2015 13 12 0 808

Prevalence of preterm labor in Iran: A systematic review and meta-analysis شیوع زایمان زودرس در ایران: مرور ساختاریافته و متاآنالیز 2 1 هدف: هدف این مطالعه تعیین شیوع زایمان زودرس در ایران بر اساس یک مطالعه متاآنالیز می باشد تا بتواند به عنوان یک معیار نهایی راهنمای سیاستگذاران در این زمینه باشد. مقدمه: زایمان زودرس که به تولد نوزاد زنده کمتر از 37 هفته بارداری اطلاق می شود، یکی از عوامل مهم تعیین کننده ابتلا و میرایی حول زایمان در سراسر جهان می باشد. مواد و روشها: در این متاآنالیز بانک های اطلاعاتی Thomson database (Web of Knowledge)، PubMed، Science Direct، Scopus، Google Scholar، Scientific Information Database (SID)، Magiran و Medlib برای مقالات منتشر شده به زبان فارسی و انگلیسی، از سال 1374 تا 1393 مورد بازبینی قرار گرفت. از بین تعداد 1370 مطالعه انجام شده با در نظر گرفتن معیارهای ورود و خروج تعداد 14 مطالعه انتخاب شدند. تجزیه و تحلیل داده ها با نرم افزار Stata نسخه 11 انجام گرفت. از آزمون Q و شاخص I2 جهت بررسی عدم تجانس استفاده شد. نتایج: آزمون کوکران و شاخص I2 نشان دهنده عدم تجانس بین نمونه های مورد مطالعه بود (0/001>Q=2505/12, P و99/5% =I2)، بنابراین از مدل تصادفی جهت متاآنالیز استفاده شد. شیوع کلی زایمان زودرس در ایران بر مبنای این مدل 2/9 درصد با فاصله اطمینان 95% (10/7 – 7/6) برآورد گردید. نتیجه گیری: مطالعه حاضر نتایج مطالعات قبلی را خلاصه کرده و یک دید جامع در مورد زایمان زودرس در ایران ارائه داد. به منظور رسیدن به حد مطلوب تر و کاهش آن در سال های آتی، تشخیص عوامل تأثیر گذار با کمک مطالعات آینده نگر و اقدامات مداخله ای و پیشگیرانه ضروری به نظر می رسد. 2 Objective Background: Preterm labor, which defines as live-birth delivery before 37 weeks of gestation is a main determinant of neonatal morbidity and mortality around the world. : The aim of this study was to determine the prevalence of preterm labor in Iran by a meta-analysis study, to be as a final measure for policy makers in this field. Materials and Methods: In this meta-analysis, the databases of Thomson database (Web of Knowledge), PubMed/Medline, Science Direct, Scopus, Google Scholar, Iranmedex, Scientific Information Database (SID), Magiran, and Medlib were searched for articles in English and Persian language published between 1995 and 2014. Among the studies with regard to the inclusion and exclusion criteria, 14 studies (out of 1370 publications) were selected. Data were analyzed by using Stata software version 11. The heterogeneity of reported prevalence among studies was evaluated by the Chi-square based Q test and I2 statistics. Results: The results of Chi-square based on Q test and I2 statistics revealed severe heterogeneity (Q=2505.12, p-value < 0.001 and I2= 99.5%) and consequently, the random effect model was used for the meta-analysis. Based on the random effect model, the overall estimated prevalence of preterm in Iran was 9.2% (95% CI: 7.6 – 10.7). Conclusion: Present study summarized the results of previous studies and provided a comprehensive view about the preterm delivery in Iran. In order to achieve a more desirable level and its reduction in the coming years, identifying affecting factor and interventional and preventive actions seem necessary. 743 748 2017/10/1 1396/7/9 2017/10/4 1396/7/12 کتایون وکیلیان Katayon Vakilian Faculty of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran ایران مهدی رنجبران Mehdi Ranjbaran Department of Epidemiology, Faculty of Health, Arak University of Medical Sciences, Arak, Iran ایران ranjbaran@arakmu.ac.ir محبوبه خورسندی Mahboobeh Khorsandi Department of Health Education and Health Promotion, Faculty of Health, Arak University of Medical Sciences, Arak, Iran ایران ناصر شرفخانی Naser Sharafkhani Department of Health Education and Health Promotion, Faculty of Health, Arak University of Medical Sciences, Arak, Iran ایران محمود خدادوست Mahmoud Khodadost Gastroenterology and Liver Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran ایران Preterm labor Prevalence Meta-analysis Iran زایمان زودرس شیوع متاآنالیز ایران. Nguyen N, Savitz DA, Thorp JM. Risk factors for preterm birth in Vietnam. Int J Gynaecol Obstet 2004; 86: 70-78.##Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The lancet 2008; 371: 75-84.##Howson C, Kinney M, Lawn J. Born too soon: the global action report on preterm birth 2012 [cited November 2014]. Available from: http://www.who.int/maternal_child_adolescent/documents/born_too_soon/en/index.html.##Afrakhteh M, Ebrahimi S, Valaie N. Prevalence of preterm delivery and its related factors in females referring to Shohada Tajrish Hospital, 1995-99. Pejouhandeh 2002; 7: 341-344.##Preterm birth: World Health Organization; 2014 [cited November 2014]. Available from: http://www.who.int/mediacentre/factsheets/fs363/en/.##Moghadami N, Aminikhah B, Davari Tanha F. The effect of maternal body mass index on spontaneous versus induced preterm birth: a prospective study. Tehran univ Med J 2009; 67: 221-225.##Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379: 2162-2172.##Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Pract Res Clin Obstet Gynaecol 2007; 21: 773-789.##Lo CC, Hsu JJ, Hsieh CC, Hsieh TT, Hung TH. Risk factors for spontaneous preterm delivery before 34 weeks of gestation among Taiwanese women. Taiwan J Obstet Gynecol 2007; 46: 389-394.##Martius JA, Steck T, Oehler MK, Wulf K-H. Risk factors associated with preterm (< 37+ 0 weeks) and early preterm birth (< 32+ 0 weeks): univariate and multivariate analysis of 106 345 singleton births from the 1994 statewide perinatal survey of Bavaria. Euro J Obstet Gynecol Reprod Biol 1998; 80: 183-189.##Derakhshi B, Esmailnasab N, Ghaderi E, Hemmatpour S. Risk factor of preterm labor in the west of iran: a case-control study. Iran J Public Health 2014; 43: 499-506.##Nabavizadeh SH, Malekzadeh M, Mousavizadeh A, Shirazi HR, Ghaffari P, Karshenas N, et al. Retrospective study of factors related to preterm labor in Yasuj, Iran. Int J Gen Med 2012; 5: 1013-1017.##Khadem N, Rahmani ME, Sanaei A, Afiat M. Association between preterm and low-birth weight with periodontal disease: a case-control study. Iran J Reprod Med 2012; 10: 561-566.##Cohn LD, Becker BJ. How meta-analysis increases statistical power. Psychol Methods 2003; 8: 243-253.##Noble JH Jr. Meta-analysis: methods, strengths, weaknesses, and political uses. J Lab Clin Med 2006; 147: 7-20.##Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Preventive Medicine 2007; 45: 247-251.##Amini L, Mahmoudi Z, Hosseini F, Mahmoudi A. The relationship between the social structure and health and pregnancy outcomes: preterm labor and rupture of water bag. Journal of Sabzevar University of Medical Sciences 2013; 20: 109-116.##Pasdar Y, Heidari N, Safari Y, Faramani RS, Izadi N, Jamshidpour M, et al. Prevalence of Some Risk Factors in Pregnant Women. Iran J Obstet Gynecol Infertil 2012; 15: 14-23.##Rajaeefard A, Mohammadbeigi A, Mohammadi M, Joulaee H, Alipour H. Evaluation of risk factors in preterm delivery and impact of education in its prevention. Daneshvar Medicine 2010; 17: 11-18.##Lotf Alizadeh M, Mohammadzadeh A, Kamandi S, Bagheri S. Prevalence and risk factors of preterm labor in Imam Reza Hospital 2003-2004. Iranian Journal Of Obstetrics, Gyneocology And Infertility 2005;8:93-100.##Bayat–Mokhtary M, Tabrizian F, Dolatabady E, Khalesian B. Analysis of some maternal risk factors in preterm delivery (in Persian). Journal of Medical Science of Islamic Azad University of Mashhad 2009; 5: 140-146.##Ganji T, Einipour Z, Hosseini F. The relationaship of pre-term delivery and stressful life events during pregnancy. IJN 2009; 22: 77-86.##Khalaji Nia Z, Sadeghi Moghadam P. Prevalence and maternal risk factors of preterm laboring in Qom, 2007. Qom University of Medical Sciences Journal 2011; 5: 30-36.##Marsusi V, Rasekh K. Etiology and prevalence of preterm deliveries in Dr. Shariatie Hospital, 1996-97. Tehran univ med J 1998; 56: 31-34.##Sehati Shaghaie F, Ghuchazade M, Asdolaie M, Farzolapur F. Prevalence and Risk Factors of Preterm labor in Health Education Centers of Ardabil Province (2009-2010). Life Science Journal 2013; 10: 231-236.##Sohrabi D, Ghanbari Gorkani M. A survey on risk factors and outcomes of women with preterm labor admitted to Valieasr hospital in Zanjan. Journal of Urmia Nursing And Midwifery Faculty 2011; 9: 84-89.##Mansourghanaei M. Seasonal Pattern of Preterm Birth. Journal of Guilan University of Medical Sciences 2011; 20: 77-83.##Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Ahmadi Hadi P. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran J Reprod Med 2014; 12: 47-56.##Mirzaie F, Mohammah-Alizadeh S. Contributing factors of preterm delivery in parturient in a University Hospital in Iran. Saudi Med J 2007; 28: 400-404.##Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller A-B, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013; 10: S2.##Gulamani SS, Premji SS, Kanji Z, Azam SI. A review of postpartum depression, preterm birth, and culture. J Perinat Neonatal Nurs 2013; 27: 52-59.##Mohammad K, Abu Dalou A, Kassab M, Gamble J, Creedy DK. Prevalence and factors associated with the occurrence of preterm birth in Irbid governorate of Jordan: a retrospective study. Int J Nurs Pract 2014; 11. doi: 10.1111/ijn.12335. [Epub ahead of print].##Vakilian K, Mirzaii K, NajmAbadi. Reproductive health in iran: international conference on population and development goals. Oman Med J 2011; 26: 143-147.##Khorsandi M, Vakilian K, Torabi Goudarzi M, Abdi M. Childbirth preparation using behavioral-cognitiveskill in childbirth outcomes of primiparous women. JBUMS 2013; 15: 76-80.##Nguyen N, Savitz DA, Thorp JM. Risk factors for preterm birth in Vietnam. Int J Gynaecol Obstet 2004; 86: 70-78.##Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The lancet 2008; 371: 75-84.##Howson C, Kinney M, Lawn J. Born too soon: the global action report on preterm birth 2012 [cited November 2014]. Available from: http://www.who.int/maternal_child_adolescent/documents/born_too_soon/en/index.html.##Afrakhteh M, Ebrahimi S, Valaie N. Prevalence of preterm delivery and its related factors in females referring to Shohada Tajrish Hospital, 1995-99. Pejouhandeh 2002; 7: 341-344.##Preterm birth: World Health Organization; 2014 [cited November 2014]. Available from: http://www.who.int/mediacentre/factsheets/fs363/en/.##Moghadami N, Aminikhah B, Davari Tanha F. The effect of maternal body mass index on spontaneous versus induced preterm birth: a prospective study. Tehran univ Med J 2009; 67: 221-225.##Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379: 2162-2172.##Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Pract Res Clin Obstet Gynaecol 2007; 21: 773-789.##Lo CC, Hsu JJ, Hsieh CC, Hsieh TT, Hung TH. Risk factors for spontaneous preterm delivery before 34 weeks of gestation among Taiwanese women. Taiwan J Obstet Gynecol 2007; 46: 389-394.##Martius JA, Steck T, Oehler MK, Wulf K-H. Risk factors associated with preterm (< 37+ 0 weeks) and early preterm birth (< 32+ 0 weeks): univariate and multivariate analysis of 106 345 singleton births from the 1994 statewide perinatal survey of Bavaria. Euro J Obstet Gynecol Reprod Biol 1998; 80: 183-189.##Derakhshi B, Esmailnasab N, Ghaderi E, Hemmatpour S. Risk factor of preterm labor in the west of iran: a case-control study. Iran J Public Health 2014; 43: 499-506.##Nabavizadeh SH, Malekzadeh M, Mousavizadeh A, Shirazi HR, Ghaffari P, Karshenas N, et al. Retrospective study of factors related to preterm labor in Yasuj, Iran. Int J Gen Med 2012; 5: 1013-1017.##Khadem N, Rahmani ME, Sanaei A, Afiat M. Association between preterm and low-birth weight with periodontal disease: a case-control study. Iran J Reprod Med 2012; 10: 561-566.##Cohn LD, Becker BJ. How meta-analysis increases statistical power. Psychol Methods 2003; 8: 243-253.##Noble JH Jr. Meta-analysis: methods, strengths, weaknesses, and political uses. J Lab Clin Med 2006; 147: 7-20.##Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Preventive Medicine 2007; 45: 247-251.##Amini L, Mahmoudi Z, Hosseini F, Mahmoudi A. The relationship between the social structure and health and pregnancy outcomes: preterm labor and rupture of water bag. Journal of Sabzevar University of Medical Sciences 2013; 20: 109-116.##Pasdar Y, Heidari N, Safari Y, Faramani RS, Izadi N, Jamshidpour M, et al. Prevalence of Some Risk Factors in Pregnant Women. Iran J Obstet Gynecol Infertil 2012; 15: 14-23.##Rajaeefard A, Mohammadbeigi A, Mohammadi M, Joulaee H, Alipour H. Evaluation of risk factors in preterm delivery and impact of education in its prevention. Daneshvar Medicine 2010; 17: 11-18.##Lotf Alizadeh M, Mohammadzadeh A, Kamandi S, Bagheri S. Prevalence and risk factors of preterm labor in Imam Reza Hospital 2003-2004. Iranian Journal Of Obstetrics, Gyneocology And Infertility 2005;8:93-100.##Bayat–Mokhtary M, Tabrizian F, Dolatabady E, Khalesian B. Analysis of some maternal risk factors in preterm delivery (in Persian). Journal of Medical Science of Islamic Azad University of Mashhad 2009; 5: 140-146.##Ganji T, Einipour Z, Hosseini F. The relationaship of pre-term delivery and stressful life events during pregnancy. IJN 2009; 22: 77-86.##Khalaji Nia Z, Sadeghi Moghadam P. Prevalence and maternal risk factors of preterm laboring in Qom, 2007. Qom University of Medical Sciences Journal 2011; 5: 30-36.##Marsusi V, Rasekh K. Etiology and prevalence of preterm deliveries in Dr. Shariatie Hospital, 1996-97. Tehran univ med J 1998; 56: 31-34.##Sehati Shaghaie F, Ghuchazade M, Asdolaie M, Farzolapur F. Prevalence and Risk Factors of Preterm labor in Health Education Centers of Ardabil Province (2009-2010). Life Science Journal 2013; 10: 231-236.##Sohrabi D, Ghanbari Gorkani M. A survey on risk factors and outcomes of women with preterm labor admitted to Valieasr hospital in Zanjan. Journal of Urmia Nursing And Midwifery Faculty 2011; 9: 84-89.##Mansourghanaei M. Seasonal Pattern of Preterm Birth. Journal of Guilan University of Medical Sciences 2011; 20: 77-83.##Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Ahmadi Hadi P. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran J Reprod Med 2014; 12: 47-56.##Mirzaie F, Mohammah-Alizadeh S. Contributing factors of preterm delivery in parturient in a University Hospital in Iran. Saudi Med J 2007; 28: 400-404.##Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller A-B, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013; 10: S2.##Gulamani SS, Premji SS, Kanji Z, Azam SI. A review of postpartum depression, preterm birth, and culture. J Perinat Neonatal Nurs 2013; 27: 52-59.##Mohammad K, Abu Dalou A, Kassab M, Gamble J, Creedy DK. Prevalence and factors associated with the occurrence of preterm birth in Irbid governorate of Jordan: a retrospective study. Int J Nurs Pract 2014; 11. doi: 10.1111/ijn.12335. [Epub ahead of print].##Vakilian K, Mirzaii K, NajmAbadi. Reproductive health in iran: international conference on population and development goals. Oman Med J 2011; 26: 143-147.##Khorsandi M, Vakilian K, Torabi Goudarzi M, Abdi M. Childbirth preparation using behavioral-cognitiveskill in childbirth outcomes of primiparous women. JBUMS 2013; 15: 76-80.## ##

