2017 15 8 0 526

Effect of metformin on maternal and neonatal outcomes in pregnant obese non-diabetic women: A meta-analysis متفورمین برای زنان باردار غیر چاق بدون دیابت: یک متاآنالیز آزمایشات تصادفی کنترل شده 2 1 مقدمه: متفورمین باعث افزایش وزن مادر و نوزاد در دیابت بارداری می­شود، با این حال، این اثر در زنان غیر­دیابتی ضعیف است. هدف: هدف ار انجام مطالعه، بررسی اثر متفورمین مصرفی در دوران بارداری بر نتایج مادران و نوزادان در زنان غیر­دیابتی چاق بود. مواد و روش­ها: ما Medline، EMBASE، و Cochrane CENTRAL برای آزمایش­های تصادفی کنترل شده (RCTs) که در بررسی اثربخشی متفورمین در زنان چاق و غیر­دیابتی باردار بود، را جستجو کردیم. داده­ها با استفاده از نرم افزار RevMan (نسخه 5.3) استخراج و تجزیه و تحلیل شدند. وزن تولد نوزاد از نتایج کلیدی بود. نتایج ثانویه شامل افزایش وزن مادر، بروز پره­اکلامپسی و عوارض جانبی نوزاد بود. نتایج: داده­های دو­طرفه از دوRCTs  (843 نفر شرکت­کننده) نشان داد که متفورمین باعث کاهش معنی­داری در افزایش وزن مادر بارداری                          ([630/0- و 08/2] CI 95%، 35/1-MD) نسبت به دارونما می­شود. برآورد خلاصه اثر، از نظر کاهش وزن نوزادان، نمره Z                                                ([06/0- و 23/0] CI 95%، 09/0-MD) بین دو گروه تفاوت معنی­داری نداشت. متفورمین با کاهش 41٪ خطر ابتلا به پره­اکلامپسی همراه بود، اما این کاهش از لحاظ آماری معنی­دار نبود ([46/11، 03/0] CI 95%، 59/0RR=). هیچ یک از عوارض جانبی نوزادی شامل تولد نوزاد ([10/3، 42/0] CI 95%، 14/1RR=) و ناهنجاری­های مادرزادی ([21/3، 58/0] CI 95%، 36/1RR=) در دو گروه تفاوت معنی­داری نداشت. نتیجه ­گیری: برای زنان باردار چاق، متفورمین می­تواند افزایش وزن حاملگی را کاهش دهد بدون اینکه در وزن نوزاد نوزاد کاهش ایجاد نماید. با توجه به شواهد موجود، متفورمین نباید برای پیشگیری از نتایج نامطلوب بارداری در زنان چاق غیر­دیابتی استفاده شود. 2 Background: Metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women. Objective: We performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women. Materials and Methods: We searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software (Version 5.3). Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects (miscarriage, stillbirth and congenital anomalies). Results: Pooled data from two RCTs (n=843) showed that metformin caused a significant reduction in maternal gestational weight gain (MD-1.35, 95% CI: [2.08, -0.630]), compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score (MD-0.09, 95% CI: [0.23, 0.06]). Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]). None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10]) and congenital anomalies (RR= 1.36, 95% CI: [0.58, 3.21]) differed significantly between the two groups. Conclusion: For obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women. 461 470 2017/10/1 1396/7/9 2017/10/14 1396/7/22 Ahmed Elmaraezy Ahmed Elmaraezy Faculty of Medicine, Al-Azhar University, Cairo, Egypt مصر Abdelrahman Ibrahim Abushouk Abdelrahman Ibrahim Abushouk Faculty of Medicine, Ain Shams University, Cairo, Egypt مصر Abdelrahman.Abushouk@med.asu.edu.eg Amany Emara Amany Emara Faculty of Medicine, Al-Azhar University, Cairo, Egypt مصر Omar Elshahat Omar Elshahat Faculty of Medicine, Al-Azhar University, Cairo, Egypt مصر Hussien Ahmed Hussien Ahmed Faculty of Medicine, Zagazig University, Zagazig, Egypt مصر Magdy I. Mostafa Magdy I. Mostafa Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt مصر Birth weight Diabetes mellitus Metformin Obesity Pregnancy. وزن هنگام تولد دیابت متفورمین چاقی بارداری. Chan A, Scott J, Nguyen AM, Sage L. Pregnancy outcome in South Australia 2008. 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Exposure of neonatal mice to Sevoflurane may induce male germ cell apoptosis in testicular tissue after puberty تماس موش در دوره نوزادی با سووفلوران، ممکن است سبب رخ دادن آپوپتوز در بافت بیضه پس از بلوغ شود 2 1 مقدمه: سوفلوران به عنوان یک داروی بیهوشی کاربرد وسیعی در اطفال دارد. این دارو با توجه به تکرارهای زیاد در کودکان در برخی از بیماری­های مادرزادی به دلیل تکرر جراحی، ممکن است منجر به القاء مرگ سلولی در برخی از سلول­های حساس بدن از جمله سلول­های زایا گردند. هدف: در این مطالعه اثر سووفلوران بر روند اسپرماتوژنز در موش­های نر بالغ که در دوران پیش از بلوغ در معرض بودند، مورد بررسی قرار گرفت. موارد و روش­ها: 24 موش نوزاد نر نژاد NMRI در 3 گروه کنترل، آزمون یک و دو به صورت تصادفی دسته­بندی شدند. گروه آزمون یک و دو به ترتیب در معرضMAC  2 و 1 سووفلوران به همراه 2 لیتر در دقیقه اکسیژن به مدت 7 روز قرار گرفتند. همه گروه­ها پس از 2 ماه کشته شدند. ارزیابی­های بافت­شناسی، ایمونوهیستوشیمی و بررسی آپوپتوز در بافت بیضه انجام گرفت. بیان ژن Bax و Bcl در بافت بیضه به وسیله Real time PCR ارزیابی شد. نتایج: نتایج ما نشان داد که در هر دو گروه آزمون یک و دو تمامیت بافت بیضه حفظ شد. شمارش سلول­های اسپرماتوگونی کاهش معناداری در گروه 2 نسبت به سایر گروه­ها نشان داد. نتایج میزان مرگ سلولی در سلول­های اسپرماتوگونی در گروه آزمون یک و دو به ترتیب 3±15% و 2±9% به دست آمد. همچنین میزان بیان ژن­های Bax و Bcl2 در گروه­های آزمون یک و دو 2615/0 و 0070/1 و در گروه کنترل 3657/9 اندازه­گیری شد. این نتایج تفاوت معنی­داری (05/0≥p) را بین گروه دو با سایر گروه­ها نشان داد. نتیجه­ گیری: قرار­گیری در معرض MAC 2 سووفلوران همراه با 2 لیتر در دقیقه اکسیژن، ممکن است باعث ایجاد آسیب بافتی بیضه شده و منجر به اختلال در عملکرد سلول­های آن شود. در صورتی که قرارگیری در معرض سطح پایین تر سووفلوران باعث کاهش نسبت بیان Bax و Bcl2 و کاهش آپوپتوز در سلول­های زایا می­شوند. 2 Background: common use of sevoflurane in congenital defects during repeated surgeries may have detrimental effects on spermatogenesis after puberty. Objective: This study investigated sevoflurane effects on spermatogenesis process in male mature mice after exposure in prepubertal time. Materials and Methods: 24 neonatal NMRI male mice were randomly classified in three groups. Experimental 1 and 2 groups (exposure to 1 minimum alveolar concentration (MAC) and 2 MAC sevoflurane, respectively in 2 lit/min oxygen (O2) for 7 days (30 min, daily) and control. All groups were sacrificed after 2 months. Histological assessment, immunohistochemistry and apoptosis process was done. Bax and Bcl2 expression was evaluated in the testicular tissue by real time Poly Chain Reaction. Results: Our results showed that the integrity of testicular tissue was preserved in both experimental groups. Count of spermatogonial cells had significant decrease in group 2 compared to others. The rate of apoptosis in spermatogonial cells was 15±3% and 9±2% in the group 2 and 1, respectively. Also, Bax/Bcl2 ratio was 0.2615, 1.0070 and 9.3657 in control, experimental group 1 and 2, respectively. This result was significant (p≤0.002) between groups 2 with other groups. Conclusion: Continuous exposure of 2 MAC sevoflurane in 2 lit/min O2 simultaneous during prepubertal may create more testicular tissue damage in terms of cellular and molecular function compared to continuous exposure to lower level of sevoflurane by increase in ratio of Bax/Bcl2 and apoptosis in germ cells after puberty. 471 478 2017/10/12017/10/1 1396/7/9 2017/10/142017/10/14 1396/7/22 مریم نژادسیستانی Maryam Nezhad Sistani Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران آناهید ملکی Anahid Maleki Department of Anesthesiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran ایران a-maleki@tums.ac.ir مریم سلیمی Maryam Salimi Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران معرفت غفاری نوین Marefat Ghaffari Novin Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران حمید نظریان Hamid Nazarian Department of Biology and Anatomical Sciences, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران Spermatogonial cell Prepubertal Germ cells. سلول های اسپرماتوگونی آپوپتوز اسپرماتوژنز. 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Women’s orgasm obstacles: A qualitative study بازدارنده های ارگاسم زن: یک مطالعه کیفی 2 1 مقدمه: ارگاسم زن نقش مهمّی در احساس سازگاری جنسی و رضایت زناشویی دارد. ارگاسم در زنان یک پدیده یاد گرفتنی است که تحت تأثیر عوامل مختلفی قرار دارد. هدف: این تحقیق به تبیین بازدارنده­های ارگاسم در زنان ایرانی می­پردازد. موارد و روش­ها: این مطالعه کیفی به شیوه تحلیل محتوای جهت­دار و مصاحبه عمیق فردی با 20 زن ایرانی در سنین مختلف در سال¬های 2015 و 2016 و در محیط دو درمانگاه طبّی در تهران انجام شده است. نتایج: بازدارنده­های ارگاسم، در یک طبقه، 4 زیر طبقه و 25 کد تبیین شد. طبقه اصلی"چند بعدی بودن بازدارنده­های ارگاسم زنان" بود. زیرطبقات و برخی از کدها عبارت بودند از: بازدارنده­های جسمانی (خستگی جسمی زن یا شوهر، عفونت یا خشکی واژینال)، بازدارنده­های روانی (کمبود آگاهی جنسی، خجالت، عدم تمرکز ذهنی بر رابطه جنسی ناشی از مشکلات خانه و بچه­ها)، بازدارنده­های ارتباطی (عجله شوهر، داشتن اختلاف و دلخوری از همسر)، بازدارنده­های زمینه­ای (ساعات خواب نامنظم، عدم آرامش در خانه, عدم حریم خصوصی و ناتوانی در جداسازی رختخواب بچه­ها از والدین). نتیجه­گیری: برای پیشگیری و درمان اختلال ارگاسم زنان، توجه به عوامل جسمانی کافی نیست. اخذ یک شرح حال کامل در ابعاد جسمانی، روانی، ارتباطی و زمینه­ای زندگی زن، ضروری است. 2 Background: Woman’s orgasm plays a vital role in sexual compatibility and marital satisfaction. Orgasm in women is a learnable phenomenon that is influenced by several factors. Objective: The aim of this study is exploring obstacles to orgasm in Iranian married women. Materials and Methods: This qualitative study with directed content analysis approach was conducted in 2015-2016, on 20 Iranian married women who were individually interviewed