancy rate in these patients. Using aspirin is easier than injecting heparin which should be chosen case by case. 73 76 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/292018/01/292018/01/292018/01/302018/01/302018/01/30 1396/11/10 نسرین قاسمی Nasrin Ghasemi Department of Medical Genetics, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران n479g@yahoo.co.uk طاهره جهانی نژاد Tahereh Jahaninejad Department of Medical Genetics, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران مهدیه سادات مصطفوی Mahdia-sadat Mostafavi Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران عباس افلاطونیان Abbas Aflatoonian Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران Thrombophilia Recurrent miscarriage Anticoagulant Live birth Aspirin Heparin. ترومبوفیلیا سقط مکرر ضد انعقادی تولد زنده آسپیرین هپارین. Toth B, Jeschke U, Rogenhofer N, Scholz C, Würfel W, Thaler CJ, et al. Recurrent miscarriage: current concepts in diagnosis and treatment. J Reprod Immunol 2010; 85: 25-32.##Carrington B, Sacks G, Regan L. Recurrent miscarriage: pathophysiology and outcome. Curr Opin Obstet Gynecol 2005; 17: 591-597.##Monien S, Kadecki O, Baumgarten S, Salama A, Dörner T, Kiesewetter H. Use of heparin in women with early and late miscarriages with and without thrombophilia. Clin Appl Thromb Hemost 2009; 15: 636-644.##Rai R, Regan L. Recurrent miscarriage. Lancet 2006; 368: 601-611.##Redline RW. Thrombophilia and placental pathology. Clin Obstet Gynecol 2006; 49: 885-894.##Heit JA. Thrombophilia: Common Questions on Laboratory Assessment and Management. Hematology Am Soc Hematol Educ Program 2007; 1: 127-135.##Behjati R, Modarressi MH, Jeddi-Tehrani M, Dokoohaki P, Ghasemi J, Zarnani AH, et al. Thrombophilic mutations in Iranian patients with infertility and recurrent spontaneous abortion. Ann Hematol 2006; 85: 268-271.##Silver RM, Warren JE. Preconception counseling for women with thrombophilia. Clin Obstet Gynecol 2006; 49: 906-919.##Mukhopadhyay R, Saraswathy KN, Ghosh PK. MTHFR C677T and factor V Leiden in recurrent pregnancy loss: a study among an endogamous group in North India. Genet Test Mol Biomarkers 2009; 13: 861-865.##Brenner B. Haemostatic changes in pregnancy. Thromb Res 2004; 114: 409-414.##Rai R, Backos M, Baxter N, Chilcott I, Regan L. Recurrent miscarriage-an aspirin a day? Hum Reprod 2000; 15: 2220-2223.##Dolitzky M, Inbal A, Segal Y, Weiss A, Brenner B, Carp H. A randomized study of thromboprophylaxis in women with unexplained consecutive recurrent miscarriages. Fertil Steril 2006; 86: 362-366.##Mitić G, Novakov Mikić A, Povazan L, Mitreski A, Kopitović V, Vejnović T. Thromboprophylaxis implementation during pregnancy in women with recurrent foetal losses and thrombophilia. Med Pregl 2011; 64: 471-475.##Kaandorp SP, Goddijn M, van der Post JA, Hutten BA, Verhoeve HR, Hamulyák K, et al. Aspiri plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med 2010; 362: 1586-1596.##Infante-Rivard C, David M, Gauthier R, Rivard GE. Lupus anticoagulants, anticardiolipin antibodies, and fetal loss a case-control study. N Engl J Med 1999; 325: 1063-1066.##Lockshin MD. Pregnancy loss in the antiphospholipid syndrome. Thromb Haemost 1999; 82: 641-648.##Greer IA. Antithrombotic treatment for recurrent pregnancy loss? J Thromb Haemost 2011; 9 (Suppl.): 302-305.##Kaandorp S, Di Nisio M, Goddijn M, Middeldorp S. Aspirin or anticoagulants for treating recurrent pregnancy loss in women without antiphospholipid syndrome. Cochrane Database Syst Rev 2009; (1): CD004734.##Laude I, Rongières-Bertrand C, Boyer-Neumann C, Wolf M, Mairovitz V, Hugel B, et al. Circulating procoagulant microparticles in women with unexplained pregnancy loss: a new insight. Thromb Haemost 2001; 85: 18-21.##Di Nisio M, Peters L, Middeldorp S. Aspirin or anticoagulants for treating. Cochrane Database Syst Rev 2005: CD004734.##Tzafettas J, Mamopoulos A, Anapliotis A, Loufopoulos A, Psarra A, Klearchou N, et al. Thromboprophylaxis throughout pregnancy in women with previous history of recurrent miscarriages of unknown aetiology. Clin Exp Obstet Gynecol 2002; 29: 267-270.##Deligiannidis A, Parapanissiou E, Mavridis P, Tabakoudis G, Mavroudi A, Papastavrou T, et al. Thrombophilia and antithrombotic therapy in women with recurrent spontaneous abortions. J Reprod Med 2007; 52: 499-502.##McNamee K, Dawood F, Farquharson RG. Thrombophilia and early pregnancy loss. Best Pract Res Clin Obstet Gynaecol 2012; 26: 91-102.##Visser J, Ulander VM, Helmerhorst FM, Lampinen K, Morin-Papunen L, Bloemenkamp KW, et al. Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: a randomised multicentre trial. Thromb Haemost 2011; 105: 295-301.## ##