Mycobacterium tuberculosis infection in women with unexplained infertility بررسی سل ژنیتال در زنان ایرانی دارای ناباروری با علت ناشناخته 2 1 مقدمه: سل دستگاه تناسلی یکی از عوامل مهم در ناباروری زنان خصوصا در کشورهای در حال توسعه می باشد. PCR مثبت سل آندومتر در غیاب آسیب لوله های رحمی امکان تشخیص بیماری با علایم بالینی یا پنهان را بالا می برد، که از مزایای شروع درمان است. هدف: هدف از این مطالعه بررسی عفونت مایکروباکتریوم توبرکلوزیس با استفاده از تکنیک PCR در نمونه بیوپسی شده اندومتر از زنان با ناباروری ناشناخته مراجعه کننده به مرکز تحقیقاتی و درمانی ناباروری دانشگاه علوم پزشکی شهید صدوقی یزد بود. مواد و روشها: این مطالعه مقطعی بر روی 144 زن نابارور با میانگین سنی 20 تا 35 سال که آزمایشات تشخیصی از جمله هیستروسکوپی تشخیصی آنها نرمال بود انجام شد. سپس نمونه آندومتر از این 144 زن برای روش PCR گرفته شد. در 93 نفر از بیماران، مایع صفاقی نیز برای PCR گرفته شده است. نتایج: با توجه به نتایج PCR، هیچ گونه موردی که احتمال وجود ,DNA MTB در نمونه آندومتر وجود داشته باشد یافت نشد و نتایج نشان داد هیچ عفونت GTB در میان بیماران ما وجود ندارد. نتایج PCR در تمام موارد منفی بود. نتیجه گیری: نتایج ما نشان داد که GTB نمی تواند به عنوان یک مشکل عمده در زنان ایرانی با ناباروری با علت ناشناخته در نظر گرفته شود. اگر چه، مطالعات نشان داده اند که PCR یک روش مفید در GTP تشخیص زود هنگام بیماری در زنان نابارور بدون شواهد اثبات اختلالات لوله ای یا آندومتر است. 2 Background: Genital tuberculosis (GTB) is an important cause of female infertility, especially in developing countries. The positive results of polymerase chain reaction (PCR) in endometrial GTB in the absence of tubal damage raise the possibility of the detection of sub-clinical or latent disease, with doubtful benefits of treatment. Objective: To evaluate the mycobacterium tuberculosis infection in endometrial biopsy samples collected from unexplained infertile women attending Yazd Research and Clinical Center for Infertility by using PCR techniques. Materials and Methods: In this cross sectional study, 144 infertile women with unexplained infertility aged 20-35 years old and normal Histro-saplango graphy findings were enrolled. Endometrial biopsy samples from each participant were tested for mycobacterium tuberculosis detecting by PCR. In 93 patients, peritoneal fluid was also taken for culture and PCR. Results: The PCR results of endometrial specimens were negative in all cases, demonstrating that there was no GTB infection among our patients. Conclusion: Our results showed that GTB could not be considered as a major problem in women with unexplained infertility. Although, studies have indicated that PCR is a useful method in diagnosing early GTB disease in infertile women with no demonstrable evidence of tubal or endometrial involvement. 749 754 2017/10/12017/10/1 1396/7/9 2017/10/42017/10/4 1396/7/12 مریم افتخار Maryam Eftekhar Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران سهیلا پورمعصومی Soheila Pourmasumi Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران spourmasumi@yahoo.com پروین ثابتی Parvin Sabeti Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران عباس افلاطونیان Abbas Aflatoonian Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران محمد حسن شیخها Mohammad Hasan Sheikhha Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران Genital mycobacterium tuberculosis Polymerase chain reaction Unexplained infertility. سل تناسلی واکنش زنجیره ای پلیمراز ناباروری با علت ناشناخته. 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Clinical presentation and epidemiology of female genital tuberculosis in eastern Sudan. Int J Gynaecol Obstet 2012; 118: 236-238.##Shaheen R, Subhan F, Tahir F. Epidemiology of genital tuberculosis in infertile population. J Pak Med Assoc 2006; 56: 306-309.##Singh N, Sumana G, Mittal S. Genital tuberculosis: a leading cause for infertility in women seeking assisted conception in North India. Arch Gynecol Obstet 2008; 278: 325-327.##Baum SE, Dooley DP, Wright J, Kost ER, Storey DF. Diagnosis of culture-negative female genital tract tuberculosis with peritoneal involvement by polymerase chain reaction. J Reprod Med 2001; 46: 929-932.##Bhanu NV, Singh UB, Chakraborty M, Suresh N, Arora J, Rana T, et al. Improved diagnostic value of PCR in the diagnosis of female genital tuberculosis leading to infertility. J Med Microbiol 2005; 54: 927-931.##Thangappah RB, Paramasivan CN, Narayanan S. Evaluating PCR, culture & histopathology in the diagnosis of female genital tuberculosis. Indian J Med Res 2011; 134: 40-46.##Qureshi RN, Samad S, Hamid R, Lakha SF. Female genital tuberculosis revisited. J Pak Med Assoc 2001; 51: 16-18.##Tripathy SN, Tripathy SN. Infertility and pregnancy outcome in female genital tuberculosis. Int J Gynaecol Obstet 2002; 76: 159-163.##Mani R, Nayak S, Kagal A, Deshpande S, Dandge N, Bharadwaj R. Tuberculous endometritis in infertility: a bacteriological and histopathological study. Indian J Tuberc 50: 161-162.##Biswas D, Agrawal M, Ali A, Bhargava R. Anti ES-31/41 antibodies: A potential tool in the serodiagnosis of extra-pulmonary Tuberculosis. Indian J Tuberc 2003; 50: 203-207.##Abebe M, Lakew M, Kidane D, Lakew Z, Kiros K, Harboe M. Female genital tuberculosis in Ethiopia. Int J Gynaecol Obstet 2004; 84: 241-246.##Hassoun A, Jacquette G, Huang A, Anderson A, Smith MA. Female genital tuberculosis: uncommon presentation of tuberculosis in the United States. Am J Med 2005; 118: 1295-1296.##Sharma JB, Roy KK, Pushparaj M, Kumar S. Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis. Int J Gynaecol Obstet 2009; 104: 49-52.##Whitehill K, Yong PJ, Williams C. Clinical predictors of endometriosis in the infertility population: is there a better way to determine who needs a laparoscopy? J Obstet Gynaecol Can 2012; 34: 552-557.##Mondal SK, Dutta T. A ten year clinicopathological study of female genital tuberculosis and impact on fertility. JNMA J Nepal Med Assoc 2009; 48: 52-57.##Banerjee A, Prateek S, Malik S, Dhingra D. Genital tuberculosis in adolescent girls from low socioeconomic status with acute ectopic pregnancy presenting at a tertiary care hospital in urban Northern India: are we missing an opportunity to treat? Arch Gynecol Obstet 2012; 286: 1477-1482.##Pešut D, Stojšić J. Female genital tuberculosis: A disease seen again in Europe. Vojnosanit Pregl 2007; 64: 855-858.##Metanat M, Sharifi-Mood B, Alavi-Naini R, Aminianfar M. The epidemiology of tuberculosis in recent years: Reviewing the status in south-eastern Iran. ZJRMS 2012; 13: 1-7.##Hatami M. Tuberculosis of the female genital tract in Iran. Arch Iranian Med 2005; 8: 32-35.##Ghosh SK, Mondal R. Quick diagnosis of female genital tuberculosis using multiplex fast polymerase chain reaction in Southern Assam, India. Int J Gynaecol Obstet 2012; 118: 72-73.##Rana T, Singh UB, Kulshrestha V, Kaushik A, Porwal C, Agarwal N, et al. Utility of reverse transcriptase PCR and DNA-PCR in the diagnosis of female genital tuberculosis. J Med Microbiol 2011; 60: 486-491.##Baxi A, Neema H, Kaushal M, Sahu P, Baxi D. Genital tuberculosis in infertile women: Assessment of endometrial TB PCR results with laparoscopic and hysteroscopic features. J Obstet Gynaecol India 2011; 61: 301-306.##Makar RS, Toth TL. The evaluation of infertility. Am J Clin Pathol 2002; 117: S95-103.##Huang HF, Liu AX. Research progress of the diseases associated infertility and assisted reproductive technology. Zhejiang Da Xue Xue Bao Yi Xue Ban 2007; 36: 417-423.##Esmaeilzadeh S, Delavar MA, Zeinalzadeh M, Mir MR. Epidemiology of infertility: a population-based study in Babol, Iran. Women Health 2012; 52: 744-754.##Bhattacharya S, Porter M, Amalraj E, Templeton A, Hamilton M, Lee A, et al. The epidemiology of infertility in the North East of Scotland. Hum Reprod 2009; 24: 3096-3107.##Wilkes S, Chinn DJ, Murdoch A, Rubin G. Epidemiology and management of infertility: a population-based study in UK primary care. Fam Pract 2009; 26: 269-274.##Schmidt L. Infertility and assisted reproduction in Denmark. Epidemiology and psychosocial consequences. Dan Med Bull 2006; 53: 390-417.##Marzieh N. Epidemiology of infertility in the west of Tehran in 2000. J Am Med Womens Assoc 2002; 57: 219.##Templeton A. Infertility and the establishment of pregnancy–overview. Br Med Bull 2000; 56: 577-587.##Pellati D, Mylonakis I, Bertoloni G, Fiore C, Andrisani A, Ambrosini G, et al. Genital tract infections and infertility. Eur J Obstet Gynecol Reprod Biol, 2008; 140: 3-11.##Stanislavov R, Chernev T, Nikolova V, Markova M. Asymptomatic infections of the genital tract and infertility. Akush Ginekol (Sofiia) 2000; 39: 18-20.##Shukla Upadhyaya K, Karunagoda K, Dei LP. Infertility caused by tubal blockage: An ayurvedic appraisal. AYU 2010; 31: 159-166.##Mahutte NG, Arici A. New advances in the understanding of endometriosis related infertility. J Reprod Immunol 2002; 55: 73-83.##Bender N, Herrmann B, Andersen B, Hocking JS, van Bergen J, Morgan J, et al. Chlamydia infection, pelvic inflammatory disease, ectopic pregnancy and infertility: cross-national study. Sex Transm Infect 2011; 87: 601-608.##Du YB, Gao MZ, Shi Y, Sun ZG, Wang J. Endocrine and inflammatory factors and endometriosis-associated infertility in assisted reproduction techniques. Arch Gynecol Obstet 2013; 287: 123-130.##Unuane D, Tournaye H, Velkeniers B, Poppe K. Endocrine disorders & female infertility. Best Pract Res Clin Endocrinol Metab 2011; 25: 861-873.##Belaisch-Allart J. Treatment options for age-related infertility. Rev Prat 2010; 60: 819-823.##Szewczuk E. Age related infertility: a tale of two technologies. Sociol Health Illn 2012; 34: 429-443.##Kamath MS, Bhattacharya S. Demographics of infertility and management of unexplained infertility. Best Pract Res Clin Obstet Gynaecol 2012; 26: 729-738.##Aisenberg Romano G, Ravid H, Zaig I, Schreiber S, Azem F, Shachar I, et al. The psychological profile and affective response of women diagnosed with unexplained infertility undergoing in vitro fertilization. Arch Womens Ment Health 2012; 15: 403-411.##Ali AA, Abdallah TM. Clinical presentation and epidemiology of female genital tuberculosis in eastern Sudan. Int J Gynaecol Obstet 2012; 118: 236-238.##Shaheen R, Subhan F, Tahir F. Epidemiology of genital tuberculosis in infertile population. J Pak Med Assoc 2006; 56: 306-309.##Singh N, Sumana G, Mittal S. Genital tuberculosis: a leading cause for infertility in women seeking assisted conception in North India. Arch Gynecol Obstet 2008; 278: 325-327.##Baum SE, Dooley DP, Wright J, Kost ER, Storey DF. Diagnosis of culture-negative female genital tract tuberculosis with peritoneal involvement by polymerase chain reaction. J Reprod Med 2001; 46: 929-932.##Bhanu NV, Singh UB, Chakraborty M, Suresh N, Arora J, Rana T, et al. Improved diagnostic value of PCR in the diagnosis of female genital tuberculosis leading to infertility. J Med Microbiol 2005; 54: 927-931.##Thangappah RB, Paramasivan CN, Narayanan S. Evaluating PCR, culture & histopathology in the diagnosis of female genital tuberculosis. Indian J Med Res 2011; 134: 40-46.##Qureshi RN, Samad S, Hamid R, Lakha SF. Female genital tuberculosis revisited. J Pak Med Assoc 2001; 51: 16-18.##Tripathy SN, Tripathy SN. Infertility and pregnancy outcome in female genital tuberculosis. Int J Gynaecol Obstet 2002; 76: 159-163.##Mani R, Nayak S, Kagal A, Deshpande S, Dandge N, Bharadwaj R. Tuberculous endometritis in infertility: a bacteriological and histopathological study. Indian J Tuberc 50: 161-162.##Biswas D, Agrawal M, Ali A, Bhargava R. Anti ES-31/41 antibodies: A potential tool in the serodiagnosis of extra-pulmonary Tuberculosis. Indian J Tuberc 2003; 50: 203-207.##Abebe M, Lakew M, Kidane D, Lakew Z, Kiros K, Harboe M. Female genital tuberculosis in Ethiopia. Int J Gynaecol Obstet 2004; 84: 241-246.##Hassoun A, Jacquette G, Huang A, Anderson A, Smith MA. Female genital tuberculosis: uncommon presentation of tuberculosis in the United States. Am J Med 2005; 118: 1295-1296.##Sharma JB, Roy KK, Pushparaj M, Kumar S. Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis. Int J Gynaecol Obstet 2009; 104: 49-52.##Whitehill K, Yong PJ, Williams C. Clinical predictors of endometriosis in the infertility population: is there a better way to determine who needs a laparoscopy? J Obstet Gynaecol Can 2012; 34: 552-557.##Mondal SK, Dutta T. A ten year clinicopathological study of female genital tuberculosis and impact on fertility. JNMA J Nepal Med Assoc 2009; 48: 52-57.##Banerjee A, Prateek S, Malik S, Dhingra D. Genital tuberculosis in adolescent girls from low socioeconomic status with acute ectopic pregnancy presenting at a tertiary care hospital in urban Northern India: are we missing an opportunity to treat? Arch Gynecol Obstet 2012; 286: 1477-1482.##Pešut D, Stojšić J. Female genital tuberculosis: A disease seen again in Europe. Vojnosanit Pregl 2007; 64: 855-858.##Metanat M, Sharifi-Mood B, Alavi-Naini R, Aminianfar M. The epidemiology of tuberculosis in recent years: Reviewing the status in south-eastern Iran. ZJRMS 2012; 13: 1-7.##Hatami M. Tuberculosis of the female genital tract in Iran. Arch Iranian Med 2005; 8: 32-35.##Ghosh SK, Mondal R. Quick diagnosis of female genital tuberculosis using multiplex fast polymerase chain reaction in Southern Assam, India. Int J Gynaecol Obstet 2012; 118: 72-73.##Rana T, Singh UB, Kulshrestha V, Kaushik A, Porwal C, Agarwal N, et al. Utility of reverse transcriptase PCR and DNA-PCR in the diagnosis of female genital tuberculosis. J Med Microbiol 2011; 60: 486-491.##Baxi A, Neema H, Kaushal M, Sahu P, Baxi D. Genital tuberculosis in infertile women: Assessment of endometrial TB PCR results with laparoscopic and hysteroscopic features. J Obstet Gynaecol India 2011; 61: 301-306.## ##