at two medical clinics in Tehran, Iran. Results: Orgasm obstacles were explored in one category, 4 subcategories, and 25 codes. The main category was “Multidimensionality of women’s orgasm obstacles”. Subcategories and some codes included: Physical obstacles (wife’s or husband’s boredom, vaginal infection, insufficient vaginal lubrication), psychological obstacles (lack of sexual knowledge, shame, lack of concentration on sex due to household and children problems), relational obstacles (husband’s hurry, having a dispute and annoyance with spouse) and contextual obstacles (Irregular sleep hours, lack of privacy and inability to separate children’s bedroom from their parents, lack of peace at home). Conclusion: For prevention or treatment of female orgasm disorders, attention to physical factors is not enough. Obtaining a comprehensive history about physical, psychological, relational and contextual dimensions of woman’s life is necessary. 479 490 2017/10/12017/10/12017/10/1 1396/7/9 2017/10/142017/10/142017/10/14 1396/7/22 مریم نکولعل تک Maryam Nekoolaltak Student Research Office, Depatment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران زهره کشاورز Zohreh Keshavarz Depatment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران keshavarzzohre57@gmail.com معصومه سیمبر Masoumeh Simbar Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran ایران علی محمد نظری Ali Mohammad Nazari Department of Nursing and Midwifery, Shahrood University of Medical Science, Shahrood, Iran ایران احمدرضا باغستانی Ahmad Reza Baghestani Department of Biostatistics, School of Allied Medical Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran ایران Female Orgasm Obstacles Sexual satisfaction Qualitative study. ارگاسم زن بازدارنده ها رضایت جنسی مطالعه کیفی. 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Association of SNP rs.2414096 CYP19 gene with polycystic ovarian syndrome in Iranian women بررسی ارتباط پلی مورفیسم تک نوکلئوتیدی rs.2414096 ژن CYP19 با سندرم تخمدان پلی کیستیک در زنان ایرانی   2 1 مقدمه: سندرم تخمدان پلی­کیستیک (PCOS) شایع­ترین اختلال اندوکرینولوژیک زنان در سنین باروری است و باور بر این است که در اتیولوژی آن عوامل ژنتیکی نقش دارند. به این دلیل که مسیر متابولیسم آندروژن در PCOS دچار اختلال است، ژن‏های دخیل در این مسیر می‏توانند به عنوان ژن‏های کاندید در ایجاد PCOS محسوب شوند. ژن CYP19 کد کننده آروماتاز است که نقش مهمی در سنتز آندروژن دارد و به نظر می‏رسد که واریانت‏های آن در پاتوژنز PCOS دخیل باشند. تحقیقات پیشین ارتباط میان پلی­مورفیسم‏های تک نوکلئوتیدی (SNP) مختلف ژن CYP19 با هایپرآندروژنیسم و PCOS را در بعضی از گروه‏های قومیتی نشان داده است. هدف: تحقیق برای یافتن ارتباط SNP rs.2414096 ژن CYP19 در PCOS در زنان ایرانی. موارد و روش­ها: در این تحقیق مورد-شاهدی، 70 زن مبتلا به PCOS و 70 زن کنترل نرمال انتخاب شدند. پس از اخذ رضایت آگاهانه، 5 میلی‏لیترخون سیاهرگی از هر شرکت­کننده گرفته شد و DNA ژنومیک آن توسط روش نمکی استخراج شد. واکنش زنجیره‏ای پلیمراز (PCR) بوسیله یک جفت پرایمر اختصاصی برای SNP rs.2414096 انجام شد و در انتها ژنوتیپ­ها توسط هضم آنزیمی با آنزیم HSP 92II معین گردید. نتایج: نسبت ژنوتیپ‏ها برای SNP rs.2414096 در زنان  PCOSبه صورت زیر است: (4/41%)GG، (3/44%) AG، (4/14%) AA در حالیکه در گروه نرمال، نسبت‏ها برای AA، AG وGG بترتیب 3/24%، 9/52% و 9/22% بودند. نسبت الل‏ها در گروه مبتلا به PCOS، 3/49% برای الل A و 7/50% برای الل G بود که در مقایسه، در گروه نرمال بشکل4/36% برای الل A و6/63% برای الل  Gبوده است. محاسبات آماری تفاوت معنا­دار در دو گروه کنترل و PCOS برای نسبت‏های ژنوتیپی و فنوتیپی نشان می‏دهد. نتیجه­گیری: واریانت‏های SNP rs.2414096 در ژن CYP19 می‏توانند درایجاد PCOS درزنان ایرانی نقش داشته باشند. 2 Background: Genetic factors are believed to play an important role in the etiology of polycystic ovarian syndrome (PCOS) which is the most common endocrinological disorder of women in their reproductive age. Androgen metabolism is impaired in PCOS and, thus, CYP19 gene which is involved in this pathway can be a candidate gene. Previous studies have shown a relationship between single nucleotide polymorphism (SNP) of CYP19 in hyperandrogenism and PCOS in some racial groups. Objective: This study was designed to elucidate the role of CYP19 gene in PCOS in Iran. Materials and Methods: In this case-control study, 70 PCOS women and 70 non-PCOS women as normal control were selected. Following the informed consent, 5 ml blood was taken from individuals and subsequently, genomic DNA was extracted by salting out method. Furthermore, a set of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) was carried out using specific primers for SNP rs.2414096 followed by enzyme digestion, with HSP92II. Results: Genotype frequencies of SNP rs. 2414096 in PCOS women were as follows: AA (14.4%), AG (44.3%), and GG (41.4%) while in normal group, genotypes were 24.3%, 52.8%, and 22.9%, respectively. Allele frequencies in PCOS group were 49.3% for A and 50.7% for G, whereas normal group had a different percentage of A (36.4%) and G (63.6%). The calculations for both genotypic and allelic frequencies showed statistical significance difference. Conclusion: Variants of SNP rs. 2414096 in CYP19 could play a role in the development of PCOS in Iranian women. 