Propofol or Thiopental sodium in patients undergoing reproductive assisted technologies: Differences in hemodynamic recovery and outcome of oocyte retrieval: A randomized clinical trial مقایسه تأثیر تیوپنتال سدیم و پروپوفول بر روی همودینامیک، ریکاوری بیهوشی و نتیجه باروری تخمک 2 1 مقدمه: تیوپنتال سدیم و پروپوفول دو داروی شایع مورد استفاده در القاء بیهوشی جهت انجام ART می­باشند. اما تأثیر این داروها بر روی ART هنوز مورد بررسی قرار نگرفته است. هدف: در این مطالعه ما به بررسی عوارض جانبی، اثرات همودینامیک و تأثیر برروی نتیجه حاملگی پرداختیم. مواد و روش­ها: در طول این بررسی بالینی دو سوکور، 90 بیمار که کاندید انجام بیهوشی برای ART بودند مورد بررسی قرار گرفتند. بیماران با کمک جدول اعداد تصادفی به دو گروه یکسان 45 نفره تقسیم شدند که یک گروه تیوپنتال سدیم و گروه دیگر پروپوفول به عنوان داروی القاء بیهوشی دریافت نمودند. گروه اول، تیوپنتال سدیم mg/kg 5 و گروه دوم پروپوفول mg/kg2/5 داروی هوشبر وریدی دریافت نمودند. وضعیت همودینامیک اولیه بیماران ثبت گردید. در طول عمل جراحی هر پنج دقیقه تغییرات همودینامیک اندازه­گیری و ثبت گردید. میزان موفقیت لانه­گزینی و موفقیت حاملگی نیز در گروه­ها بررسی و ثبت شد. نتایج: بررسی نتایج حاصله، تفاوت معنی­داری بین دو گروه در زمان پاسخ به تحریک صوتی (0/001>p)، زمان طبیعی شدن سرعت و کیفیت تنفس (0/001>p)، تهوع (0/001>p) و استفراغ (0/001>p) وجود داشت. تمام این معیارها در گروه پروپوفول بهتر از گروه دیگر بود. تفاوت معنی­داری در سایر معیارهای مورد بررسی در دوگروه مشاهده نشد. نتیجه­گیری: براساس یافته­های مطالعه حاضر، استفاده از پروپوفول در اعمال جراحی ART بر استفاده از تیوپنتال ارجح می­باشد. همچنین نتایج حاصل از این مطالعه و مطالعات منتشر شده قبلی، عوارض کمتری را برای پروپوفول بیان نموده­اند. 2 Background: Thiopental sodium and Propofol are two widely-used drugs in the induction of anesthesia in assisted reproductive technology (ART). However, the side effects and outcome of recovery from anesthesia of these drugs on ART have not been identified yet. Objective: This study aimed at investigating the side effects and hemodynamic effects of using thiopental sodium and propofal as well as effects of these drugs on pregnancy outcome in ART cycles. Materials and Methods: In this double blinded) randomized controlled trial, 90 woman candidate for ART were randomly divided into two groups. 47 patients received Propofol (2.5 mg/kg) and 43 patients received thiopental (5mg/kg) for anesthesia induction. The entry hemodynamic parameters of the patients were documented. During the anesthesia process, hemodynamic parameters were checked at five-minute intervals. Results: The results of the study showed a statistically significant difference between two groups in terms of their response to verbal stimulation (p<0.001), the normalization time of the rate and quality of breathing (p<0.001), nausea (p<0.001), and vomiting (p<0.001). Also, in comparison with the other group, all these parameters were better in Propofol group. There was found no significant difference between two groups in terms of other variables. Conclusion: Based on the findings of the study, Propofol has fewer known side effects. Vomiting and nausea as two known side effect of anesthesia are significantly lower in patients receiving Propofol than patients who received thiopental. 77 82 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2018/01/282018/01/282018/01/282018/01/292018/01/292018/01/292018/01/292018/01/302018/01/302018/01/302018/01/30 1396/11/10 محمدحسین جراح زاده Mohammad Hossein Jarahzadeh Department of Anesthesiology and Critical Care, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران رضا جویا Reza Jouya Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران فاطمه السادات موسوی Fatemeh Sadat Mousavi Department of Anesthesiology and Critical Care, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران محمد دهقان طزرجانی Mohammad Dehghan-tezerjani Department of Anesthesiology and Critical Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران dr.dehghan@gmail.com شکوفه بهداد Shekoofa Behdad Department of Anesthesiology and Critical Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران حمیدرضا سلطانی Hamid Reza Soltani Scientific Society of Medicine, Yazd Branch, Islamic Azad University, Yazd, Iran ایران Thiopental sodium Propofol Assisted reproductive technology تیوپنتال سدیم پروپوفول ناباروری تکنیک های کمک باروری. Martin R, Tsen LC, Tzeng G, Hornstein MD, Datta S. Anesthesia for in vitro fertilization: the addition of fentanyl to 1.5% lidocaine. Anesth Analg 1999; 88: 523-526.