Association of kinase insert domain-containing receptor (KDR) gene polymorphism/ haplotypes with recurrent spontaneous abortion and genetic structure ارتباط پلی مورفیسم/هاپلوتایپ های ژن KDR با سقط مکرر خودبخودی و ساختار ژنتیکی 2 1 مقدمه: سقط مکرر خودبخودی یکی از بیماری هایی است که می تواند باعث ایجاد مشکلات جسمی، روانی و اقتصادی برای افراد و جامعه شود. به تازگی تعدادی از پلی مورفیسم های ژن گیرنده دومین داخلی کینازی (KDR) که می تواند باعث به خطر افتادن جنین مادران باردار شود مورد بررسی قرار گرفته است. هدف :ریسک پلی مورفیسم های ژن  KDRدر زنان ایرانی با سقط مکرر ایدیوپاتیک مورد بررسی قرار گرفته است. مواد و روش ها: مطالعه از نوع مورد-شاهد است. 100 بیمار سقط مکرر خود به خودی ایدیوپاتیک با حداقل دو سقط متوالی قبل از هفته 20 حاملگی با کاریوتیپ نرمال مورد مطالعه قرار گرفت. همچنین 100 زن با حداقل یک حاملگی طبیعی به عنوان گروه کنترل در این مطالعه در نظر گرفته شد. دو SNP عملکردی واقع در ژنKDR  شامل rs1870377 (Q472H) و (rs2305948 (V297I و همچنین یک SNP tag در اینترون (rs6838752) توسط واکنش زنجیره ایی پلی مرازی بر پایه چند شکلی طول قطعه محدودالاثر (PCR-RFLP) مورد تجزیه و تحلیل ژنوتایپی قرار گرفت. فراوانی هاپلوتایپ ها برای ژنوتیپ های سه SNP برآورد شد. تجزیه و تحلیل ساختار ژنتیکی و خوشه بندی K-means به منظور بررسی تنوع ژنتیکی انجام شد. نتایج:  SNPعملکردی  (rs1870377)پیوستگی بالایی با(rs6838752) tag SNP (D´ value=0.214; χ2 = 16.44 p=0.000) نشان داد. خوشه بندی K-means K=8 را به عنوان بهترین تعداد زیر گروه های ژنتیکی ایده ال برای نمونه های مورد مطالعه شبیه به نتایج تجزیه و تحلیل خوشه ای Neighbor Joining نشان داد. نتیجه گیری: در این مطالعه، فراوانی آللی و ژنوتیپی ارتباطی با سقط مکرر خودبخودی بین افراد بیمار و کنترل نشان نداد. نتایج متناقض در جمعیت های مختلف با فراوانی آللی متفاوت در بیماران با سقط مکرر خودبخودی و کنترل ممکن است برگرفته از دو عامل اصلی همچون تنوع قومیتی و حجم نمونه در این مطالعات باشد. 2 Background: Recurrent spontaneous abortion is one of the diseases that can lead to physical, psychological, and, economical problems for both individuals and society. Recently a few numbers of genetic polymorphisms in kinase insert domain-containing receptor (KDR) gene are examined that can endanger the life of the fetus in pregnant women. Objective: The risk of KDR gene polymorphisms was investigated in Iranian women with idiopathic recurrent spontaneous abortion (RSA). Materials and Methods: A case controlled study was performed. One hundred idiopathic recurrent spontaneous abortion patients with at least two consecutive pregnancy losses before 20 weeks of gestational age with normal karyotypes were included in the study. Also, 100 healthy women with at least one natural pregnancy were studied as control group. Two functional SNPs located in KDR gene; rs1870377 (Q472H), and rs2305948 (V297I) as well as one tag SNP in the intron region (rs6838752) were genotyped by using PCR based restriction fragment length polymorphism (PCR-RFLP) technique. Haplotype frequency was determined for these three SNPs’ genotypes. Analysis of genetic STRUCTURE and K means clustering were performed to study genetic variation. Results: Functional SNP (rs1870377) was highly linked to tag SNP (rs6838752) (D´ value=0. 214; χ2 = 16.44, p<0. 001). K means clustering showed that k = 8 as the best fit for the optimal number of genetic subgroups in our studied materials. This result was in agreement with Neighbor Joining cluster analysis. Conclusion: In our study, the allele and genotype frequencies were not associated with RSA between patient and control individuals. Inconsistent results in different populations with different allele frequencies among RSA patients and controls may be due to ethnic variation and used sample size.   755 764 2017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/4 1396/7/12 شیوا شهسواری Shiva Shahsavari Department of Biology, School of Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran ایران زهرا نورمحمدی Zahra Noormohammadi Department of Biology, School of Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran ایران marjannm@yahoo.com شهره زارع کاریزی Shohreh Zare Karizi Department of Biology, Pishva Branch, Islamic Azad University, Varamin, Iran ایران Abortion Genetic structures Polymorphism Restriction fragment length polymorphism VEGF receptor 2 سقط ساختار ژنتیکی پلی مورفیسم RFLP گیرنده 2 VEGF. Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril 2008; 90: S60.##Sondheimer S: Abortion. Encycl Reprod 1999; 1: 1-6.##Clifford K, Rai R, Watson H, Regan L. An informative protocol for the investigation of recurrent miscarriage: preliminary experience of 500 consecutive cases. Hum Reprod 1994; 9: 1328–1332.##Stirrat GM. Recurrent miscarriage. Lancet 1990; 336: 673–675.##Su MT, Lin SH, Chen YC. Genetic association studies of angiogenesis- and vasoconstriction-related genes in women with recurrent pregnancy loss: a systematic review and meta-analysis. Hum Reprod Update 2011; 17: 803–812.##Su MT, Lin SH, Lee IW, Chen YC, Kuo PL. Association of polymorphisms/haplotypes of the genes encoding vascular endothelial growth factor and its KDR receptor with recurrent pregnancy loss. Hum Reprod 2011; 26: 758–764.##Lee HH, Hong SH, Shin SJ, Ko JJ, Oh D, Kim NK. Association study of vascular endothelial growth factor polymorphisms with the risk of recurrent spontaneous abortion. Fertil Steril 2010; 93: 1244–1247.##Rah H, Jeon YJ, Lee BE, Choi DH, Yoon TK, Lee WS, et al. Association of kinase insert domain-containing receptor (KDR) gene polymorphisms with idiopathic recurrent spontaneous abortion in korean women. Fertil Steril 2013; 99: 753-760.##Park YS, Jeon YJ, Kim HS, Chae KY, Oh SH, Han IB, et al. The role of VEGF and KDR polymorphisms in moyamoya disease and collateral revascularization. PLoS One 2012; 7: e47158.##An SJ, Chen ZH, Lin QX, Su J, Chen HJ, Lin JY, et al. The- 271 G>A polymorphism of kinase insert domain-containing receptor gene regulates its transcription level in patients with non-small cell lung cancer. BMC Cancer 2009; 9: 144.##Wang Y, Zheng Y, Zhang W, Yu H, Lou K, Zhang Y, et al. Polymorphisms of KDR gene are associated with coronary heart disease. J Am Coll Cardiol 2007; 50: 760-767.##Sole´X, Guino´ E, Valls J, Iniesta R, Moreno V. SNPstats: a web tool for the analysis of association studies. Bioinformatics 2006; 22: 1928–1929.##Weising K, Nybom H, Wolf K, Kahl G. DNA Finger Printing in Plants. 2nd Ed. New York; CRC Press, Taylor and Francis; 2005.##Freeland JR, Kirk H, Peterson, S.D. Molecular Ecology . 2nd Ed. UK; Wiley-Blackwell; 2011.##Peakall R, Smouse PE. GENALEX 6: genetic analysis in excel. population genetic software for teaching and research. Mol Ecol Notes 2006; 6: 288- 295.##Earl, DA, von Holdt BM. STRUCTURE HARVESTER: a website and program for visualizing STRUCTURE output and implementing the Evanno method. Conserv Genet Resour 2012; 4: 359-361.##Evanno G, Regnaut S, Goudet J. Detecting the number of clusters of individuals using the software STRUCTURE: a simulation study. Mol Ecol 2005; 14: 2611-2620.##Calinski R, Harabasz J. A dendrite method for cluster analysis. Commun Stat 1974; 3: 1-27.##Schwarz G. Estimating the dimension of a model. Ann Stat 1978; 6: 461-464.##Meirmans PG, Van Tienderen PH. GENOTYPE and GENODIVE: two programs for the analysis of genetic diversity of asexual organisms. Mol Ecol Notes 2004; 4: 792-794.##Greene JM, Dunaway CW, Bowers SD, Rude BJ, Feugang JM, Ryan PL. In vivo monitoring of fetoplacental Vegfr2 gene activity in a murine pregnancy model using a Vegfr2-luc reporter gene and bioluminescent imaging. Reprod Biol Endocrinol 2011; 9: 51.##Bogic LV, Brace RA, Cheung CY. Developmental expression of vascular endothelial growth factor (VEGF) receptors and VEGF binding in ovine placenta and fetal membranes. Placenta 2001; 22: 265–275.##Sugino N, Kashida S, Karube-Harada A, Takiguchi S, Kato H. Expression of vascular endothelial growth factor (VEGF) and its receptors in human endometrium throughout the menstrual cycle and in early pregnancy. Reproduction 2002; 123: 379–387.##Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril 2008; 90: S60.##Sondheimer S: Abortion. Encycl Reprod 1999; 1: 1-6.##Clifford K, Rai R, Watson H, Regan L. An informative protocol for the investigation of recurrent miscarriage: preliminary experience of 500 consecutive cases. Hum Reprod 1994; 9: 1328–1332.##Stirrat GM. Recurrent miscarriage. Lancet 1990; 336: 673–675.##Su MT, Lin SH, Chen YC. Genetic association studies of angiogenesis- and vasoconstriction-related genes in women with recurrent pregnancy loss: a systematic review and meta-analysis. Hum Reprod Update 2011; 17: 803–812.##Su MT, Lin SH, Lee IW, Chen YC, Kuo PL. Association of polymorphisms/haplotypes of the genes encoding vascular endothelial growth factor and its KDR receptor with recurrent pregnancy loss. Hum Reprod 2011; 26: 758–764.##Lee HH, Hong SH, Shin SJ, Ko JJ, Oh D, Kim NK. Association study of vascular endothelial growth factor polymorphisms with the risk of recurrent spontaneous abortion. Fertil Steril 2010; 93: 1244–1247.##Rah H, Jeon YJ, Lee BE, Choi DH, Yoon TK, Lee WS, et al. Association of kinase insert domain-containing receptor (KDR) gene polymorphisms with idiopathic recurrent spontaneous abortion in korean women. Fertil Steril 2013; 99: 753-760.##Park YS, Jeon YJ, Kim HS, Chae KY, Oh SH, Han IB, et al. The role of VEGF and KDR polymorphisms in moyamoya disease and collateral revascularization. PLoS One 2012; 7: e47158.##An SJ, Chen ZH, Lin QX, Su J, Chen HJ, Lin JY, et al. The- 271 G>A polymorphism of kinase insert domain-containing receptor gene regulates its transcription level in patients with non-small cell lung cancer. BMC Cancer 2009; 9: 144.##Wang Y, Zheng Y, Zhang W, Yu H, Lou K, Zhang Y, et al. Polymorphisms of KDR gene are associated with coronary heart disease. J Am Coll Cardiol 2007; 50: 760-767.##Sole´X, Guino´ E, Valls J, Iniesta R, Moreno V. SNPstats: a web tool for the analysis of association studies. Bioinformatics 2006; 22: 1928–1929.##Weising K, Nybom H, Wolf K, Kahl G. DNA Finger Printing in Plants. 2nd Ed. New York; CRC Press, Taylor and Francis; 2005.##Freeland JR, Kirk H, Peterson, S.D. Molecular Ecology . 2nd Ed. UK; Wiley-Blackwell; 2011.##Peakall R, Smouse PE. GENALEX 6: genetic analysis in excel. population genetic software for teaching and research. Mol Ecol Notes 2006; 6: 288- 295.##Earl, DA, von Holdt BM. STRUCTURE HARVESTER: a website and program for visualizing STRUCTURE output and implementing the Evanno method. Conserv Genet Resour 2012; 4: 359-361.##Evanno G, Regnaut S, Goudet J. Detecting the number of clusters of individuals using the software STRUCTURE: a simulation study. Mol Ecol 2005; 14: 2611-2620.##Calinski R, Harabasz J. A dendrite method for cluster analysis. Commun Stat 1974; 3: 1-27.##Schwarz G. Estimating the dimension of a model. Ann Stat 1978; 6: 461-464.##Meirmans PG, Van Tienderen PH. GENOTYPE and GENODIVE: two programs for the analysis of genetic diversity of asexual organisms. Mol Ecol Notes 2004; 4: 792-794.##Greene JM, Dunaway CW, Bowers SD, Rude BJ, Feugang JM, Ryan PL. In vivo monitoring of fetoplacental Vegfr2 gene activity in a murine pregnancy model using a Vegfr2-luc reporter gene and bioluminescent imaging. Reprod Biol Endocrinol 2011; 9: 51.##Bogic LV, Brace RA, Cheung CY. Developmental expression of vascular endothelial growth factor (VEGF) receptors and VEGF binding in ovine placenta and fetal membranes. Placenta 2001; 22: 265–275.##Sugino N, Kashida S, Karube-Harada A, Takiguchi S, Kato H. Expression of vascular endothelial growth factor (VEGF) and its receptors in human endometrium throughout the menstrual cycle and in early pregnancy. Reproduction 2002; 123: 379–387.## ##

Sodium metabisulfite-induced changes on testes, spermatogenesis and epididymal morphometric values in adult rats تغییرات ایجاد شده توسط سدیم متا بی سولفیت بر روی بیضه ها، اسپرماتوژنز و مقادیر مورفومتریک اپیدیدیم در موش های بالغ 2 1 مقدمه: سولفیت ها به طور گسترده به عنوان مخافظت کننده و آنتی اکسیدانت در صنایع غذایی و دارویی استفاده می شوند. در مطالعات گذشته، بسیاری از اثرات بیولوژیکی و سمی سولفیت ها در اندام های مختلف پستانداران نشان داده شده است. هدف: هدف از این مطالعه بررسی اثرات سدیم متا­بی سولفیت (SMB) بر روی عملکرد بیضه و مقادیر مورفومتریک اپیدیدیم در موش های نر بالغ از نژاد ویستار بود. مواد و روش ها: در کل 48 موش به طور تصادفی به چهار گروه تقسیم شدند. گروه های تجربی، SMB را در دوزهایmg/kg 10  (S10),  و 260 (S260) دریافت کردند، در حالی که به گروه کنترل معادل همان حجم نرمال سالین به طریق گاواژ تجویز شد. بعد از 28 روز موش ها بی هوش و بیضه چپ با سر اپیدیدیم به دنبال برش شکم جهت بافت شناسی با استفاده از رنگ آمیزی H/E برداشته شدند. نمونه های سرم جمع آوری و سطح تستوسترون سرم بررسی شد. ابتدای اپیدیدیم برای حرکت، تعداد و مورفولوژی اسپرم تجزیه و تحلیل گردید. نتایج: نتایج این مطالعه نشان داد که مورفولوژی طبیعی، تعداد، حرکت اسپرم ها و سطح تستوسترون در گروه تیمارشده با SMB کاهش یافت. در مقایسه با گروه کنترل، SMB منجر به تعداد کمتر اسپرماتوگونی، اسپرماتوسیت اولیه، اسپرماتید، و سلول های لیدیگ گردید. نتیجه گیری: نشان داده شد که SMB تولید اسپرم را کاهش می دهد و اثرات جانبی بالقوه بر باروری موش های نر دارد. 2 Background: Sulphites are widely used as a preservative and antioxidant additives in the food and pharmaceutical industries. Many types of biological and toxicological effects of sulphites in multiple organs of mammals have been shown in previous studies. Objective: The aim of this study was to investigate the effects of sodium metabisulfite (SMB) on testicular function and morphometric values of epididymis in adult male Wistar rats. Materials and Methods: A total of 32 rats were randomly divided into four groups. The experimental groups received SMB at doses of 10 mg/kg (S10), 100mg/kg (S100), and 260 mg/kg (S260) while an equal volume of normal saline was administered to the control group via gavage. The rats were anaesthetized after 28 days and the left testis with the head of epididimis was excised following abdominal incision for histological observation using hematoxylin and eosin staining. Serum samples were collected for assay of testosterone level. The initial epididymis was analyzed for motility, morphology, and the number of sperms. Result: The results of this study showed that normal morphology, count, and motility of sperms and testosterone level were decreased in the SMB treated groups. In comparison with the control group, SMB resulted in a lower total number of spermatogonia, primary spermatocyte, spermatids, and Leydig cells. Conclusion: It is suggested that SMB decreases the sperm production and has the potential to affect the fertility adversely in male rats. 765 770 2017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/42017/10/4 1396/7/12 شهناز شکرفروش Shahnaz Shekarforoush Department of Physiology, Islamic Azad University, Arsanjan Branch, Fars, Iran ایران shek@iaua.ac.ir زهرا ابراهیمی Zahra Ebrahimi Department of Physiology, Islamic Azad University, Arsanjan Branch, Fars, Iran ایران مریم حسینی Maryam Hoseini Department of Physiology, Islamic Azad University, Arsanjan Branch, Fars, Iran ایران Sodium metabisulfite Sperm Testosterone Epididymis. سدیم متابی سولفیت اسپرم تستوسترون اپیدیدیم. Adebayo OL, Adenuga GA. Oxidative damage on the testes of adult rats by sodium metabisulfite (MBS). Int J Biolog Chem Sci 2012; 6: 738-744.##Ozturk OH, Oktar S, Aydin M, Kucukatay V. Effect of sulfite on antioxidant enzymes and lipid peroxidation in normal and sulfite oxidase-deficient rat erythrocytes. J Physiol Biochem 2010; 66: 205-212.##Nair B, Elmore AR. Final report on the safety assessment of sodium sulfite, potassium sulfite, ammonium sulfite, sodium bisulfite, ammonium bisulfite, sodium metabisulfite and potassium metabisulfite. Int J Toxicol 2003; 22: 63-88.##Meng Z, Bai W. Oxidation damage of sulfur dioxide on testicles of mice. Environ Res 2004; 96: 298-304.##Baud O, Laudenbach V, Evrard P, Gressens P. Neurotoxic effects of fluorinated glucocorticoid preparations on the developing mouse brain: role of preservatives. Pediatr Res 2001; 50: 706-711.##Ozturk N, Yargicoglu P, Derin N, Akpinar D, Agar A, Aslan M. Dose-dependent effect of nutritional sulfite intake on visual evoked potentials and lipid peroxidation. Neurotoxicol Teratol 2011; 33: 244-254.##Noorafshan A, Asadi-Golshan R, Karbalay-Doust S, Abdollahifar MA, Rashidiani-Rashidabadi A. Curcumin, the main part of turmeric, prevents learning and memory changes induced by sodium metabisulfite, a preservative agent, in rats. Exp Neurobiol 2013; 22: 23-30.##Nasiraei-Moghadam SN, Parivar K, Ahmadiani A, Movahhedin M, Vaez Mahdavi MR. Protective Effect of Melatonin against Inequality-Induced Damages on Testicular Tissue and Sperm Parameters. Int J Fertil Steril 2014; 7: 313-322.##Adebayo AO, Olurode SA. The morphology and morphometry of the epididymis in the greater cane rat (Thryonomys swinderianus Temmincks). Folia Morphol 2010; 69: 246-252.