491 496 2017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/142017/10/142017/10/142017/10/14 1396/7/22 آناهیتا مهدی‌زاده Anahita Mehdizadeh Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران سیدمهدی کلانتر Seyed Mehdi Kalantar Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران smkalantar@yahoo.com محمدحسن شیخها Mohammad Hassan Sheikhha Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران بی‌بی شهناز عالی Bibi Shahnaz Aali Physiology Research Center, Department of Obstetrics and Gynecology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran ایران اعظم قانعی Azam Ghanei Department of Internal Medicine, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران Polycystic ovarian syndrome CYP19 Single nucleotide polymorphism. سندرم تخمدان پلی کیستیک CYP19 پلی مورفیسم تک نوکئوتیدی. 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Association between CYP19 gene SNP rs2414096 Polymorphism and polycystic ovary syndrome in Chinese women. BMC Med Genet 2009; 10: 139.##The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25.##Yu Y, Sun C, Liu Y, Li Y, Wang L, Zhang W. Promoter methylation of CYP19A1 gene in Chinese polycystic ovary syndrome patients. Gynecol Obstet Invest 2013; 76: 209-213##Xu P, Zhang XL, Xie GB, Zhang CW, Shen SM, Zhang XX, et al. The (TTTA) n polymorphism in intron 4 of CYP19 and the polycystic ovary syndrome risk in a Chinese population. Mol Biol Rep 2013; 40: 5041-5047.##Zhang X, Zhang C, Xu P, Liang F. SNP rs2470152 in CYP19 is correlated to aromatase activity in Chinese polycystic ovary syndrome patients. Mol Med Rep 2012; 5: 245-249.##Ghasemi N, Mortazavizadeh MR, Khorasani Gerdekoohi A. Frequency of poly cystic ovary syndrome in patients with premenopausal breast cancer. Int J Reprod Biomed 2010; 8: 86-89.##Mehdizadeh A, Sheikhha MH, Kalantar SM, Aali BS, Ghanei A. Mutation analysis of exon1 of bone morphogenetic protein-15 gene in Iranian patients with polycystic ovarian syndrome. Int J Reprod Biomed 2016; 14: 527-532.## ##

Impact of age on semen parameters in male partners of infertile couples in a rural tertiary care center of central India: A cross-sectional study اثر سن بر پارامترهای مایع منی در 1219 مرد از زوج‌های نابارور: یک تحلیل گذشته نگر در مرکز مراقبت عالی روستای مرکزی هند 2 1 مقدمه: میزان بالای رشد و نمو در بالغین پس از 40 سالگی، در دوران بارداری بسیار بالا است. در مقایسه با اوجنسیس، اسپرماتوژنز در مردان مسن ادامه دارد. هدف: بررسی آثار پیری بر پارامترهای مایع منی در مردان زوج­های نابارور در مناطق روستایی کشور در حال توسعه در طی 10 سال. می­توان تعیین نمود که آیا پیری بر باروری و پارامترهای مختلف اسپرم در این کشور در حال توسعه تأثیر می­گذارد. موارد و روش­ها: تجزیه و تحلیل گذشته­نگر 10 ساله در بخش مامایی و زنان و واحد بیولوژی تولید­مثل بخش فیزیولوژی مرکز مراقبت­های بالینی روستای مرکزی هند از ژانویه 2005 تا دسامبر 2014 پس از تایید کمیته اخلاق انجام شد. پرونده 1219 مرد بالغ در بخش زنان و زایمان از زوج­های نابارور از واحد بیولوژی تولید­مثل بخش فیزیولوژی جمع­آوری شد. بر اساس سن، بیماران تقسیم شدند به گروه 1: 21-28 سال (57 نفر)، گروه 2: 29-35 سال (450=n)، گروه 3: 36-42 سال (532=n)، گروه 4: 43-49 سال (165 نفر) و گروه 5: 50-60 سال (15 = n). ارزیابی تمام پارامترهای مایع منی به صورت مقطعی مطابق معیار استاندارد سازمان بهداشت جهانی (1999) انجام شد. نتایج: تجزیه و تحلیل تحلیل گذشته­نگر 1219 مایع منی نشان داد ارتباط معنادار منفی بین حجم اسپرم، تعداد کل اسپرم، تحرک اسپرم و مورفولوژی با سن وجود داشت. پس از سن 35 سالگی، میزان کل اسپرم، تحرک اسپرم و مورفولوژی کاهش نشان داد. نتیجه­گیری: در مطالعه حاضر، سن اثر منفی معنادار بر حجم منی، تعداد کل اسپرم، تحرک اسپرم و مورفولوژی اسپرم انسان در این منطقه در هندوستان دارد. 2 Background: High rates of sub-fertility and adverse pregnancy outcomes were seen after age 40. In contrast to oogenesis, spermatogenesis continues in elderly men. Objective: To retrospectively study the impact of aging on semen parameters in male partners of infertile couples in the rural area of developing country over 10 years and to find out whether aging affects male factor fertility and various semen parameters in this part of developing country. Materials and Methods: In this cross