##Soussis I, Boyd O, Paraschos T, Duffy S, Bower S, Troughton P, et al. Follicular fluid levels of midazolam, fentanyl, and alfentanil during transvaginal oocyte retrieval. Fertil Steril 1995; 64:1003-1007.##Endler GC, Stout M, Magyar DM, Hayes MF, Moghissi KS, Sacco AG. Follicular fluid concentrations of thiopental and thiamylal during laparoscopy for oocyte retrieval. Fertil Steril 1987; 48: 828-833.##Pierce ET, Smalky M, Alper MM, Hunter JA, Amrhein RL, Pierce EC Jr. Comparison of pregnancy rates following gamete intrafallopian transfer (GIFT) under general anesthesia with thiopental sodium or Propofol. J Clin Anesth 1992; 4: 394-398.##Tramer MR, Moore RA, McQuay HJ. Propofol and bradycardia: causation, frequency and severity. Br J Anaesth 1997; 78: 642-651.##Tatone C, Francione A, Marinangeli F, Lottan M, Varrassi G, Colonna R. An evaluation of Propofol toxicity on mouse oocytes and preimplantation embryos. Hum Reprod 1998; 13: 430-435.##Palot M, Harika G, Lamiable D, Pigeon F, Visseaux H, Leon A, et al. [General anesthesia with Propofol alone for ovocyte removal. Concentration of follicular liquid and rate of cleavage]. Ann Fr Anesth Reanim 1989;##8 (Suppl.): R68. (In French) 8. Imoedemhe DA, Sigue AB, Abdul Ghani I, Abozeid MA, Abdel Halim MS. An evaluation of the effect of the anesthetic agent profofol (Diprivan) on the outcome of human in vitro fertilization. J Assist Reprod Genet 1992; 9: 488-491.##Stetson PL, Domino EF, Sneyd JR. Determination of plasma Propofol levels using gas chromatography-mass spectrometry with selected-ion monitoring. J Chromatogr 1993; 620: 260-267.##Hill G, Freeman M, Bastias M, Rogers B, Herbert 3rd C, Osteen K and Wentz A. The influence of oocyte maturity and embryo quality on pregnancy rate in a program for in vitro fertilization-embryo transfer. Fertility and sterility 1989; 52:801-806##Huang HW, Huang FJ, Kung FT, Tsai MY, Lin H, Chang SY, et al. Effects of induction anesthetic agents on outcome of assisted reproductive technology: a comparison of Propofol and thiopental sodium. Chang Gung Med J 2000; 23: 513-519.##Pierce ET, Smalky M, Alper MM, Hunter JA, Amrhein RL, Pierce EC, Jr. Comparison of pregnancy rates following gamete intrafallopian transfer (GIFT) under general anesthesia with thiopental sodium or Propofol. J Clin Anesth 1992; 4: 394-398.##Milanini MN, D'Onofrio P, Melani Novelli AM, Dabizzi S, Cozzi C, Evangelisti P, et al. Local anesthesia versus intravenous infusion of remifentanil for assisted reproductive technologies. A retrospective study. Minerva Ginecol 2008; 60: 203-207.##Ma YY, Shen Y, Zhang LS. [Comparison of midazolam and Propofol as conscious sedation in oocyte retrieval of IVE-ET]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2008; 37: 304-307. (In Chinese)##Beilin Y, Bodian CA, Mukherjee T, Andres LA, Vincent RD Jr, Hock DL, et al. The use of Propofol, nitrous oxide, or isoflurane does not affect the reproductive success rate following gamete intrafallopian transfer (GIFT): a multicenter pilot trial/survey. Anesthesiology 1999; 90: 36-41.##Rosenblatt MA, Bradford CN, Bodian CA, Grunfeld L. The effect of a Propofol-based sedation technique on cumulative embryo scores, clinical pregnancy rates, and implantation rates in patients undergoing embryo transfers with donor oocytes. J Clin Anesth 1997; 9: 614-617.##Erdogan MA, Begec Z, Aydogan MS, Ozgul U, Yucel A, Colak C, et al. Comparison of effects of Propofol and ketamine-Propofol mixture (ketofol) on laryngeal mask airway insertion conditions and hemodynamics in elderly patients: a randomized, prospective, double-blind trial. J Anesth 2013; 27: 12-17.##Tontisirin O, Rojanasakul A, Srisombut C, Wongkularb A, Chatasingh S. Propofol anesthesia for transvaginal ultrasound guided oocyte retrieval. J Med Assoc Thai 1996; 79: 618-623.##Ghatak T, Singh D, Kapoor R, Bogra J. Effects of addition of ketamine, fentanyl and saline with Propofol induction on hemodynamics and laryngeal mask airway insertion conditions in oral clonidine premedicated children. Saudi J Anaesth 2012; 6: 140-144.## ##