##Ahangarpour A, Oroojan AA, Radan M. Effect of aqueous and hydro-alcoholic extracts of lettuce (Lactuca sativa) seed on testosterone level and spermatogenesis in NMRI mice. Iran J Reprod Med 2014; 12: 65-72.##Derin AT, Kose O, Derin N, Savcioglu F, Hacioglu G, Ozcaglar HU, et al. Auditory brainstem response disturbances in rats induced by sodium metabisulfite ingestion. Mediterr J Otol 2008; 4: 77-85.##Elmas O, Aslan M, Caglar S, Derin N, Agar A, Aliciguzel Y, et al. The prooxidant effect of sodium metabisulfite in rat liver and kidney. Regul Toxicol Pharmacol 2005; 42: 77-82.##Ercan S, Ozturk N, Celik-Ozenci C, Gungor NE, Yargicoglu P. Sodium metabisulfite induces lipid peroxidation and apoptosis in rat gastric tissue. Toxicol Ind Health 2010; 26: 425-431.##Shi X, Mao Y. 8-Hydroxy-2'-deoxyguanosine formation and DNA damage induced by sulfur trioxide anion radicals. Biochem Biophys Res Commun 1994; 30: 141-147.##Izgut-Uysal VN, Kucukatay V, Bulbul M, Tan R, Yargicoglu P, Agar A. Effect of sulfite on macrophage functions of normal and sulfite oxidase-deficient rats. Food Chem Toxicol 2005; 43: 599-605.##Noorafshan A, Rashidiani-Rashidabadi A, Karbalay-Doust S, Poostpasand A, Abdollahifar MA, Asadi-Golshan R. Curcumin can prevent the changes in cerebellar structure and function induced by sodium metabisulfite in rat. Exp Neurobiol 2013; 22: 258-267.##Selevan SG, Borkovec L, Slott VL, Zudova Z, Rubes J, Evenson DP, et al. Semen quality and reproductive health of young Czech men exposed to seasonal air pollution. Environ Health Perspect 2000; 108: 887-894.##Zhang J, Liang C, Ma J, Zhou B, Wang J. Changes in testis protein and metabolic enzyme activities in rats induced by sodium fluoride and sulfur dioxide. Fluoride 2006; 39: 179-184.##Sofikitis N, Giotitsas N, Tsounapi P, Baltogiannis D, Giannakis D, Pardalidis N. Hormonal regulation of spermatogenesis and spermiogenesis. J Steroid Biochem Mol Biol 2008; 109: 323-330.##Smith LB, Walker WH. The regulation of spermatogenesis by androgens. Semin Cell Dev Biol 2014; 30: 2-13.##Suresh S, Shanthi Santhosh Kumari S, Preethi U, Venkatalakshmi N, Karthik Ganesh M, Ganesh L, et al. Long-Term Hyperglycemic effect on rat Epididymis and Sperm. Int J Anat Sci 2011; 2: 11-17.##Adebayo OL, Adenuga GA. Oxidative damage on the testes of adult rats by sodium metabisulfite (MBS). Int J Biolog Chem Sci 2012; 6: 738-744.##Ozturk OH, Oktar S, Aydin M, Kucukatay V. Effect of sulfite on antioxidant enzymes and lipid peroxidation in normal and sulfite oxidase-deficient rat erythrocytes. J Physiol Biochem 2010; 66: 205-212.##Nair B, Elmore AR. Final report on the safety assessment of sodium sulfite, potassium sulfite, ammonium sulfite, sodium bisulfite, ammonium bisulfite, sodium metabisulfite and potassium metabisulfite. Int J Toxicol 2003; 22: 63-88.##Meng Z, Bai W. Oxidation damage of sulfur dioxide on testicles of mice. Environ Res 2004; 96: 298-304.##Baud O, Laudenbach V, Evrard P, Gressens P. Neurotoxic effects of fluorinated glucocorticoid preparations on the developing mouse brain: role of preservatives. Pediatr Res 2001; 50: 706-711.##Ozturk N, Yargicoglu P, Derin N, Akpinar D, Agar A, Aslan M. Dose-dependent effect of nutritional sulfite intake on visual evoked potentials and lipid peroxidation. Neurotoxicol Teratol 2011; 33: 244-254.##Noorafshan A, Asadi-Golshan R, Karbalay-Doust S, Abdollahifar MA, Rashidiani-Rashidabadi A. Curcumin, the main part of turmeric, prevents learning and memory changes induced by sodium metabisulfite, a preservative agent, in rats. Exp Neurobiol 2013; 22: 23-30.##Nasiraei-Moghadam SN, Parivar K, Ahmadiani A, Movahhedin M, Vaez Mahdavi MR. Protective Effect of Melatonin against Inequality-Induced Damages on Testicular Tissue and Sperm Parameters. Int J Fertil Steril 2014; 7: 313-322.##Adebayo AO, Olurode SA. The morphology and morphometry of the epididymis in the greater cane rat (Thryonomys swinderianus Temmincks). Folia Morphol 2010; 69: 246-252.##Ahangarpour A, Oroojan AA, Radan M. Effect of aqueous and hydro-alcoholic extracts of lettuce (Lactuca sativa) seed on testosterone level and spermatogenesis in NMRI mice. Iran J Reprod Med 2014; 12: 65-72.##Derin AT, Kose O, Derin N, Savcioglu F, Hacioglu G, Ozcaglar HU, et al. Auditory brainstem response disturbances in rats induced by sodium metabisulfite ingestion. Mediterr J Otol 2008; 4: 77-85.##Elmas O, Aslan M, Caglar S, Derin N, Agar A, Aliciguzel Y, et al. The prooxidant effect of sodium metabisulfite in rat liver and kidney. Regul Toxicol Pharmacol 2005; 42: 77-82.##Ercan S, Ozturk N, Celik-Ozenci C, Gungor NE, Yargicoglu P. Sodium metabisulfite induces lipid peroxidation and apoptosis in rat gastric tissue. Toxicol Ind Health 2010; 26: 425-431.##Shi X, Mao Y. 8-Hydroxy-2'-deoxyguanosine formation and DNA damage induced by sulfur trioxide anion radicals. Biochem Biophys Res Commun 1994; 30: 141-147.##Izgut-Uysal VN, Kucukatay V, Bulbul M, Tan R, Yargicoglu P, Agar A. Effect of sulfite on macrophage functions of normal and sulfite oxidase-deficient rats. Food Chem Toxicol 2005; 43: 599-605.##Noorafshan A, Rashidiani-Rashidabadi A, Karbalay-Doust S, Poostpasand A, Abdollahifar MA, Asadi-Golshan R. Curcumin can prevent the changes in cerebellar structure and function induced by sodium metabisulfite in rat. Exp Neurobiol 2013; 22: 258-267.##Selevan SG, Borkovec L, Slott VL, Zudova Z, Rubes J, Evenson DP, et al. Semen quality and reproductive health of young Czech men exposed to seasonal air pollution. Environ Health Perspect 2000; 108: 887-894.##Zhang J, Liang C, Ma J, Zhou B, Wang J. Changes in testis protein and metabolic enzyme activities in rats induced by sodium fluoride and sulfur dioxide. Fluoride 2006; 39: 179-184.##Sofikitis N, Giotitsas N, Tsounapi P, Baltogiannis D, Giannakis D, Pardalidis N. Hormonal regulation of spermatogenesis and spermiogenesis. J Steroid Biochem Mol Biol 2008; 109: 323-330.##Smith LB, Walker WH. The regulation of spermatogenesis by androgens. Semin Cell Dev Biol 2014; 30: 2-13.##Suresh S, Shanthi Santhosh Kumari S, Preethi U, Venkatalakshmi N, Karthik Ganesh M, Ganesh L, et al. Long-Term Hyperglycemic effect on rat Epididymis and Sperm. Int J Anat Sci 2011; 2: 11-17.## ##

No relationship between most polymorphisms of steroidogenic acute regulatory (StAR) gene with polycystic ovarian syndrome عدم ارتباط پلی مورفیسم های ژن StAR و بیماری پلی کیستیک تخمدان 2 1 بیماری تخمدان پلی کیستیک (PCOS) یکی از شایع ترین اختلالات اندوکرین در زنان در سنین باروری می باشد. در این بیماری افزایش آندروژن می تواند منجر به نقص در فرآیند استروئید سازی شود و به عنوان یک نقش اساسی در اتیولوژی PCOS به شمار آید. در طی فرآیند استرویید سازی به نظر می رسد که ژن StAR باعث افزایش انتقال کلسترول از طریق غشای میتوکندری می گردد، بنابراین پلی مورفیسم های این ژن می توانند روی پروتیین آن و در نهایت بر روی اتیولوژی PCOS موثر واقع شوند. هدف: ارتباط بین 7 پلی مورفیسم شایع ژن steroidogenic acute regulatory protein )StAR( که شامل پلی موذفیسم های تک نوکلئوتیدی (SNPs) با کدrs104894086, rs104894089, rs104894090, rs137852689 ,rs10489487, rs104894085 می باشد، در بیماری تخمدان پلی کیستیک مورد بررسی قرار گرفت. مواد و روشها: در این مطالعه مورد شاهدی 45 زن مبتلا به PCOS به عنوان گروه بیمار، 40 زن بارور و 40 زن نابارور (male factor) به عنوان گروه کنترل انتخاب گردیدند سپس SNP انتخاب شده با استفاده از روش RFLP-PCR مورد بررسی قرار گرفتند. نتایج: در این مطالعه ژنوتیپ هتروزیگوت در SNP با کد , rs13785268 در 7 مورد از بیماران PCOS، 1 مورد در گروه زنان بارور و 5 مورد در گروه male factor مشاهده شد. اما از نظر آماری ارتباط معنا داری بین SNP ذکر شده و همچنین SNP های انتخاب شده و بیماری PCOS مشاهده نگردید. نتیجه گیری: نتایج RFLP هفت SNP مورد بررسی که در اگزون های شماره 5 و 7 ژن StAR قرار دارند وضعیت نرمالی را در هر سه گروه مورد مطالعه نشان داده است. به عبارت دیگر هیچ گونه تغییر ژنوتیپی هتروزیگوت یا هموزیگوت در نمونه های مورد بررسی مشاهده نگردید.   2 Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine women’s disorders in reproductive age. Hyperandrogenism has a critical role in the etiology of PCOS and it can cause fault in Steroidogenesis process. During steroidogenesis, steroidogenic acute regulatory protein (StAR) seems to increase the delivery of cholesterol through mitochondrial membrane. Therefore, polymorphisms of StAR might effect on this protein and play a role in the etiology of PCOS. Objective: The aim of this study was to investigate the association between StAR SNPs with PCOS. Thus, seven polymorphisms in this gene: rs104894086, rs104894089, rs104894090, rs137852689, rs10489487, rs104894085 were detected. Materials and Methods: In this case control study, 45 PCOS women, 40 male factor/unexplained infertile women, and 40 fertile women as two control groups were participated from 2008-2012. Polymorphisms were detected using restriction fragment length polymorphism (PCR-RFLP) method. Results: Heterozygote genotyping for rs137852689 SNP (amino acid 218 C > T) was only seen in seven PCOS patients, one in normal ovulatory women, and five in male factor/unexplained infertile women (15.5%, 2.5%, 12.5%, respectively) (p= 0.12). While, it has shown no association between other SNPS with PCOs. Conclusion: The RFLP results for seven chosen SNPs, which located in exon 5 and 7 showed normal status in three groups, it means no heterozygous or homozygous forms of selected SNPs were observed. So, it seems evaluation of the active amino acid sites should be investigated and also the study population should be increased. 771 778 2017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/42017/10/42017/10/4 1396/7/12 آزاده سادات ناظوری Azadeh-Sadat Nazouri Department of Biology, Sciences Faculty, Shahid Beheshti University, Tehran, Iran ایران مونا خسروی فر Mona Khosravifar Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran ایران علی اصغر اخلاقی Ali-Asghar Akhlaghi Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran ایران مرضیه شیوا Marzieh Shiva Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran ایران پروانه افشاریان Parvaneh Afsharian Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran ایران pafshar@royaninstitute.org Polycystic ovary syndrome Steroidogenic acute regulatory (StAR) gene Single nucleotide polymorphism سندروم تخمدان پلی کیستیک ژن StAR پلی مورفیسم تک نوکلئوییدی. Rotterdam ESHRE/ASRM- Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19: 41-47.##Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria: Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG 2006; 113: 1210-1217.##Overbeek A, Lambalk CB. Phenotypic and pharmacogenetic aspects of ovulation induction in WHO II anovulatory women. Gynecol Endocrinol 2009; 25: 222-234.##Mukherjee S, Maitra A. Molecular & genetic factors contributing to insulin resistance in polycystic ovary syndrome. Indian J Med Res 2010; 131: 743-760.##Sander VA, Hapon MB, Sicaro L, Lombardi EP, Jahn GA, Motta AB. Alterations of folliculogenesis in women with polycystic ovary syndrome. J Steroid Biochem Mol Biol 2011; 124: 58-64.##Kahsar-Miller MD, Conway-Myers BA, Boots LR, Azziz R. Steroidogenic acute regulatory protein (StAR) in the ovaries of healthy women and those with polycystic ovary syndrome. Am J Obstet Gynecol 2001; 185: 1381-1387.##Barbar E, Lehoux JG, Lavigne P. Toward the NMR structure of StAR. Mol Cell Endocrinol 2009; 300: 89-93.##Miller WL. Steroidogenic acute regulatory protein (StAR), a novel mitochondrial cholesterol transporter. Biochim Biophys Acta 2007; 6: 663-676.##Stocco DM. The role of the StAR protein in steroidogenesis: challenges for the future. J Endocrinol 2000; 167: 247-253.##Pol LA, Hartigan JA, Orme-Johnson NR. Acute ACTH regulation of adrenal corticosteroid biosynthesis.Rapid accumulation of a phosphoprotein. J Biolo Chem 1986; 2: 13309-13316.##Roostaee A, Barbar E, Lehoux JG, Lavigne P. Cholesterol binding is a prerequisite for the activity of the steroidogenic acute regulatory protein (StAR). Biochem J 2008; 412: 553-562.##Strauss JF, kishida T, Christenson LK, Fujimoto T,Hiroi H. START domain protein and the intracellular trafficking of cholesterol in steroidogenic cells.Mol Cell Endocrinol 2003; 202: 59-65.##Jehaimi CT, Araiza VC, Batish SD, Brosnan PG. Polycystic ovaries and adrenal insufficiency in a young pubescent female with lipoid congenital adrenal hyperplasia due to splice mutation of the StAR gene: a case report and review of the literature. J Pediatr Endocrinol Metab 2010; 23: 1225-1231.##NCBI. National center for biotechnology information. "StAR SNP". http://www.ncbi.nlm.nih.gov/snp.##Christenson L k, Strauss J F. Steroidogenic Acute Regulatory Protein: An Update on Its Regulation and Mechanism of Action. Arch Med Res 2001; 32: 576-586.##Miller WL. StAR Search-What We Know about How the Steroidogenic Acute Regulatory Protein Mediates Mitochondrial Cholesterol Import. Mol Endocrinol 2007; 21: 589-601.##Strauss JF. Some new thoughts on the pathophysiology and genetics of polycystic ovary syndrome. Ann N Y Acad Sci 2003; 997: 42-48.##Yanxi N, Qianming B, Hong L, Xiabo L, William k.P, Fengdi Z, et al.Overexpression of mitochondrial cholesterol delivery protein, StAR, decreases intracellular lipids and inflammatory factors secretion in macrophages. Atherosclerosis 2009; 204: 114-120.##Jakubowski L. Genetic aspects of polycystic ovary syndrome. Endokrynol Pol 2005; 56: 285-293.##Sun SJ, Hsiao KH, Hsu CC, Wu MH, Tsai SJ. Transactivation of steroidogenic acute regulatory protein in human endometriotic stromalcells is mediated by the prostaglandin EP2 receptor. Endocrinology 2003; 144: 3934-3942.##He C, Kraft P, Chen C, Buring JE, Pare G, Hankinson SE, et al. Genome-wide associa tion studies identify loci associated with age at menarche and age at natural menopause. Nat Genet 2009; 41: 724-728.##Terry K, McGrath M, Lee IM, Buring J, De Vivo I. Genetic variation in CYP11A1 and StAR in relation to endometrial cancer risk. Gynecol Oncol 2010; 117: 255-259.##Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012; 97: 28-38.##Rotterdam ESHRE/ASRM- Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19: 41-47.##Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria: Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG 2006; 113: 1210-1217.##Overbeek A, Lambalk CB. Phenotypic and pharmacogenetic aspects of ovulation induction in WHO II anovulatory women. Gynecol Endocrinol 2009; 25: 222-234.##Mukherjee S, Maitra A. Molecular & genetic factors contributing to insulin resistance in polycystic ovary syndrome. Indian J Med Res 2010; 131: 743-760.##Sander VA, Hapon MB, Sicaro L, Lombardi EP, Jahn GA, Motta AB. Alterations of folliculogenesis in women with polycystic ovary syndrome. J Steroid Biochem Mol Biol 2011; 124: 58-64.##Kahsar-Miller MD, Conway-Myers BA, Boots LR, Azziz R. Steroidogenic acute regulatory protein (StAR) in the ovaries of healthy women and those with polycystic ovary syndrome. Am J Obstet Gynecol 2001; 185: 1381-1387.##Barbar E, Lehoux JG, Lavigne P. Toward the NMR structure of StAR. Mol Cell Endocrinol 2009; 300: 89-93.##Miller WL. Steroidogenic acute regulatory protein (StAR), a novel mitochondrial cholesterol transporter. Biochim Biophys Acta 2007; 6: 663-676.##Stocco DM. The role of the StAR protein in steroidogenesis: challenges for the future. J Endocrinol 2000; 167: 247-253.