sectional study, the laboratory semen analysis records of 1219 male partners of infertile couples of a rural tertiary care center of Central India in a 10-year period from January 2005 to December 2014 were evaluated into 5 groups based on men age: Group 1: 21-28 yr (n=57); group 2: 29-35 yr (n=450); group 3: 36-42 yr (n=532); group 4: 43-49 yr (n=165), and group 5: 50-60 yr (n=15). Evaluation of all semen parameters were done according to WHO standard criteria (1999). Results: The analysis of semen records revealed the significant negative association of semen volume, total sperm count, sperm motility, and morphology with age. There was a significant fall in total sperm count, sperm motility, and morphology after the age of 35 yr. Conclusion: Age has significant negative effect on semen volume, total sperm count, and sperm motility and morphology in this region of India. 497 502 2017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/142017/10/142017/10/142017/10/142017/10/14 1396/7/22 Naina Kumar Naina Kumar Department of Obstetrics and Gynecology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India هند drnainakumar@gmail.com Amit K Singh Amit K Singh Department of Physiology, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India هند Ajay R Choudhari Ajay R Choudhari Department of Physiology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India. هند Fertility Infertility Semen analysis Sperm Sperm motility. باروری ناباروری آنالیز اسپرم اسپرم تحرک اسپرم. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod 2009; 24: 2683-2687.##Aflatoonian A, Seyedhassani SM, Tabibnejad N. The epidemiological and etiological aspects of infertility in Yazd province of Iran. Iran J Reprod Med 2009; 7: 117-122.##WHO. WHO laboratory manual for the examination and processing of human semen. 5th Ed. 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The effects of advanced paternal age on fertility. Asian J Androl 2013; 15: 723-728.##Eskenazi B, Wyrobek AJ, Sloter E, Kidd SA, Moore L, Young S, Moore D. The association of age and semen quality in healthy men. Hum Reprod 2003; 18: 447-454.##WHO Laboratory Manual for the Examination of Human Semen and Sperm-cervical Mucus Interaction. 4th Ed. Cambridge, Cambridge University Press; 1999: 128.##Joffe M, Li Z. Male and female factors in fertility. Am J Epidemiol 1994; 140: 921-929.##Girsh E, Katz N, Genkin L, Girtler O, Bocker J, Bezdin S, Barr I. Male age influences oocyte-donor program results. J Assist Reprod Genet 2008; 25: 137-143.##Sasano N, Ichijo S. Vascular patterns of the human testis with special reference to its senile changes. Tohoku J Exp Med 1969; 99: 269-280.##Kidd SA, Eskenazi B, Wyrobek AJ. Effects of male age on semen quality and fertility: a review of the literature. Fertil Steril 2001; 75: 237-248.##de la Rochebrochard E, Thonneau P. Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Hum Reprod 2002; 17: 1649-1656.##Jung A, Schuppe HC, Schill WB. Comparison of semen quality in older and younger men attending an andrology clinic. Andrologia 2002; 34: 116-22.##Klonoff-Cohen HS, Natarajan L. The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer. Am J Obstet Gynecol 2004; 191: 507-514.##Zhu QX, Meads C, Lu ML, Wu JQ, Zhou WJ, Gao ES. Turning point of age for semen quality: a population-based study in Chinese men. Fertil Steril 2011; 96: 572-576.##de Almeida Ferreira Braga DP, Setti AS, Figueira RC, Nichi M, Martinhago CD, Iaconelli A Jr, et al. Sperm organelle morphologic abnormalities: contributing factors and effects on intracytoplasmic sperm injection cycles outcomes. Urology 2011; 78: 786-791.##Slama R, Bouyer J, Windham G, Fenster L, Werwatz A, Swan SH. Influence of paternal age on the risk of spontaneous abortion. Am J Epidemiol 2005; 161: 816-823.##Kleinhaus K, Perrin M, Friedlander Y, Paltiel O, Malaspina D, Harlap S. Paternal age and spontaneous abortion. Obstet Gynecol 2006; 108: 369-377.##Glaser RL, Broman KW, Schulman RL, Eskenazi B, Wyrobek AJ, Jabs EW. The paternal-age effect in Apert syndrome is due, in part, to the increased frequency of mutations in sperm. Am J Hum Genet 2003; 73: 939-947.##Lambert SM, Masson P, Fisch H. The male biological clock. World J Urol 2006; 24: 611-617.##Wyrobek AJ, Eskenazi B, Young S, Arnheim N, Tiemann-Boege I, Jabs EW, Glaser RL, Pearson FS, Evenson D. Advancing age has differential effects on DNA damage, chromatin integrity, gene mutations, and aneuploidies in sperm. Proc Natl Acad Sci USA 2006; 103: 9601-9606.##Schmid TE, Eskenazi B, Baumgartner A, Marchetti F, Young S, Weldon R, et al. The effects of male age on sperm DNA damage in healthy non-smokers. Hum Reprod 2007; 22: 180-187.