##Pol LA, Hartigan JA, Orme-Johnson NR. Acute ACTH regulation of adrenal corticosteroid biosynthesis.Rapid accumulation of a phosphoprotein. J Biolo Chem 1986; 2: 13309-13316.##Roostaee A, Barbar E, Lehoux JG, Lavigne P. Cholesterol binding is a prerequisite for the activity of the steroidogenic acute regulatory protein (StAR). Biochem J 2008; 412: 553-562.##Strauss JF, kishida T, Christenson LK, Fujimoto T,Hiroi H. START domain protein and the intracellular trafficking of cholesterol in steroidogenic cells.Mol Cell Endocrinol 2003; 202: 59-65.##Jehaimi CT, Araiza VC, Batish SD, Brosnan PG. Polycystic ovaries and adrenal insufficiency in a young pubescent female with lipoid congenital adrenal hyperplasia due to splice mutation of the StAR gene: a case report and review of the literature. J Pediatr Endocrinol Metab 2010; 23: 1225-1231.##NCBI. National center for biotechnology information. "StAR SNP". http://www.ncbi.nlm.nih.gov/snp.##Christenson L k, Strauss J F. Steroidogenic Acute Regulatory Protein: An Update on Its Regulation and Mechanism of Action. Arch Med Res 2001; 32: 576-586.##Miller WL. StAR Search-What We Know about How the Steroidogenic Acute Regulatory Protein Mediates Mitochondrial Cholesterol Import. Mol Endocrinol 2007; 21: 589-601.##Strauss JF. Some new thoughts on the pathophysiology and genetics of polycystic ovary syndrome. Ann N Y Acad Sci 2003; 997: 42-48.##Yanxi N, Qianming B, Hong L, Xiabo L, William k.P, Fengdi Z, et al.Overexpression of mitochondrial cholesterol delivery protein, StAR, decreases intracellular lipids and inflammatory factors secretion in macrophages. Atherosclerosis 2009; 204: 114-120.##Jakubowski L. Genetic aspects of polycystic ovary syndrome. Endokrynol Pol 2005; 56: 285-293.##Sun SJ, Hsiao KH, Hsu CC, Wu MH, Tsai SJ. Transactivation of steroidogenic acute regulatory protein in human endometriotic stromalcells is mediated by the prostaglandin EP2 receptor. Endocrinology 2003; 144: 3934-3942.##He C, Kraft P, Chen C, Buring JE, Pare G, Hankinson SE, et al. Genome-wide associa tion studies identify loci associated with age at menarche and age at natural menopause. Nat Genet 2009; 41: 724-728.##Terry K, McGrath M, Lee IM, Buring J, De Vivo I. Genetic variation in CYP11A1 and StAR in relation to endometrial cancer risk. Gynecol Oncol 2010; 117: 255-259.##Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012; 97: 28-38.## ##

Effect of supraphysiological dose of Nandrolone Decanoate on the testis and testosterone concentration in mature and immature male rats: A time course study بررسی اثرات دوزهای فیزیولوژیکی ناندرولون دکانوئات بر روی بیضه و غلظت تستوسترون در موش های صحرایی بالغ و نابالغ: مطالعه در یک دوره زمانی 2 1 زمینه: مطالعات زیادی بر روی سوء مصرف استروئیدهای آندوژنی آنابولیک بر روی افراد بالغ انجام شده است اما داده های اندکی برای افراد نابالغ وجود دارد. هدف: این مطالعه با هدف ارزیابی اثر ناندرولون دکانوئات بر روی بیضه و غلظت تستوسترون در موش های صحرایی نابالغ در مقایسه با موش های بالغ در کوتاه مدت و بلند مدت انجام پذیرفت. مواد و روش ها: چهل سر موش صحرایی بالغ به 4 گروه تقسیم شدند: گروه A (زمان کوتاه)، گروه B (گروه زمان بلند)؛ به ترتیب برای مدت 35 و 70 روز، 10 میلی گرم به ازای هر کیلوگرم وزن بدن در روز ناندرولون دکانوئات به صورت داخل صفاقی دریافت کردند. گروه C (گروه کنترل) بود و گروه D (گروه شم)؛ دی متیل سولفوکسید را در دو دوره 35 و 70 روزه دریافت کردند. 40 سر موش صحرایی نابالغ هم مانند گروه های بالغ تقسیم شدند. پس از جراحی، وزن بدن، اندازه بیضه، هیستومورفومتری بیضه و سطح سرم تستوسترون ارزیابی شد. نتایج: این مطالعه نشان داد که ناندرولون دکانوئات سلول های لیدیگ را در موش های صحرایی بالغ در گروه( B (39.9 ± .919، گروه (A(43.4 ± .120 و بلند مدت (40.6 ± .299) کاهش می دهد که می تواند غلظت تستوسترون را در همه گروه ها به جز گروه کوتاه مدت موش های بالغ به طور معنی داری کاهش دهد. تعداد سلول های سرتولی، اندازه بیضه و قطر لوله های اسپرم ساز را در گروه نابالغ بلند مدت کاهش یافت. در نهایت تعداد اسپرم در گروه های بالغ و نابالغ کاهش یافت اما کاهش شدید اسپرم در هر دو گروه بالغ و نابالغ در بلند مدت (36.05 ± 2.15) در مقایسه با گروه کنترل بود(53.9 ± 1.716) (p<0.05). نتیجه گیری: این مطالعه نشان داد که دوزهای فیزیولوژیکی ناندرولون دکانوئات ممکن است بر روی سلول های لیدیگ، اسپرم و غلظت تستوسترون در موش های بالغ و نابالغ اثر منفی داشته باشد. اگرچه تعداد سلول های سرتولی، اندازه بیضه و قطر لوله ها تنها در موش های نابالغ بلند مدت کاهش یافت.   2 Background: Most studies on anabolic-androgenic steroids abuse have been done in adult rats, but few data are available to immature. Objective: This study was conducted to assay the effect of Nandrolone Decanoate (ND) on the testis and testosterone concentration in male immature rats compare with mature ones in short and long time. Materials and Methods: 40 mature rats were divided into 4 groups: group A (short term) and group B (long-term) received 10 mg/kg/day ND interaperitoneally for 35 and 70 days, respectively. Group C (control) without any treatment, and group D (vehicle) received dimethyl sulfoxide (DMSO) solution in two periods 35 and 70 days. 40 immature rats were divided into 4 groups same as mature ones. After surgery body weight, testis size, histomorphometry of testis, and serum testosterone level were evaluated. Results: Our results showed that ND decreased the number of Leydig cells in group B (39.9 ±. 919), group A (43.4 ±. 120), and long term (40.6 ±. 299) immature rats, which could result in a reduction of testosterone concentration significantly in all experimental groups except short term mature group. Number of sertoli cells, testis size, and diameter of seminiferous tubules decreased in the long-term immature group. Eventually, the number of sperm was decreased in mature and immature groups, but a severe depletion of sperm was occurred in both mature and immature in long time  in comparison to the control group  (p< 0.05). Conclusion: This time course study showed that supraphysiological dose of ND may negatively affect the number of Leydig cells, sperm cell, and testosterone concentration of immature rats in the same matter of mature rats. However, the number of sertoli cell, testis size, and seminferous diameter were decreased only in the long immature rats. 779 786 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/42017/10/42017/10/42017/10/4 1396/7/12 راحیل جنتی فر Rahil Jannatifar ACECR Center for Infertility Treatment, Qom Branch, Qom, Iran ایران سعید شکری Saeed Shokri Department of Anatomical Sciences, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran ایران احمد فرخی Ahmad Farrokhi Department of Anatomical Sciences, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran ایران رضا نجات بخش Reza Nejatbakhsh Department of Anatomical Sciences, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran ایران reza_nejat@yahoo.com Nandrolone Decanoate Testis Testosterone Mature Immature Rat ناندرولون دکانوئات بیضه تستوسترون بالغ نابالغ موش صحرایی. Lee D-M, Min T, Choi I, Cheon Y-P, Chun T, Park C-S, et al. Feeding effect of an anabolic steroid, nandrolone, on the male rat testis. Asian-Australas J Anim Sci 2010; 23: 1566-1577.##Dohle GR, Smit M, Weber RF. Androgens and male fertility. World J Urol 2003; 21: 341-345.##Naraghi MA, Abolhasani F, Kashani I, Anarkooli IJ, Hemadi M, Azami A, et al. The effects of swimming exercise and supraphysiological doses ofnandrolone decanoate on the testis in adult male rats: a transmission electron microscope study. Folia Morphol (Warsz) 2010; 69: 138-146.##Birgner C, Kindlundh-Hogberg AM, Oreland L, Alsio J, Lindblom J, Schioth HB, et al. Reduced activity of monoamine oxidase in the rat brain following repeated nandrolone decanoate administration. Brain Res 2008; 1219: 103-110.##Feinberg MJ, Lumia AR, McGinnis MY. The effect of anabolic-androgenic steroids on sexual behavior and reproductive tissues in male rats. Physiol Behav 1997; 62: 23-30.##Tan RS, Scally MC. Anabolic steroid-induced hypogonadism-towards a unified hypothesis of anabolic steroid action. Med Hypotheses 2009; 72: 723-728.##Clark AS, Harrold EV, Fast AS. Anabolic-androgenic steroid effects on the sexual behavior of intact male rats. Horm Behav 1997; 31: 35-46.##Shokri S, Hemadi M, Bayat G, Bahmanzadeh M, Jafari-Anarkooli I, Mashkani B. Combination of running exercise and high dose of anabolic androgenic steroid, nandrolonedecanoate, increases protamine deficiency and DNA damage in rat spermatozoa. Andrologia 2014; 46: 184-190.##Karila T, Hovatta O, Seppala T. Concomitant abuse of anabolic androgenic steroids and human chorionic gonadotrophin impairs spermatogenesis in power athletes. Int J Sports Med 2004; 25: 257-263.##Sato SM, Schulz KM, Sisk CL, Wood RI. Adolescents and androgens, receptors and rewards. Horm Behav 2008; 53: 647-658.##Tahtamouni L, Mustafa NH, Hassan EM, Ahmad IM, Yasin SR, Abdalla MY. Nandrolone Decanoate Administration to Male Rats Induces Oxidative Stress, Seminiferous Tubules Abnormalities, and Sperm DNA Fragmentation. JJBS 2010; 3: 165-174.##Mesbah F, Shokri S, Karbalay-Doust S, Mirkhani H. Effects of Nandrolone Decanoate on the Ultarstructure of testis inadult Male Rats. IJMS 2008; 32: 94-100.##Bremner WJ, Millar MR, Sharpe RM, Saunders PT. Immunohistochemical localization of androgen receptors in the rat testis: evidence for stage-dependent expression and regulation by androgens. Endocrinology 1994; 135: 1227-1234.##Purkayastha S, Mahanta R. Effect of NandroloneDecanoate on Serum FSH, LH and Testosterone Concentration in Male Albino Mice. WJALSS 2012; 2: 123-127.##Parrilla-Carrero J, Figueroa O, Lugo A, Garcia-Sosa R, Brito-Vargas P, Cruz B, et al. The anabolic steroids testosterone propionate and nandrolone, but not 17alpha-methyltestosterone, induce conditioned place preference in adult mice. Drug Alcohol Depend 2009; 100: 122-127.##Brower KJ, Blow FC, Young JP, Hill EM. Symptoms and correlates of anabolic-androgenic steroid dependence. Br J Addict 1991; 86: 759-768.##Moss HB, Panzak GL, Tarter RE. Sexual functioning of male anabolic steroid abusers. Arch Sex Behav 1993; 22: 1-12.##Perry PJ, Andersen KH, Yates WR. Illicit anabolic steroid use in athletes. A case series analysis. Am J Sports Med 1990; 18: 422-428.##Hall RC, Hall RC. Abuse of supraphysiologic doses of anabolic steroids. South Med J 2005; 98: 550-555.##Mirkhani H, Golbahar J, Shokri S. Chronic administration of nandrolone decanoate does not increase the plasma homocysteine level of male rats. Basic Clin Pharmacol Toxicol 2005; 97: 214-217.##Trenton AJ, Currier GW. Behavioural manifestations of anabolic steroid use. CNS Drugs 2005; 19: 571-595.##Gonzalez B, Hernando R, Manso R. Anabolic steroid and gender-dependent modulation of cytosolic HSP70s in fast- and slow-twitch skeletal muscle. J Steroid Biochem Mol Biol 2000; 74: 63-71.##Junior AA, Neto AC, Junior AS, Menezes DJ, Alves FR, Sousa AL, et al. Daily sperm production and testicular morphometry in goats according to external scrotal conformation. Anim Reprod Sci 2011; 127: 73-77.##Wilson JD. Androgen abuse by athletes. Endocr Rev 1988; 9: 181-199.##Seed J, Chapin RE, Clegg ED, Dostal LA, Foote RH, Hurtt ME, et al. Methods for assessing sperm motility, morphology, and counts in the rat, rabbit, and dog: a consensus report. ILSI Risk Science Institute Expert Working Group on Sperm Evaluation. Reprod Toxicol 1996; 10: 237-244.##Lindblom J, Kindlundh AM, Nyberg F, Bergstrom L, Wikberg JE. Anabolic androgenic steroid nandrolone decanoate reduces hypothalamic proopiomelanocortin mRNA levels. Brain Res 2003; 986: 139-147.##Carson JA, Lee WJ, McClung J, Hand GA. Steroid receptor concentration in aged rat hindlimb muscle: effect of anabolic steroid administration. J Appl Physiol 2002; 93: 242-250.##Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med 1996; 335: 1-7.##Noorafshan A, Karbalay-Doust S, Ardekani FM. High doses of nandrolone decanoate reduce volume of testis and length of seminiferous tubules in rats. APMIS 2005; 113: 122-125.##Vargas RA, Oliveira LP, Frankenfeld S, Souza DB, Costa WS, Favorito LA, et al. The prostate after administration of anabolic androgenic steroids: a morphometrical studyin rats. Int Braz J Urol 2013; 39: 675-682.##Takahashi M, Tatsugi Y, Kohno T. Endocrinological and pathological effects of anabolic-androgenic steroid in male rats. Endocr J 2004; 51: 425-434.##Vornberger W, Prins G, Musto NA, Suarez-Quian CA. Androgen receptor distribution in rat testis: new implications for androgen regulation of spermatogenesis. Endocrinology 1994; 134: 2307-2316.##Bilinska B, Hejmej A, Gancarczyk M, Sadowska J. Immunoexpression of androgen receptors in the reproductive tract of the stallion. Ann N Y Acad Sci 2005; 1040: 227-229.##Kerr JB, Donachie K, Rommerts FF. Selective destruction and regeneration of rat Leydig cells in vivo. A new method for the study of seminiferous tubular-interstitial tissue interaction. Cell Tissue Res 1985; 242: 145-156.##Shokri S, Aitken RJ, Abdolvahhabi M, Abolhasani F, Ghasemi FM, Kashani I, et al. Exercise and supraphysiological dose of nandrolone decanoate increase apoptosis in spermatogenic cells. Basic Clin Pharmacol Toxicol 2010; 106: 324-330.##Karbalay-Doust S, Noorafshan A, Ardekani FM, Mirkhani H. The reversibility of sperm quality after discontinuing nandrolone decanoate in adult male rats. Asian J Androl 2007; 9: 235-239.##Lee D-M, Min T, Choi I, Cheon Y-P, Chun T, Park C-S, et al. Feeding effect of an anabolic steroid, nandrolone, on the male rat testis. Asian-Australas J Anim Sci 2010; 23: 1566-1577.##Dohle GR, Smit M, Weber RF. Androgens and male fertility. World J Urol 2003; 21: 341-345.##Naraghi MA, Abolhasani F, Kashani I, Anarkooli IJ, Hemadi M, Azami A, et al. The effects of swimming exercise and supraphysiological doses ofnandrolone decanoate on the testis in adult male rats: a transmission electron microscope study. Folia Morphol (Warsz) 2010; 69: 138-146.##Birgner C, Kindlundh-Hogberg AM, Oreland L, Alsio J, Lindblom J, Schioth HB, et al. Reduced activity of monoamine oxidase in the rat brain following repeated nandrolone decanoate administration. Brain Res 2008; 1219: 103-110.##Feinberg MJ, Lumia AR, McGinnis MY. The effect of anabolic-androgenic steroids on sexual behavior and reproductive tissues in male rats. Physiol Behav 1997; 62: 23-30.##Tan RS, Scally MC. Anabolic steroid-induced hypogonadism-towards a unified hypothesis of anabolic steroid action. Med Hypotheses 2009; 72: 723-728.##Clark AS, Harrold EV, Fast AS. Anabolic-androgenic steroid effects on the sexual behavior of intact male rats. Horm Behav 1997; 31: 35-46.##Shokri S, Hemadi M, Bayat G, Bahmanzadeh M, Jafari-Anarkooli I, Mashkani B. Combination of running exercise and high dose of anabolic androgenic steroid, nandrolonedecanoate, increases protamine deficiency and DNA damage in rat spermatozoa. Andrologia 2014; 46: 184-190.##Karila T, Hovatta O, Seppala T. Concomitant abuse of anabolic androgenic steroids and human chorionic gonadotrophin impairs spermatogenesis in power athletes. Int J Sports Med 2004; 25: 257-263.##Sato SM, Schulz KM, Sisk CL, Wood RI. Adolescents and androgens, receptors and rewards. Horm Behav 2008; 53: 647-658.##Tahtamouni L, Mustafa NH, Hassan EM, Ahmad IM, Yasin SR, Abdalla MY. Nandrolone Decanoate Administration to Male Rats Induces Oxidative Stress, Seminiferous Tubules Abnormalities, and Sperm DNA Fragmentation. JJBS 2010; 3: 165-174.