##Ford WC, North K, Taylor H, Farrow A, Hull MG, Golding J. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC study team (Avon longitudinal study of pregnancy and childhood). Hum Reprod 2000; 15: 1703-1708.##Mukhopadhyay D, Varghese AC, Pal M, Banerjee SK, Bhattacharyya AK, Sharma RK, et al. Semen quality and age-specific changes: a study between two decades on 3,729 male partners of couples with normal sperm count and attending an andrology laboratory for infertility-related problems in an Indian city. Fertil Steril 2010; 93: 2247-2254.##Itoh N, Kayama F, Tatsuki TJ, Tsukamoto T. Have sperm counts deteriorated over the past 20 years in healthy, young Japanese men? Results from the Sapporo area. J Androl 2001; 22: 40-44.##Seo JT, Rha KH, Park YS, Lee MS. Semen quality over a 10-year period in 22,249 men in Korea. Int J Androl 2000; 23: 194-198.##Rolf C, Behre HM, Nieschlag E. Reproductive parameters of older compared to younger men of infertile couples. Int J Androl 1996; 19: 135-142.##Auger J, Kunstmann JM, Czyglik F, Jouannet P. Decline in semen quality among fertile men in Paris during the past 20 years. N Engl J Med 1995; 332: 281-285.##Fisch H, Goluboff ET, Olson JH, Feldshuh J, Broder SJ, Barad DH. Semen analyses in 1,283 men from the United States over a 25-year period: no decline in quality. Fertil Steril 1996; 65: 1009-1014.##Andolz P, Bielsa MA, Vila J. Evolution of semen quality in North-eastern Spain: a study in 22,759 infertile men over a 36 year period. Hum Reprod 1999; 14: 731-735.##Sloter E, Schmid TE, Marchetti F, Eskenazi B, Nath J, Wyrobek AJ. Quantitative effects of male age on sperm motion. Hum Reprod 2006; 21: 2868-2875.##Gopalkrishnan K. Characteristics of semen parameters in a selected population of Indian men over a period of 10years. 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Polymorphism of MnSOD (Val16Ala) gene in pregnancies with blighted ovum: A case-control study پلی مورفیسم ژن (MnSOD, Val16Ala) در حاملگی هایی با تخمک پوچ: یک مطالعه کنترل موردی 2 1 مقدمه: تخمک پوچ یکی از شایع­ترین علل سقط جنین در سه ماهه اول بارداری است. منگنز سوپراکسیددیسموتاز (MnSOD) یک آنزیم مهم آنتی­اکسیدان در سیستم ایمنی انسان است. ژن آن روی کرموزوم (6q25) قرار دارد و روی ماتریکس میتوکندری عمل می­کند. در صورت موتاسیون و یا عدم فعالیت این آنزیم، DNA میتوکندریایی و هسته­ای به شدت تخریب می­شوند. معمول­ترین پلی­مورفیسم این ژن تغییر والین 16 به آلانین (Val16Ala) است. هدف: هدف از این پژوهش بررسی موتاسیون ممکن ژن در زنانی بود که به دلیل تخمک پوچ مجبور به سقط در دو ماه اول بارداری شده بودند. موارد و روش­ها: در یک مطالعه کنترل موردی، 34 بیمار و 34 خانم سالم وارد تحقیق شدند. DNA ژنومی از نمونه­های بزاقی آنها استخراج شده و ژنوتیپ با استفاده از پرایمر (Tetra Primer ARMS-PCR) مشخص گردید. نتایج: در گروه بیمار 16 نفر (48%) ژنوتیپ Val/Val، 17 نفر (50%) هتروزیگوت Val/Ala و یک نفر (2%) ژنوتیپ Ala/Ala بودند. در میان افراد کنترل، 7 مورد (22%) ژنوتیپ Val/Val، 6 نفر (17%) ژنوتیپ Val/Ala و 21 نفر (61%) Ala/Ala بود. ژنوتیپ فرکانس مربوط به ژنوتیپ­های (TT)، (CT) و (CC) در بیماران به ترتیب 48%، 50% و 2% و در گروه کنترل 22%، 17% و 61% بودند. آنالیز آماری رابطه معنی­داری بین پلی­مورفیسم (Val16Ala) در ژن (MnSOD) و تخمک پوچ نشان داد (0003/0=p). نتیجه­گیری: بر اساس نتایج به دست آمده از تحقیق ما، نتیجه­گیری می­شود که ارتباط قابل توجه بین پلی­مورفیسم (Val16Ala) در ژن (MnSOD) و تخمک پوچ وجود دارد. 2 Background: Blighted ovum is one of the most common reasons for abortion during the first three months of pregnancy. Manganese superoxide dismutase (MnSOD) is an important antioxidant enzyme in the human immune system. The gene is located on 6q25 chromosome and acts on mitochondrial matrix. In the case of mutation or inactivity of this enzyme, mitochondrial and nuclear DNA will severely be destructed. The most common polymorphism of its gene is Val16Ala. Objective: The aim was to investigate a possible mutation in pregnant women who had abortion during the first trimester of pregnancy due to blighted ovum. Materials and Methods: In this case-control study, 34 women were entered as the case and control groups, respectively. Genome DNA was extracted from saliva samples and its genotype was determined using Tetra-primer amplification refractory mutation system polymerase chain reaction technique. Results: In the case group, 16 (48%) cases had Val/Val genotype, 17 (50%) were heterozygote and had Val/Ala genotype, and 1 (2%) had Ala/Ala genotype. Among controls, 7 (22%) items had Val/Val genotype, 6 (17%) had Val/Ala genotype, and 21 (61%) had Ala/Ala genotype. The frequency of TT, CT, and CC genotypes was 48%, 50%, and 