##Mesbah F, Shokri S, Karbalay-Doust S, Mirkhani H. Effects of Nandrolone Decanoate on the Ultarstructure of testis inadult Male Rats. IJMS 2008; 32: 94-100.##Bremner WJ, Millar MR, Sharpe RM, Saunders PT. Immunohistochemical localization of androgen receptors in the rat testis: evidence for stage-dependent expression and regulation by androgens. Endocrinology 1994; 135: 1227-1234.##Purkayastha S, Mahanta R. Effect of NandroloneDecanoate on Serum FSH, LH and Testosterone Concentration in Male Albino Mice. WJALSS 2012; 2: 123-127.##Parrilla-Carrero J, Figueroa O, Lugo A, Garcia-Sosa R, Brito-Vargas P, Cruz B, et al. The anabolic steroids testosterone propionate and nandrolone, but not 17alpha-methyltestosterone, induce conditioned place preference in adult mice. Drug Alcohol Depend 2009; 100: 122-127.##Brower KJ, Blow FC, Young JP, Hill EM. Symptoms and correlates of anabolic-androgenic steroid dependence. Br J Addict 1991; 86: 759-768.##Moss HB, Panzak GL, Tarter RE. Sexual functioning of male anabolic steroid abusers. Arch Sex Behav 1993; 22: 1-12.##Perry PJ, Andersen KH, Yates WR. Illicit anabolic steroid use in athletes. A case series analysis. Am J Sports Med 1990; 18: 422-428.##Hall RC, Hall RC. Abuse of supraphysiologic doses of anabolic steroids. South Med J 2005; 98: 550-555.##Mirkhani H, Golbahar J, Shokri S. Chronic administration of nandrolone decanoate does not increase the plasma homocysteine level of male rats. Basic Clin Pharmacol Toxicol 2005; 97: 214-217.##Trenton AJ, Currier GW. Behavioural manifestations of anabolic steroid use. CNS Drugs 2005; 19: 571-595.##Gonzalez B, Hernando R, Manso R. Anabolic steroid and gender-dependent modulation of cytosolic HSP70s in fast- and slow-twitch skeletal muscle. J Steroid Biochem Mol Biol 2000; 74: 63-71.##Junior AA, Neto AC, Junior AS, Menezes DJ, Alves FR, Sousa AL, et al. Daily sperm production and testicular morphometry in goats according to external scrotal conformation. Anim Reprod Sci 2011; 127: 73-77.##Wilson JD. Androgen abuse by athletes. Endocr Rev 1988; 9: 181-199.##Seed J, Chapin RE, Clegg ED, Dostal LA, Foote RH, Hurtt ME, et al. Methods for assessing sperm motility, morphology, and counts in the rat, rabbit, and dog: a consensus report. ILSI Risk Science Institute Expert Working Group on Sperm Evaluation. Reprod Toxicol 1996; 10: 237-244.##Lindblom J, Kindlundh AM, Nyberg F, Bergstrom L, Wikberg JE. Anabolic androgenic steroid nandrolone decanoate reduces hypothalamic proopiomelanocortin mRNA levels. Brain Res 2003; 986: 139-147.##Carson JA, Lee WJ, McClung J, Hand GA. Steroid receptor concentration in aged rat hindlimb muscle: effect of anabolic steroid administration. J Appl Physiol 2002; 93: 242-250.##Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med 1996; 335: 1-7.##Noorafshan A, Karbalay-Doust S, Ardekani FM. High doses of nandrolone decanoate reduce volume of testis and length of seminiferous tubules in rats. APMIS 2005; 113: 122-125.##Vargas RA, Oliveira LP, Frankenfeld S, Souza DB, Costa WS, Favorito LA, et al. The prostate after administration of anabolic androgenic steroids: a morphometrical studyin rats. Int Braz J Urol 2013; 39: 675-682.##Takahashi M, Tatsugi Y, Kohno T. Endocrinological and pathological effects of anabolic-androgenic steroid in male rats. Endocr J 2004; 51: 425-434.##Vornberger W, Prins G, Musto NA, Suarez-Quian CA. Androgen receptor distribution in rat testis: new implications for androgen regulation of spermatogenesis. Endocrinology 1994; 134: 2307-2316.##Bilinska B, Hejmej A, Gancarczyk M, Sadowska J. Immunoexpression of androgen receptors in the reproductive tract of the stallion. Ann N Y Acad Sci 2005; 1040: 227-229.##Kerr JB, Donachie K, Rommerts FF. Selective destruction and regeneration of rat Leydig cells in vivo. A new method for the study of seminiferous tubular-interstitial tissue interaction. Cell Tissue Res 1985; 242: 145-156.##Shokri S, Aitken RJ, Abdolvahhabi M, Abolhasani F, Ghasemi FM, Kashani I, et al. Exercise and supraphysiological dose of nandrolone decanoate increase apoptosis in spermatogenic cells. Basic Clin Pharmacol Toxicol 2010; 106: 324-330.##Karbalay-Doust S, Noorafshan A, Ardekani FM, Mirkhani H. The reversibility of sperm quality after discontinuing nandrolone decanoate in adult male rats. Asian J Androl 2007; 9: 235-239.## ##

Serum levels of lycopene, beta-carotene, and retinol and their correlation with sperm DNA damage in normospermic and infertile men عنوان:مطالعه سطوح سرمی لیکوپن، بتا کاروتن و رتینول و ارتباط آنها با آسیب DNA اسپرم در مردان نرمو اسپرمیک و نابارور 2 1 مقدمه: استرس اکسیداتیو در سیستم تولید مثل به آسیب DNA اسپرم و پراکسیداسیون لیپید های غشاء اسپرم منتهی می شود و ممکن است در پاتوژنز ناباروری مردان بخصوص موارد ایدوپاتیک نقش مهمی داشته باشد. آنتی اکسیدان ها مثل کاروتنوئید ها در مقابل آسیب رادیکال های آزاد عمل می کنند. هدف :هدف از انجام این مطالعه تعیین سطوح سرمی لیکوپن، بتا کاروتن و رتینول و ارتباط آنها با آسیب DNA اسپرم و پراکسیداسیون لیپید های غشاء اسپرم در مردان نرمو اسپرم و نابارور بود. مواد و روش ها: شصت و دو مرد نابارور و 71 مرد نرمواسپرمیک در این مطالعه شرکت نمودند. از همه این افراد نمونه خون و سمن تهیه شد. آسیب DNA با روش TUNEL اندازه گیری شد. غلظت سرمی لیکوپن، بتاکاروتن و رتینول با HPLC تعیین شد. نتایج: فراگمنتیشن DNA در مردان نابارور در مقایسه با گروه کنترل بالاتر بود. سطوح سرمی لیکوپن، بتا کاروتن و ویتامین  Aدر مردان نابارور بطور معنی داری کمتر از افراد نرمواسپرمیک بود ( مقدار p به ترتیب کمتر از 0.001 ، برابر با 0.005 و برابر با 0.003 ). نتیجه گیری: نتیجه گرفته شد که لیکوپن، بتا کاروتن و رتینول می توانند فرگمنتیشن  DNAو پراکسیداسیون لیپید ها را از طریق خاصیت آنتی اکسیدانی مهار کنند. بنابر این تعیین فرگمنتیشن DNA و اندازه گیری ترکیباتی مثل لیکوپن، بتا کاروتن و رتینول همراه با آنالیز اسپرم می تواند در تشخیص و درمان موارد ناباروری ایدویوپاتیک مفید باشد. 2 Background: Oxidative stress in reproductive system leads to sperm DNA damage and sperm membrane lipid peroxidation and may play an important role in the pathogenesis of male infertility, especially in idiopathic cases. Antioxidants such as carotenoids function against free radical damages. Objective : The aim of this study was to determine the levels of lycopene, beta-carotene and retinol in serum and their relationship with sperm DNA damage and lipid peroxidation in infertile and normospermic males. Materials and Methods: Sixty two infertile men and 71 normospermic men participated in this study. Blood and semen samples were collected from all subjects. Sperm DNA damage was measured using TUNEL method. Carotenoids, retinol, and malonedildehyde in serum were also determined. Results: DNA fragmentation was higher in infertile group comparing to control group. Serum levels of lycopene, beta-carotene and, vitamin A in infertile men were significantly lower than normospermic men (p< 0.001, =0.005, and =0.003 respectively). While serum MDA was not significantly different between two groups, MDA in seminal plasma of infertile men was significantly higher than control group (p< 0.001). Conclusion: We concluded that lycopene, beta-carotene, and retinol can reduce sperm DNA fragmentation and lipid peroxidation through their antioxidant effect. Therefore the DNA fragmentation assay and determination of antioxidants factors such as lycopene, beta-carotene and retinol, along with sperm analysis can be useful in diagnosis and treatment of men with idiopathic infertility. 787 792 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/42017/10/42017/10/42017/10/42017/10/4 1396/7/12 طیبه قیاسوند Taiebeh Ghyasvand Department of Clinical Biochemistry, Hamadan University of Medical Sciences, Hamadan, Iran ایران محمدتقی گودرزی Mohammad Taghi Goodarzi Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran ایران mt.goodarzi@umsha.ac.ir Iraj Amiri Iraj Amiri Endometer and Endometriosis Centre, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran ایران جمشید کریمی Jamshid Karimi Department of Clinical Biochemistry, Hamadan University of Medical Sciences, Hamadan, Iran ایران مرضیه قربانی Marzieh Ghorbani Endometer and Endometriosis Centre, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran ایران Infertility Lycopene Beta- carotene Retinol DNA damage Lipid peroxidation Malondialdehyde ناباروری لیکوپن بتا کاروتن رتینول آسیب DNA پراکسیداسیون لیپید مالون دی آلدئید. Ko EY, Siddiqi K, Brannigan RE, Sabanegh ES Jr. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol 2012; 187: 973-978.##Kessopoulou E, Tomlinson MJ, Barratt CL, Bolton AE, Cooke ID. Origin of reactive oxygen species in human semen: spermatozoa or leucocytes? J Reprod Fertil 1992; 94: 463-470.##Agarwal A, Saleh RA. Role of oxidants in male infertility: rationale, significance, and treatment. Urol Clin North Am 2002; 29: 817–827.##de Lamirande E, Jiang H, Zini A, Kodama H, Gagnon C. Reactive oxygen species and sperm physiology. Rev Reprod 1997; 2: 48-54.##Aitken J, Krausz C, Buckingham D. Relationships between biochemical markers for residual sperm cytoplasm, reactive oxygen species generation, and the presence of leukocytes and precursor germ cells in human sperm suspensions. Mol Reprod Dev 1994; 39: 268–279.##Cooke MS, Evans MD, Dizdaroglu M, Lunec J. Oxidative DNA damage: mechanisms, mutation, and disease. FASEB J 2003; 17: 1195-1214.##Twigg J, Irvine DS, Houston P, Fulton N, Michael L, Aitken RJ. Iatrogenic DNA damage induced in human spermatozoa during sperm preparation: Protective significance of seminal plasma. Mol Hum Reprod 1998; 4: 439–445.##Kamiya, H. Mutagenic potentials of damaged nucleic acids produced by reactive oxygen/nitrogen species: approaches using synthetic oligonucleotides and nucleotides: survey and summary. Nucleic Acids Res 2003; 31: 517-531.##Johnson EJ. The role of carotenoids in human health. Nutr Clin Care 2002; 5: 56-65.##Agarwal S, Rao AV. Carotenoids and chronic diseases. Drug Metabol Drug Interact 2000; 17: 189–210.##Elliott R. Mechanisms of genomic and non-genomic actions of carotenoids. Biochim Biophys Acta 2005; 1740: 147–154.##Ribaya-Mercado JD, Blumberg JB. Lutein and zeaxanthin and their potential roles in disease prevention. J Am Coll Nutr 2004; 23: 567S–587S.##Arab L, Steck S. lycopene and cardiovascular disease. Am J Clin Nutr 2000; 71: 1691s-1695s.##Boileau AC, Merchen NR, Wasson K, Atkinson, Erdman JW Jr. Cis-lycopene is more bioavailable than trans-lycopene in vitro and in vivo in lymph-cannulated ferrets. J Nutr 1999; 129: 1176-1181.##Hogarth CA, Griswold MD. The key role of vitamin A in spermatogenesis. J Clin Invest 2010; 120: 956–962.##Dandekar SP, Nadkarni GD, Kulkarni VS, Punekar S. Lipid peroxidation and antioxidants enzymes in male infertility. J Postgrad Med 2002; 48: 186-189.##World Health Organization. WHO laboratory manual for the examination of human semen and spermcervical mucus interaction, 4th ed. New York: Cambridge University Press 1999; 218-220.##Talwara D, Ha TK, Cooneya J, Brownlee C, O'Reilly DS. A routine method for the simultaneous measurement of retinol, alpha-tocopherol and five carotenoids in human plasma by reverse phase HPLC. Clin Chim Acta 1998; 270: 85–100.##Neyestani TR, Shariatzadeh N, Gharavi A, Kalayi A, Khalaji N. Physiological dose of lycopene suppressed oxidative stress and enhanced serum levels of immunoglobin in patients with type 2 diabetes mellitus: A possible role in the prevention of long term complications. J Endocrin Invest 2007; 30: 833-838.##Mehrotra A, Katiyar DK, Agarwal A, Das V, Pant KK. Role of total antioxidant capacity and lipid peroxidation in fertile and infertile men. Biomed Res 2013; 24: 347-352.##Tavilani H, Doosti M, Saeidi H. Malondialdehyde levels in sperm and seminal plasma of asthenozoospermic and its relationship with semen parameters. Clin Chim Acta 2005; 356: 199-203.##Ben Abdallah F, Dammak L, Attia H, Hentati B, Ammar-Keskes L. Lipid Peroxidation and Antioxidant Enzyme Activities in Infertile Men: Correlation With Semen Parameter. J Clin Lab Anal 2009; 23: 99–104.##Agarwal A, Virk G, Ong C, du Plessis SS. Effect of Oxidative Stress on Male Reproduction. World J Mens Health 2014; 32: 1-17.##Alizadeh Nili H, Mozdarani H, Pellestor F. Impact of DNA damage on the frequency of sperm Chromosomal aneuploidy in normal and subfertile men. Iran Biomed J 2011; 15: 122-129.##Takeda K, Uchiyama K, Kinukawa M, Tagami T, Kaneda M, Watanabe S. Evaluation of sperm DNA damage in bulls by TUNEL assay as a parameter of semen quality. J Reprod Dev 2015; 61: 185-190.##Sharma RK, Sabanegh E, Mahfouz R. Gupta S, Thiyagarajan A, Agarwal A. TUNEL as a test for sperm DNA damage in the evaluation of male infertility. Urology 2010; 76: 1380-1386.##Sergerie M, Laforest G, Bujan L, Bissonnette F, Bleau G. Sperm DNA fragmentation: threshold value in male fertility. Hum Reprod 2005; 20: 3446-3451.##Trisini AT, Singh NP, Duty SM, Hauser R. Relationship between human semen parameters and deoxyribonucleic acid damage assessed by the neutral comet assay. Fertil Steril 2004; 82: 1623-1632.##Zini A, Bielecki R, Phang D, Zenzes MT. Correlations between two markers of sperm DNA integrity, DNA denaturation and DNA fragmentation, in fertile and infertile men. Fertil Steril 2001; 75: 674-677.##Loft S, Kold-Jensen T, Hjollund NH, Giwercman A, Gyllemborg J, Ernst E, et al. Oxidative DNA damage in human sperm influences time to pregnancy. Hum Reprod 2003; 18: 1265-1272.##Carrell DT, Liu L, Peterson CM, Jones KP, Hatasaka HH, Erickson L, et al. Sperm DNA fragmentation is increased in couples with unexplained recurrent pregnancy loss. Arch Androl 2003; 49: 49-55.##Rao AV. Processed tomato products as a source of dietary lycopene: bioavailability and antioxidant properties. Can J Diet Pract Res 2004; 65: 161–165.##Allen CM, Smith AM, Clinton SK, Schwartz SJ. Tomato consumption increases lycopene isomer concentrations in breast milk and plasma of lactating women. J Am Diet Assoc 2002; 102: 1257–1262.##Goyal A, Chopra M, Lwaleed BA, Birch B, Cooper AJ. The effects of dietary lycopene supplementation on human seminal plasma. BJU Int 2007; 99: 1456-1460.##Gupta NP, Kumar R. Lycopene therapy in idiopathic male infertility – a preliminary report. Int Urol Nephrol 2002; 34: 369–372.##Palini S, De Stefani S, Dott Benedetti S, Bulletti DC, Canestrari F. Analysis of the correlation between semen parameters and the levels of retinol, tocopherol and carotenoids in human seminal plasma and blood. Fertil Steril 2011; 96: 457.##Lewis SE. Sterling ES, Young IS, Thompson W. Comparison of individual antioxidants of sperm and seminal plasma in fertile and infertile men. Fertil Steril 1997; 67: 142-147.##Zini A, San Gabriel M, Libman J. Lycopene supplementation in vitro can protect human sperm deoxyribonucleic acid from oxidative damage. Fertil Steril 2010; 94: 1033-1036.##Ko EY, Siddiqi K, Brannigan RE, Sabanegh ES Jr. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol 2012; 187: 973-978.##Kessopoulou E, Tomlinson MJ, Barratt CL, Bolton AE, Cooke ID. Origin of reactive oxygen species in human semen: spermatozoa or leucocytes? J Reprod Fertil 1992; 94: 463-470.##Agarwal A, Saleh RA. Role of oxidants in male infertility: rationale, significance, and treatment. Urol Clin North Am 2002; 29: 817–827.