2% in case group and 22%, 17%, and 61% in control group, respectively. Statistical analysis revealed a significant relationship between Val16Ala polymorphism of MnSOD gene and blighted ovum (p= 0.0003). Conclusion: It has concluded that a significant relationship exists between Val16Ala polymorphism of MnSOD gene and blighted ovum. 503 508 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/142017/10/142017/10/142017/10/142017/10/142017/10/14 1396/7/22 آسیه مشتاقی Asiyeh Moshtaghi Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran. ایران حمیدرضا وزیری Hamidreza Vaziri Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran ایران ریحانه سریری Reyhaneh Sariri Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran ایران sariri@guilan.ac.ir حوریه شایگان Hoorieh Shaigan Guilan University of Medical Sciences, Rasht, Iran ایران Molecular genetic Abnormalities Blighted Ovum Abortion Gestational sac Superoxide dismutase. ژنتیک مولولی ناهنجاری تخمک پوچ سقط کیسه جنینی سوپراکسید دیسموتاز. Coughlin LB, Roberts D, Haddad NG, Long A. 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The effects of propolis extract on ovarian tissue and oxidative stress in rats with maternal separation stress اثر عصاره ی پروپولیس بر بافت و استرس اکسیداتیو تخمدان موش های صحرایی متعاقب استرس جدایی از مادر 2 1 مقدمه: استرس در دوران نوزادی بر سیستم­های مختلف بدن از جمله، عصبی، غدد درون­ریز، ایمنی، تولید­مثلی و غیره اثرات شدیدی دارد. هدف: هدف از این مطالعه بررسی اثر عصاره هیدروالکلی پروپولیس ایرانی (EIP) بر تغییرات هیستوپاتولوژیک و فعالیت آنتی­اکسیدانی تخمدان در موش­های مبتلا به استرس جدایی از مادر می­باشد. موارد و روش­ها: تعداد 48 سر موش صحرایی ماده نابالغ به طور تصادفی به شش گروه تقسیم شدند. گروه کنترل، گروه کنترل+سالین، گروه استرس، شامل نوزادانی که روزانه شش ساعت از مادرشان جدا بودند، گروه چهارم، پنجم و ششم شامل نوزادانی بودند که علاوه بر استرس روزانه به ترتیب به میزان50، 100 و mg/kg  200 عصاره پروپولیس دریافت کردند. سپس غلظت سرمی کورتیکواسترون، 17- بتا استرادیول، FRAPS، MDA، T-SOD و GPx اندازه­گیری شد. مقاطع تخمدان با استفاده از رنگ آمیزی­های هماتوکسیلین- ائوزین، پریودیک اسید شیف و تانل آماده و مورد بررسی میکروسکوپی قرار گرفتند. نتایج: استرس باعث افزایش سطح سرمی کورتیکوسترون و کاهش 17- بتا استرادیول گردید و EIP از این تغییرات جلوگیری کرد. EIP تعداد فولیکول­های تخمدانی، اووسیت و قطر اووسیت را در نوزادان تحت استرس افزایش داد. EIP همچنین تعداد فولیکول­های آترتیک، تعداد سلول­های گرانولوزای تانل مثبت و سطح سرمی MDA را کاهش و سطح سرمی FRAPS، MDA، T-SOD و GPx را در نوزادان تحت استرس افزایش داد. نتیجه­گیری: این مطالعه نشان داد که عصاره آبی– الکلی پروپولیس ایرانی می­تواند بطور معنی­داری از تغییرات استرس اکسیداتیو و هیستوپاتولوژیک تخمدان نوزادان موش صحرائی به دنبال استرس جلوگیری کند. 2 Background: Stress in infancy has dramatic effects on different systems, including the nervous system, endocrine, immune, reproductive and etc. Objective: The purpose of this study was to investigate the effects of extract of Iranian propolis (EIP) on ovarian tissue and oxidative stress in rats with maternal separation stress. Materials and Methods: 48 immature female rats were divided randomly into six groups. 1) Control group, 2) Control group+saline, 3) Stress group, includes infants that were separated from their mothers 6 hr/day, the 4th, 5th and 6th groups consisted of infants who in addition to daily stress received 50, 100 and 200 mg/kg of EIP, respectively. Then serum corticosterone, 17-beta-estradiol, malondialdehyde, total superoxide dismutase, glutathione peroxidase and ferric reducing antioxidant power levels were measured. The ovarian sections were stained by H&E, PAS, and TUNEL methods and were studied with optical microscopy. Results: Stress increased the blood serum corticosterone levels and 17-beta-estradiol reduced significantly (p<0.001) and EIP prevented from this changes (p<0.01). EIP significantly increased the number of ovarian follicles, oocytes and oocytes diameter in neonatal rat following stress (p<0.01). EIP also significantly decreased the number of atretic follicles, TUNEL+granulosa cells, malondialdehyde levels and increased ferric reducing antioxidant power, total superoxide dismutase and glutathione peroxidase serum levels in neonatal rats following stress. The dose of 200 mg/kg EIP was more effective. Conclusion: This Study showed that the Iranian Propolis significantly could prevent oxidative stress and histopathological changes in the ovary of the neonatal rat the following stress. 