##de Lamirande E, Jiang H, Zini A, Kodama H, Gagnon C. Reactive oxygen species and sperm physiology. Rev Reprod 1997; 2: 48-54.##Aitken J, Krausz C, Buckingham D. Relationships between biochemical markers for residual sperm cytoplasm, reactive oxygen species generation, and the presence of leukocytes and precursor germ cells in human sperm suspensions. Mol Reprod Dev 1994; 39: 268–279.##Cooke MS, Evans MD, Dizdaroglu M, Lunec J. Oxidative DNA damage: mechanisms, mutation, and disease. FASEB J 2003; 17: 1195-1214.##Twigg J, Irvine DS, Houston P, Fulton N, Michael L, Aitken RJ. Iatrogenic DNA damage induced in human spermatozoa during sperm preparation: Protective significance of seminal plasma. Mol Hum Reprod 1998; 4: 439–445.##Kamiya, H. Mutagenic potentials of damaged nucleic acids produced by reactive oxygen/nitrogen species: approaches using synthetic oligonucleotides and nucleotides: survey and summary. Nucleic Acids Res 2003; 31: 517-531.##Johnson EJ. The role of carotenoids in human health. Nutr Clin Care 2002; 5: 56-65.##Agarwal S, Rao AV. Carotenoids and chronic diseases. Drug Metabol Drug Interact 2000; 17: 189–210.##Elliott R. Mechanisms of genomic and non-genomic actions of carotenoids. Biochim Biophys Acta 2005; 1740: 147–154.##Ribaya-Mercado JD, Blumberg JB. Lutein and zeaxanthin and their potential roles in disease prevention. J Am Coll Nutr 2004; 23: 567S–587S.##Arab L, Steck S. lycopene and cardiovascular disease. Am J Clin Nutr 2000; 71: 1691s-1695s.##Boileau AC, Merchen NR, Wasson K, Atkinson, Erdman JW Jr. Cis-lycopene is more bioavailable than trans-lycopene in vitro and in vivo in lymph-cannulated ferrets. J Nutr 1999; 129: 1176-1181.##Hogarth CA, Griswold MD. The key role of vitamin A in spermatogenesis. J Clin Invest 2010; 120: 956–962.##Dandekar SP, Nadkarni GD, Kulkarni VS, Punekar S. Lipid peroxidation and antioxidants enzymes in male infertility. J Postgrad Med 2002; 48: 186-189.##World Health Organization. WHO laboratory manual for the examination of human semen and spermcervical mucus interaction, 4th ed. New York: Cambridge University Press 1999; 218-220.##Talwara D, Ha TK, Cooneya J, Brownlee C, O'Reilly DS. A routine method for the simultaneous measurement of retinol, alpha-tocopherol and five carotenoids in human plasma by reverse phase HPLC. Clin Chim Acta 1998; 270: 85–100.##Neyestani TR, Shariatzadeh N, Gharavi A, Kalayi A, Khalaji N. Physiological dose of lycopene suppressed oxidative stress and enhanced serum levels of immunoglobin in patients with type 2 diabetes mellitus: A possible role in the prevention of long term complications. J Endocrin Invest 2007; 30: 833-838.##Mehrotra A, Katiyar DK, Agarwal A, Das V, Pant KK. Role of total antioxidant capacity and lipid peroxidation in fertile and infertile men. Biomed Res 2013; 24: 347-352.##Tavilani H, Doosti M, Saeidi H. Malondialdehyde levels in sperm and seminal plasma of asthenozoospermic and its relationship with semen parameters. Clin Chim Acta 2005; 356: 199-203.##Ben Abdallah F, Dammak L, Attia H, Hentati B, Ammar-Keskes L. Lipid Peroxidation and Antioxidant Enzyme Activities in Infertile Men: Correlation With Semen Parameter. J Clin Lab Anal 2009; 23: 99–104.##Agarwal A, Virk G, Ong C, du Plessis SS. Effect of Oxidative Stress on Male Reproduction. World J Mens Health 2014; 32: 1-17.##Alizadeh Nili H, Mozdarani H, Pellestor F. Impact of DNA damage on the frequency of sperm Chromosomal aneuploidy in normal and subfertile men. Iran Biomed J 2011; 15: 122-129.##Takeda K, Uchiyama K, Kinukawa M, Tagami T, Kaneda M, Watanabe S. Evaluation of sperm DNA damage in bulls by TUNEL assay as a parameter of semen quality. J Reprod Dev 2015; 61: 185-190.##Sharma RK, Sabanegh E, Mahfouz R. Gupta S, Thiyagarajan A, Agarwal A. TUNEL as a test for sperm DNA damage in the evaluation of male infertility. Urology 2010; 76: 1380-1386.##Sergerie M, Laforest G, Bujan L, Bissonnette F, Bleau G. Sperm DNA fragmentation: threshold value in male fertility. Hum Reprod 2005; 20: 3446-3451.##Trisini AT, Singh NP, Duty SM, Hauser R. Relationship between human semen parameters and deoxyribonucleic acid damage assessed by the neutral comet assay. Fertil Steril 2004; 82: 1623-1632.##Zini A, Bielecki R, Phang D, Zenzes MT. Correlations between two markers of sperm DNA integrity, DNA denaturation and DNA fragmentation, in fertile and infertile men. Fertil Steril 2001; 75: 674-677.##Loft S, Kold-Jensen T, Hjollund NH, Giwercman A, Gyllemborg J, Ernst E, et al. Oxidative DNA damage in human sperm influences time to pregnancy. Hum Reprod 2003; 18: 1265-1272.##Carrell DT, Liu L, Peterson CM, Jones KP, Hatasaka HH, Erickson L, et al. Sperm DNA fragmentation is increased in couples with unexplained recurrent pregnancy loss. Arch Androl 2003; 49: 49-55.##Rao AV. Processed tomato products as a source of dietary lycopene: bioavailability and antioxidant properties. Can J Diet Pract Res 2004; 65: 161–165.##Allen CM, Smith AM, Clinton SK, Schwartz SJ. Tomato consumption increases lycopene isomer concentrations in breast milk and plasma of lactating women. J Am Diet Assoc 2002; 102: 1257–1262.##Goyal A, Chopra M, Lwaleed BA, Birch B, Cooper AJ. The effects of dietary lycopene supplementation on human seminal plasma. BJU Int 2007; 99: 1456-1460.##Gupta NP, Kumar R. Lycopene therapy in idiopathic male infertility – a preliminary report. Int Urol Nephrol 2002; 34: 369–372.##Palini S, De Stefani S, Dott Benedetti S, Bulletti DC, Canestrari F. Analysis of the correlation between semen parameters and the levels of retinol, tocopherol and carotenoids in human seminal plasma and blood. Fertil Steril 2011; 96: 457.##Lewis SE. Sterling ES, Young IS, Thompson W. Comparison of individual antioxidants of sperm and seminal plasma in fertile and infertile men. Fertil Steril 1997; 67: 142-147.##Zini A, San Gabriel M, Libman J. Lycopene supplementation in vitro can protect human sperm deoxyribonucleic acid from oxidative damage. Fertil Steril 2010; 94: 1033-1036.## ##

Association of vitamin D receptor gene variants with polycystic ovary syndrome: A case control study ارتباط بین پلی مورفیسم های ژن گیرنده ویتامین D با سندرم تخمدان پلی سیستیسک: یک مطالعه مورد-شاهدی 2 1 مقدمه: ویتامین D و انسولین نقش مهمی در استعداد ابتلا به سندرم تخمدان پلی سیستیسک (PCOS) دارند و بنابراین پلی مورفیسم های ژنهای گیرنده ویتامین D (VDR)، هورمون پاراتیرویید (PTH) و گیرنده انسولین (INSR) ممکن است که در این سندرم نقش داشته باشند. هدف: این مطالعه به منظور بررسی ارتباط احتمالی بین پلی مورفیسم های ژنهای VDR ،PTH و INSR با استعداد ابتلا به PCOS طراحی شد. مواد و روش ها: پلی مورفیسم های ژنهای VDR ،PTH و INSR با استفاده از تکنیک PCR-RFLP در 35 بیمار مبتلا به PCOS و 35 فرد سالم کنترل تعیین ژنوتیپ شدند. ضمنا سطح سرمی گلوکز و انسولین نیز اندازه گیری شد. نتایج: اختلاف معنی داری بین بیماران مبتلا به PCOS و افراد کنترل از نظر پلی مورفیسم های FokI ،Tru9I و TaqI از ژن VDR و پلی مورفیسم DraII از ژن PTH و پلی مورفیسم های NSiI، و PmlI از ژن INSR یافت نشد. ولی پس از ادجاستمنت برای فاکتورهای اخلال گر ژنوتیپ Bb از پلی مورفیسم BsmI ژن VDR و ژنوتیپ Aa از پلی مورفیسم ApaI ژن VDR کمتر در بیماران مشاهده شدند (به ترتیب (p= 0.016; OR= 0.250; 95% CI= 0.081-0.769 و p= 0.017; OR= 0.260; 95% CI= 0.086-0.788). ضمنا در بیماران مبتلا به PCOS سطح سرمی انسولین در افراد با ژنوتیپ NN در مقایسه با افراد با ژنوتیپ Nn+nn از پلی مورفیسم NSiI ژن INSR پایین تر بود. نتیجه گیری: نتایج این مطالعه نوعی ارتباط بین پلی مورفیسم های BsmI و ApaI از ژن VDR با استعداد ابتلا به PCOS را نشان می دهند. این مطالعه همچنین نشان داد که پلی مورفیسم NSiI ژن INSR نوعی مارکر برای سطح انسولین سرمی در بیماران مبتلا به PCOS می باشد.   2 Background: Vitamin D and insulin play an important role in susceptibility to polycystic ovary syndrome (PCOS), and therefore vitamin D receptor (VDR), parathyroid hormone (PTH), and insulin receptor (INSR) gene variants might be involved in the pathogenesis of PCOS. Objective: The present study was designed to investigate the possible associations between polymorphisms in VDR, PTH, and INSR genes and the risk of PCOS. Materials and Methods: VDR, PTH, and INSR gene variants were genotyped in 35 women with PCOS and 35 controls using Polymerase chain reaction – Restriction fragment length polymorphism method. Furthermore, serum levels of glucose and insulin were measured in all participants. Results: No significant differences were observed for the VDR FokI, VDR Tru9I, VDR TaqI, PTH DraII, INSR NsiI, and INSR PmlI gene polymorphisms between the women with PCOS and controls. However, after adjustment for confounding factors, the VDR BsmI “Bb” genotype and the VDR ApaI "Aa" genotype were significantly under transmitted to the patients (p= 0.016; OR= 0.250; 95% CI= 0.081-0.769, and p= 0.017; OR= 0.260; 95% CI= 0.086-0.788, respectively). Furthermore, in the women with PCOS, insulin levels were lower in the participants with the INSR NsiI "NN" genotype compared with those with the "Nn + nn" genotypes (P= 0.045). Conclusion: The results showed an association between the VDR gene BsmI and ApaI polymorphisms and PCOS risk. These data also indicated that the INSR "NN" genotype was a marker of decreased insulin in women with PCOS. Our findings, however, do not lend support to the hypothesis that PTH gene DraII variant plays a role in susceptibility to PCOS. 793 800 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/42017/10/42017/10/42017/10/42017/10/42017/10/4 1396/7/12 تورج محمودی Touraj Mahmoudi Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران mahmouditouraj@gmail.com کیوان مجید زاده Keivan Majidzadeh Cancer Genetics Department, Breast Cancer Research Center (BCRC), ACECR, Tehran, Iran ایران حمید فراهانی Hamid Farahani Department of Physiology, School of Medicine, Qom University of Medical Sciences, Qom, Iran ایران مژگان میراخورلی Mojgan Mirakhorli Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران رضا دبیری Reza Dabiri Internal Medicine Department, Semnan University of Medical Sciences, Semnan, Iran ایران حسین نوبخت Hossein Nobakht Internal Medicine Department, Semnan University of Medical Sciences, Semnan, Iran ایران اسداله اسدی Asadollah Asadi Department of Biology, Faculty of Science, University of Mohaghegh Ardabili, Ardabil, Iran ایران Insulin Insulin receptor Polycystic ovary syndrome Vitamin D receptor انسولین گیرنده انسولین سندرم تخمدان پلی سیستیسک گیرنده ویتامین D. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004; 89: 2745-2749.##Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update 2010; 16: 347-363.##Kurabayashi T, Yahata T, Quan J, Tanaka K. Association of polymorphisms in the beta2 and beta3 adrenoceptor gene with polycystic ovary syndrome. J Reprod Med 2006; 51: 389-393.##Cankaya S, Demir B, Aksakal SE, Dilbaz B, Demirtas C, Goktolga U. Insulin resistance and its relationship with high molecular weight adiponectin in adolescents with polycystic ovary syndrome and a maternal history of polycystic ovary syndrome. Fertil Steril 2014; 102: 826-830.##Panidis D, Balaris C, Farmakiotis D, Rousso D, Kourtis A, Balaris V, et al. Serum parathyroid hormone concentrations are increased in women with polycystic ovary syndrome. Clin Chem 2005; 51: 1691-1697.##Hahn S, Haselhorst U, Tan S, Quadbeck B, Schmidt M, Roesler S, et al. Low serum 25-hydroxyvitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome. Exp Clin Endocr Diab 2006; 114: 577-583.##Mahmoudi T, Gourabi H, Ashrafi M, Yazdi RS, Ezabadi Z. Calciotropic hormones, insulin resistance and the polycystic vary syndrome. Fertil Steril 2010; 93: 1208-1214.##Grundberg E, Brandstrom H, Ribom EL, Ljunggren O, Mallmin H, Kindmark A. Genetic variation in the human vitamin D receptor is associated with muscle strength, fat mass and body weight in Swedish women. Eur J Endocrinol 2004; 150: 323-328.##Wehr E, Trummer O, Giuliani A, Gruber H, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol 2011; 164: 741-749.##Ranjzad F, Mahban A, Irani Shemirani A, Mahmoudi T, Vahedi M, Nikzamir A, et al. Influence of gene variants related to calcium homeostasis on biochemical parameters of women with polycystic ovary syndrome. J Assist Reprod Genet 2011; 28: 225-232.##Zofkova II, Zajickova K, Hill M. Serum parathyroid hormone levels are associated with FokI polymorphism of the vitamin D receptor gene in untreated postmenopausal women. Eur J Intern Med 2003; 14: 232-236.##Lin MW, Tsai SJ, Chou PY, Huang MF, Sun HS, Wu MH. Vitamin D receptor 1a promotor -1521 G/C and -1012 A/G polymorphisms in polycystic ovary syndrome. Taiwan J Obstet Gynecol 2012; 51: 565-571.##Mahmoudi T. Genetic variation in the vitamin D receptor and polycystic ovary syndrome risk. Fertil Steril 2009; 92: 1381-1383.##Gohda T, Shou I, Fukui M, Funabiki K, Horikoshi S, Shirato I, et al. Parathyroid hormonr gene polymorphism and secondary hyperparathyroidism in hemodialysis patients. Am J Kidney Dis 2002; 39: 1255-1260.##Goodarzi MO, Louwers YV, Taylor KD, Jones MR, Cui J, Kwon S, et al. Replication of association of a novel insulin receptor gene polymorphism with polycystic ovary syndrome. Fertil Steril 2011; 95: 1736-1741.##Lee EJ, Yoo KJ, Kim SJ, Lee SH, Chan KY, Baek KH. Single nucleotide polymorphism in exon 17 of the insulin receptor gene is not associated with polycystic ovary syndrome in a Korean population. Fertil Steril 2006; 86: 380-384.##Ranjzad F, Mahmoudi T, Irani Shemirani A, Mahban A, Vahedi M, Ashrafi M, et al. A common variant in the adiponectin gene and polycystic ovary syndrome risk. Mol Biol Rep 2012; 39: 2313-2319.##Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961; 21: 1440–1447.##Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Meriiam GR, Ed., Polycystic ovary syndrome. In: Hershman SM, Series Ed., Current Issues in Endocrinology and Metabolism. Blackwell, Boston, MA, USA, 1992; 377-384.##Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419.##Flores-Martínez SE, Islas-Andrade S, Machorro-Lazo MV. DNA polymorphism analysis of candidate genes for type 2 diabetes mellitus in a Mexican ethnic group. Ann Genet 2004; 47: 339-348.##Urbanek M, Legro RS, Driscoll D, Strauss JF, Dunaif A, Spielman RS. Searching for the polycystic ovary syndrome genes. J Pediatr Endocrinol Metab 2000; 13: 1311-1313.##Mukherjee S, Shaikh N, Khavale S, Shinde G, Meherji P, Shah N, et al. Genetic variation in exon 17 of INSR is associated with insulin resistance and hyperandrogenemia among lean Indian women with polycystic ovary syndrome. Eur J Endocrinol 2009; 160: 855-862.##Oh JY, Barrett-Connor E. Association between vitamin D receptor polymorphism and type 2 diabetes or metabolic syndrome in community-dwelling older adults: the Rancho Bernardo study. Metabolism 2002; 51: 356-359.##Fang Y, van Meurs JB, Alesio A, Jhamai M, Zhao H, Rivadeneira F, et al. Promoter and 3'-untranslated-region haplotypes in the vitamin d receptor gene predispose to osteoporotic fracture: the rotterdam study. Am J Hum Genet 2005; 77: 807-823.##Whitfield GK, Remus LS, Jurutka PW, Zitzer H, Oza AK, Hope T, et al. Are human vitamin D receptor gene polymorphisms functionally significant? In: Norman AW, Bouillon R, Thomasset M. Vitamin D Endocrine System: structural, Biological Genetic and Clinical Aspects. California, USA: University of California, Riverside; 2000; 817- 824.##Apparao KB, Lovely LP, Gui Y, Lininger RA, Lessey BA. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod 2002; 66: 297-304.##Maestro B, Campion J, Davila N, Calle C. Stimulation by 1, 25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000; 47: 383-391.##Darwish H, DeLuca HF. Vitamin D-regulated gene expression. Crit Rev Eukaryot Gene Expr 1993; 3: 89-116.##Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004; 89: 2745-2749.##Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update 2010; 16: 347-363.##Kurabayashi T, Yahata T, Quan J, Tanaka K. Association of polymorphisms in the beta2 and beta3 adrenoceptor gene with polycystic ovary syndrome. J Reprod Med 2006; 51: 389-393.##Cankaya S, Demir B, Aksakal SE, Dilbaz B, Demirtas C, Goktolga U. Insulin resistance and its relationship with high molecular weight adiponectin in adolescents with polycystic ovary syndrome and a maternal history of polycystic ovary syndrome. Fertil Steril 2014; 102: 826-830.##Panidis D, Balaris C, Farmakiotis D, Rousso D, Kourtis A, Balaris V, et al. Serum parathyroid hormone concentrations are increased in women with polycystic ovary syndrome. Clin Chem 2005; 51: 1691-1697.##Hahn S, Haselhorst U, Tan S, Quadbeck B, Schmidt M, Roesler S, et al. Low serum 25-hydroxyvitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome. Exp Clin Endocr Diab 2006; 114: 577-583.##Mahmoudi T, Gourabi H, Ashrafi M, Yazdi RS, Ezabadi Z. Calciotropic hormones, insulin resistance and the polycystic vary syndrome. Fertil Steril 2010; 93: 1208-1214.##Grundberg E, Brandstrom H, Ribom EL, Ljunggren O, Mallmin H, Kindmark A. Genetic variation in the human vitamin D receptor is associated with muscle strength, fat mass and body weight in Swedish women. Eur J Endocrinol 2004; 150: 323-328.##Wehr E, Trummer O, Giuliani A, Gruber H, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol 2011; 164: 741-749.##Ranjzad F, Mahban A, Irani Shemirani A, Mahmoudi T, Vahedi M, Nikzamir A, et al. Influence of gene variants related to calcium homeostasis on biochemical parameters of women with polycystic ovary syndrome. J Assist Reprod Genet 2011; 28: 225-232.##Zofkova II, Zajickova K, Hill M. Serum parathyroid hormone levels are associated with FokI polymorphism of the vitamin D receptor gene in untreated postmenopausal women. Eur J Intern Med 2003; 14: 232-236.##Lin MW, Tsai SJ, Chou PY, Huang MF, Sun HS, Wu MH. Vitamin D receptor 1a promotor -1521 G/C and -1012 A/G polymorphisms in polycystic ovary syndrome. Taiwan J Obstet Gynecol 2012; 51: 565-571.##Mahmoudi T. Genetic variation in the vitamin D receptor and polycystic ovary syndrome risk. Fertil Steril 2009; 92: 1381-1383.##Gohda T, Shou I, Fukui M, Funabiki K, Horikoshi S, Shirato I, et al. Parathyroid hormonr gene polymorphism and secondary hyperparathyroidism in hemodialysis patients. Am J Kidney Dis 2002; 39: 1255-1260.##Goodarzi MO, Louwers YV, Taylor KD, Jones MR, Cui J, Kwon S, et al. Replication of association of a novel insulin receptor gene polymorphism with polycystic ovary syndrome. Fertil Steril 2011; 95: 1736-1741.##Lee EJ, Yoo KJ, Kim SJ, Lee SH, Chan KY, Baek KH. Single nucleotide polymorphism in exon 17 of the insulin receptor gene is not associated with polycystic ovary syndrome in a Korean population. Fertil Steril 2006; 86: 380-384.##Ranjzad F, Mahmoudi T, Irani Shemirani A, Mahban A, Vahedi M, Ashrafi M, et al. A common variant in the adiponectin gene and polycystic ovary syndrome risk. Mol Biol Rep 2012; 39: 2313-2319.##Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961; 21: 1440–1447.##Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Meriiam GR, Ed., Polycystic ovary syndrome. In: Hershman SM, Series Ed., Current Issues in Endocrinology and Metabolism. Blackwell, Boston, MA, USA, 1992; 377-384.##Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419.##Flores-Martínez SE, Islas-Andrade S, Machorro-Lazo MV. DNA polymorphism analysis of candidate genes for type 2 diabetes mellitus in a Mexican ethnic group. Ann Genet 2004; 47: 339-348.##Urbanek M, Legro RS, Driscoll D, Strauss JF, Dunaif A, Spielman RS. Searching for the polycystic ovary syndrome genes. J Pediatr Endocrinol Metab 2000; 13: 1311-1313.##Mukherjee S, Shaikh N, Khavale S, Shinde G, Meherji P, Shah N, et al. Genetic variation in exon 17 of INSR is associated with insulin resistance and hyperandrogenemia among lean Indian women with polycystic ovary syndrome. Eur J Endocrinol 2009; 160: 855-862.##Oh JY, Barrett-Connor E. Association between vitamin D receptor polymorphism and type 2 diabetes or metabolic syndrome in community-dwelling older adults: the Rancho Bernardo study. Metabolism 2002; 51: 356-359.##Fang Y, van Meurs JB, Alesio A, Jhamai M, Zhao H, Rivadeneira F, et al. Promoter and 3'-untranslated-region haplotypes in the vitamin d receptor gene predispose to osteoporotic fracture: the rotterdam study. Am J Hum Genet 2005; 77: 807-823.##Whitfield GK, Remus LS, Jurutka PW, Zitzer H, Oza AK, Hope T, et al. Are human vitamin D receptor gene polymorphisms functionally significant? In: Norman AW, Bouillon R, Thomasset M. Vitamin D Endocrine System: structural, Biological Genetic and Clinical Aspects. California, USA: University of California, Riverside; 2000; 817- 824.##Apparao KB, Lovely LP, Gui Y, Lininger RA, Lessey BA. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod 2002; 66: 297-304.##Maestro B, Campion J, Davila N, Calle C. Stimulation by 1, 25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000; 47: 383-391.##Darwish H, DeLuca HF. Vitamin D-regulated gene expression. Crit Rev Eukaryot Gene Expr 1993; 3: 89-116.## ##

Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility ساختار عاملی پرسشنامه 28 سوالی سلامت عمومی زنان نابارور مراجعه کننده به مرکز ناباروری یزد 2 1 مقدمه : مشکل ناباروری در دنیای امروز به صورت یک نگرانی اجتماعی درآمده و با معضلات روانشناختی و اجتماعی متعددی همراه است. همچنین این مشکل بر روابط بین فردی، خانوادگی و اجتماعی تاثیر گذار است. با توجه به اینکه زنان در معرض عوامل تنش‏زای جسمی، روانی و اجتماعی درمان ناباروری قرار دارند، فراهم ساختن یک ابزار غربالگری روانسنجی برای اختلالات این گروه یک ضرورت می باشد. هدف: هدف این مطالعه تعیین ساختار عاملی پرسشنامه سلامت عمومی 28 سؤالی برای پی بردن به اختلالات روانی بر روی زنان نابارور می باشد. مواد و روش ها: 220 زن نابارور مراجعه کننده به مرکز ناباروری یزد در سال 1390 که تحت درمان ناباروری بودند، با نمونه گیری آسان انتخاب شدند. پس از تکمیل پرسشنامه سلامت عمومی توسط، روایی و پایایی پرسشنامه بترتیب بوسیله ساختار عاملی تائیدی و آلفای کرونباخ محاسبه شد. نتایج: با تحلیل ساختار عاملی چهار مولفه اضطراب و اختلال خواب، اختلال در عملکرد اجتماعی، افسردگی و علائم جسمی به ترتیب استخراج شد. 12/50 درصد مجموع واریانس توسط این 4 مولفه تبیین شد. پایایی پرسشنامه 90/0 بدست آمد. نتیجه گیری: تحلیل ساختار عاملی و پایایی پرسشنامه سلامت عمومی 28 سوالی نشان داد که این پرسشنامه بعنوان یک ابزار غربالگری برای ارزیابی سلامت عمومی در زنان نابارور مناسب است.  2 Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28  showed that it is suitable as a screening instrument for assessing general health of infertile women. 801 808 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/42017/10/42017/10/42017/10/42017/10/42017/10/42017/10/42017/10/42017/10/4 1396/7/12 زهرا شایان Zahra Shayan Department of Community Medicine, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran ایران زهرا پور موحد Zahra Pourmovahed Social Determinates of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران فاطمه نجفی پور Fatemeh Najafipour Shiraz University of Medical Sciences, Shiraz, Iran ایران علی محمد عبدلی Ali Mohammad Abdoli Yazd Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران فاطمه محب پور Fatemeh Mohebpour Shiraz University of Medical Sciences, Shiraz, Iran ایران صدیقه نجفی پور Sedighe Najafipour Department of Medical Education, Medical School, Tehran University Medical Sciences, Tehran, Iran ایران Se_najafipour@yahoo.com Factor structure General Health Questionnaire-28 Infertile women ساختار عاملی پرسشنامه سلامت عمومی GHQ-28 زنان نابارور. Wichman CL, Ehlers SL, Wichman SE, Weaver AL, Coddington C. Comparison of multiple psychological distress measures between men and women preparing for invitro fertilization. Fertil Steril 2011; 95: 717-721.##Shakeri J, Hosseini M, Golshani S, Sadeghi Kh, feyzollahi V. General health, coping strategies and marital satisfaction in fertile and infertile women. Fertil Infertil 2006; 14: 269-275.##Sargolzaee MR, Moharreri F, Arshadi HR, Javadi K, Karimi SH, Fayyazi-bordbar MR. Psychosexual and depression disorders in infertile female referring to Mashhad infertility treatment center. J Reprod Infertil 2001; 2: 46-51.##Gharaie V, Mazaheri MA, Sahebi A, Peivandi S, Agha Hossinei M. Effect of behavioral-cognitive education on reduction of anxiety in women with primary infertility who undergo GIFT and ZIFT. J Reprod Infertil 2004; 5: 170-180.##Heidari P, Latifnejhad R, Sahebi A, Jahaniyan M, Mazloum SR. Impact of cognitive behaviour therapy on anxiety level of primary infertile women undergoing IUI. J Reprod Infertil 2002; 3: 40-51.##Simbar M, Hashemi S, Shams J, Alavi Majd H. Association between infertile women's anxiety with ART success rates. J Reprod Infertil 2010; 10: 239-244.##Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979; 9: 139-145.##Molina J, Andrade-Rosa C, González-Parra S, Blasco-Fontecilla H, Real MA, Pintor C. The factor structure of the General Health Questionnaire (GHQ): a scaled version for general practice in Spain. European psychiatry. Eur Psychiat 2006; 21: 478-486.##Gibbons P, Arévalo HF, Mónico M. Assessing of the factor structure and reliability of the 28 item version of the General Health Questionnaire (GHQ-28) in: Salvador EL. Int J Clin Health Psychol 2004; 4: 389-398.##Nagyova I, Krol B, Szilasiova A, Stewart RE, van Dijk JP, van den Heuvel WJA. General Health Questionnaire-28: psychometric evaluation of the Slovak version. Studia Psychologica 2000 42: 351-361.##Aderbighe YA, Riley W, Lewin T, Gureje O. Factor structure of the 28 Item General Health Questionnaire in a sample of women. Int J Psychiatry Med 1996; 26: 263-269.##Taghavi M. Assessment of the Validity and reliability of the General Health Questionnaire. J Psychology 2001; 5: 381-389.##Molavi H. Validation factor structure and reliability of the farsi version of General Health Questionnaire 28 in Iranian students. Pakistan J Psychol Res 2002; 17: 87-98.##Ebrahimi A, Molavi H, Moosavi G, Bornamanesh A, Yaghoubi M. Psychometric properties and factor Structure of General Health Questionnaire 28 (GHQ-28) in Iranian psychiatric patients. J Res Behav Sci 2007; 5: 5-11.##Rezaei S, Salehi I, Yousefzadeh Chabok SH, Moosavi H, Kazemnejad E. Factor Structure, Clinical Cut off Point and Psychometric Properties Of 28- Itemes Version for General Health Questionnaire in Patients with Traumatic Brain Injury. J Guilan Uni Med Sci 2011; 78: 56-70. (In Persian)##Ghanbarnejad A, Turki H, Golestan B, Arbabi M, Nedjat S. Factor Structure of Persian General Health Questionnaire-28 in Dermatologic Patients: A confirmatory factor analysis. Int Elec J Med 2013; 2: 11-21.##Javanmard GH, Mamaghani J. Standardization of GHQ-28 inventory on the students of Azerbaijan province of Iran. Procedia – Soc Behav Sci 2013; 84: 47–52.##Behjati Ardakani Z, Akhondi MM, Kamali K, Fazli Khalaf Z, Eskandari SH, Ghorbani B. Mental Health Status of Patients Attending Avicenna Infertility Clinic. J Reprod Infertil 2010; 11: 319-324. (in Persian)##Baghiani Moghadm MH, Aminian AH, Abdoli AM, Seighal N, Falahzadeh H, Ghasemi N. Evaluation of the general health of the infertile couples. Iran J Rep Med 2011; 9: 309-314.##Yaghoubi N, Nasr M, Shahmohammadi D. Epidemiological study of mental disorders in urban and urban areas of SoumaahSara city- Gilan. Andisheh Raftar J 1995; 4: 55-65 (In Persian).##Palahang H, Nasr M, Baraheni MT, et al. Epidemiological study of mental disorders in Kashan city. Andisheh Raftar J 1996; 8: 19-27 (In Persian).##Malakouti SK, Fatollahi P, Mirabzadeh A, Zandi T. Reliability, validity and factor structure of the GHQ-28 used among elderly Iranians. Int Psychogeriatr 2007; 19: 623-634.##Werneke U, Goldberg DP, Yalcin I, Ustün BT. The stability of the factor structure of the General Health Questionnaire. Psychol Med 2000; 30: 823-829.##Chan CH, Ng EH, Chan CL, Ho, Chan TH. Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study. Fertil Steril 2006; 85: 339-346.##Pasch LA, Gregorich SE, Katz PK, Millstein SG, Nachtigall RD, Bleil ME. Psychological distress and in vitro fertilization outcome. Fertil Steril 2012; 98: 459-464.##Wichman CL, Ehlers SL, Wichman SE, Weaver AL, Coddington C. Comparison of multiple psychological distress measures between men and women preparing for invitro fertilization. Fertil Steril 2011; 95: 717-721.##Shakeri J, Hosseini M, Golshani S, Sadeghi Kh, feyzollahi V. General health, coping strategies and marital satisfaction in fertile and infertile women. Fertil Infertil 2006; 14: 269-275.##Sargolzaee MR, Moharreri F, Arshadi HR, Javadi K, Karimi SH, Fayyazi-bordbar MR. Psychosexual and depression disorders in infertile female referring to Mashhad infertility treatment center. J Reprod Infertil 2001; 2: 46-51.##Gharaie V, Mazaheri MA, Sahebi A, Peivandi S, Agha Hossinei M. Effect of behavioral-cognitive education on reduction of anxiety in women with primary infertility who undergo GIFT and ZIFT. J Reprod Infertil 2004; 5: 170-180.##Heidari P, Latifnejhad R, Sahebi A, Jahaniyan M, Mazloum SR. Impact of cognitive behaviour therapy on anxiety level of primary infertile women undergoing IUI. J Reprod Infertil 2002; 3: 40-51.##Simbar M, Hashemi S, Shams J, Alavi Majd H. Association between infertile women's anxiety with ART success rates. J Reprod Infertil 2010; 10: 239-244.##Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979; 9: 139-145.##Molina J, Andrade-Rosa C, González-Parra S, Blasco-Fontecilla H, Real MA, Pintor C. The factor structure of the General Health Questionnaire (GHQ): a scaled version for general practice in Spain. European psychiatry. Eur Psychiat 2006; 21: 478-486.##Gibbons P, Arévalo HF, Mónico M. Assessing of the factor structure and reliability of the 28 item version of the General Health Questionnaire (GHQ-28) in: Salvador EL. Int J Clin Health Psychol 2004; 4: 389-398.##Nagyova I, Krol B, Szilasiova A, Stewart RE, van Dijk JP, van den Heuvel WJA. General Health Questionnaire-28: psychometric evaluation of the Slovak version. Studia Psychologica 2000 42: 351-361.##Aderbighe YA, Riley W, Lewin T, Gureje O. Factor structure of the 28 Item General Health Questionnaire in a sample of women. Int J Psychiatry Med 1996; 26: 263-269.##Taghavi M. Assessment of the Validity and reliability of the General Health Questionnaire. J Psychology 2001; 5: 381-389.##Molavi H. Validation factor structure and reliability of the farsi version of General Health Questionnaire 28 in Iranian students. Pakistan J Psychol Res 2002; 17: 87-98.##Ebrahimi A, Molavi H, Moosavi G, Bornamanesh A, Yaghoubi M. Psychometric properties and factor Structure of General Health Questionnaire 28 (GHQ-28) in Iranian psychiatric patients. J Res Behav Sci 2007; 5: 5-11.##Rezaei S, Salehi I, Yousefzadeh Chabok SH, Moosavi H, Kazemnejad E. 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