509 520 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/142017/10/142017/10/142017/10/142017/10/142017/10/142017/10/14 1396/7/22 عاطفه عرب عامری Atefeh Arabameri Department of Biology, Faculty of Basic Sciences, Islamic Azad University, Damghan, Iran ایران حمیدرضا ثامنی Hamidreza Sameni Nervous System Stem Cells Research Center, Department of Anatomical Sciences, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran ایران hrsameni@gmail.com احمدرضا بندگی Ahmadreza Bandegi Nervous System Stem Cells Research Center, Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran ایران Propolis Stress Ovary Corticosterone Oxidative stress Rats.  پروپولیس استرس تخمدان کورتیکوسترون استرس اکسیداتیو موش صحرایی. 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Frequency of TNFR1 36 A/G gene polymorphism in azoospermic infertile men: A case-control study فراوانی پلی مورفیسم ژن TNFR1 36 A>G در مردان نابارور آزواسپرم 2 1 مقدمه: فاکتور نکروزیز دهنده تومور آلفا (TNFα) یک سیتوکاین با فعالیت چند گانه است که فعالیت­های مختلف سلولی در ارتباط با  اسپرماتوژنز  را  تنظیم می­کند. رسپتور شماره 1 TNFα فعالیت TNFα را تنظیم می­کند و وجود پلی­مورفیسم در این رسپتور می­تواند به اختلال کارکرد ژنی و ناباروری مردانه منتهی گردد. هدف: هدف از این مطالعه تعیین ارتباط بین پلی­مورفیسم TNFR1 36 A/G و آزواسپرمی ایدیوپاتیک در جمعیت مردان ایرانی است. موارد و روش­ها: در این مطالعه مورد شاهدی، 108 مرد آزواسپرم و 119 مرد بارور مورد بررسی قرار گرفتند. در این تحقیق میزان پلی­مورفیسم TNFR1 36 A/G در گروه مورد که مبتلا به آزواسپرمی ایدیوپاتیک بودند و به مرکز ناباروری یزد مراجعه کردند با گروه شاهد مقایسه گردید. جهت شناسایی پلی­مورفیسم روش PCR-RFLP در دو گروه مورد استفاده قرار گرفت، هضم آنزیمی محصولات PCR به وسیله آنزیم Mspa1I انجام و محصولات روی ژل الکتروفورز نمایش داده شد. فراوانی A→G در مردان آزواسپرم و سالم محاسبه شد. نتایج: نتایج نشان داد که فراوانی ژنوتیپ AG، GG در مردان آزواسپرم به صورت معنی­داری بیش از گروه شاهد بود                                                     (007/0= pو (229/4-248/1) 298/2=OR)، (149/0=p، (498/2-869/0) 47/1=OR). نتایج نشان داد که فراوانی آلل G در مردان آزواسپرم تفاوت معنی­دار آماری با گروه مردان بارور دارد (001/0>p، (355/3-580/1) 302/2=OR). نتیجه­ گیری: ژنوتیپ GG و فراوانی آلل G احتمال بروز آزواسپرمی غیر­انسدادی را افزایش می­دهد. 2 Background: Tumor necrosis factor-alpha (TNF-α) is a multifunctional cytokine that regulates different cellular activities related to spermatogenesis. Tumor necrosis factor-alpha receptor 1 (TNFR1) mediates TNF-α activity and polymorphism in TNFR1 could lead to gene dysfunction and male infertility. Objective: The aim of this study is to determine the association of TNFR1 36 A/G polymorphism with the idiopathic azoospermia in Iranian population. Materials and Methods: This case-control study included 108 azoospermic and 119 fertile men. This research investigated the frequency of TNFR1 36 A/G polymorphism in cases who were idiopathic azoospermic men referred to Yazd Research and Clinical Center for Infertility, Iran in comparison with controls. polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) method was used to investigate the polymorphism in both case and control groups. PCR fragments were digested by Mspa1I enzyme and products were appeared by gel electrophoresis. The abundance of A→G was calculated in the azoospermic and healthy men. Results: According to the present study, GG and AG genotypes frequency in the azoospermic men group were higher than the control group (OR= 2.298 (1.248-4.229), p=0.007), (OR=1.47 (0.869-2.498, p=0.149). Our findings also showed that G allele frequency in azoospermic men had significant difference compared to the control group (OR=2.302 (1.580-3.355), p<0.001). Conclusion: It seems that the GG genotype and G allele have an association with increased risk of non-obstructive azoospermia 521 526 2017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/12017/10/1 1396/7/9 2017/10/142017/10/142017/10/142017/10/142017/10/142017/10/142017/10/142017/10/14 1396/7/22 حمید رضا اشرف زاده Hamid Reza Ashrafzadeh Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran ایران طاهره نظری Tahere Nazari Department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran ایران مسعود دهقان طزرجانی Masoud Dehghan Tezerjani Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران مریم خادمی بمی Maryam Khademi Bami Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran ایران سعید قاسمی اسماعیل آباد Saeed Ghasemi-Esmailabad Recurrent Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران نسرین قاسمی Nasrin Ghasemi Recurrent Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ایران n479g@yahoo.co.uk Polymorphism Male infertility Spermatozoa Cytokines Tumor necrosis factor alpha. پلی مورفیسم ناباروری مردانه اسپرماتوزوآ سایتوکاین TNFα. 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