1 2476-4108 Shahid Sadoughi University of Medical Sciences, Yazd, Iran 693 1H NMR- based metabolomics approaches as non- invasive tools for diagnosis of endometriosis Ghazi Negar b Arjmand Mohammad c Akbari Ziba d Owsat Mellati Ali e Saheb-Kashaf Hamid f Zamani Zahra g b Department of Biochemistry, Zanjan Medical University, Zanjan, Iran c Department of Biochemistry, Pasteur Institute of Iran, Tehran, Iran d Department of Biochemistry, Zanjan Medical University, Zanjan, Iran e Department of Biochemistry, Zanjan Medical University, Zanjan, Iran f Navid Medical Center, Tehran, Iran g Department of Biochemistry, Pasteur Institute of Iran, Tehran, Iran 1 1 2016 14 1 1 8 01 10 2017 04 10 2017 Background: So far, non-invasive diagnostic approaches such as ultrasound, magnetic resonance imaging, or blood tests do not have sufficient diagnostic power for endometriosis disease. Lack of a non-invasive diagnostic test contributes to the long delay between onset of symptoms and diagnosis of endometriosis. Objective: The present study focuses on the identification of predictive biomarkers in serum by pattern recognition techniques and uses partial least square discriminant analysis, multi-layer feed forward artificial neural networks (ANNs) and quadratic discriminant analysis (QDA) modeling tools for the early diagnosis of endometriosis in a minimally invasive manner by 1H- NMR based metabolomics. Materials and Methods: This prospective cohort study was done in Pasteur Institute, Iran in June 2013. Serum samples of 31 infertile women with endometriosis (stage II and III) who confirmed by diagnostic laparoscopy and 15 normal women were collected and analyzed by nuclear magnetic resonance spectroscopy. The model was built by using partial least square discriminant analysis, QDA, and ANNs to determine classifier metabolites for early prediction risk of disease. Results: The levels of 2- methoxyestron, 2-methoxy estradiol, dehydroepiandrostion androstendione, aldosterone, and deoxy corticosterone were enhanced significantly in infertile group. While cholesterol and primary bile acids levels were decreased. QDA model showed significant difference between two study groups. Positive and negative predict value levels obtained about 71% and 78%, respectively. ANNs provided also criteria for detection of endometriosis. Conclusion: The QDA and ANNs modeling can be used as computational tools in noninvasive diagnose of endometriosis. However, the model designed by QDA methods is more efficient compared to ANNs in diagnosis of endometriosis patients.
692 Nitric oxide donors improve the ovulation and pregnancy rates in anovulatory women with polycystic ovary syndrome treated with clomiphene citrate: A RCT Mahran Ahmad h Abdelmeged Ayman i Shawki Hossam j Moheyelden Abdelrazek k Ahmed Asmaa Mohamed l h Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt i Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt j Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt k Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt l Department of Obstetrics and Gynecology, Beni-Mazar General hospital, Minia, Egypt 1 1 2016 14 1 9 14 01 10 2017 04 10 2017 Background: Clomiphene citrate (CC) is the first line agent used for ovulation induction in patients with polycystic ovarian syndrome (PCOS). However, there is marked discrepancy between the ovulation and pregnancy rates achieved, which may be attributed to the undesirable effect of CC on cervical mucus and endometrium. Objective: The aim of this study was to evaluate the effect of Isosorbid monoitrate (ISMN) as nitric oxide (NO) donors on the ovulation and pregnancy rates in an ovulatory women with PCOS treated with CC. Materials and Methods: Ninety patients with PCOS were randomly allocated into three groups. Patients in group A) were treated with 100 mg CC for five days starting from the fifth day of the cycle. Patients in group B) and C) received 10 mg and 20 mg of ISMN respectively in addition to CC, applied vaginally till the diagnosis of ovulation. Results: There was a significant increase in the ovulation and pregnancy rates in the patients treated with CC+ISMN as compared with patients treated with CC alone (p< 0.001). Conclusion: Concomitant use of NO with CC seems to improve the ovulation and pregnancy rates in the patients with PCOS with no significant increase in side effects as compared with CC alone. 691 Altered expression of KLC3 may affect semen parameters Kargar- Dastjerdy Pegah m Tavalaee Marziyeh n Salehi Mansoor o Falahati Mojtaba p Izadi Tayebeh Nasr Esfahani Mohammad Hossein m Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran n Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran o Department of Genetics and Molecular Biology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran p Department of Nanotechnology, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran Isfahan Fertility and Infertility Center, Isfahan, Iran 1 1 2016 14 1 15 22 01 10 2017 04 10 2017 Background: KLC3 protein as a member of the kinesin light-chain protein family plays an important role in spermatogenesis, during formation of mitochondrial sheath in the mid piece of the sperm tail. Objective: This study for the first time aims to compare the expression of the KLC3 gene between fertile and infertile individuals. Materials and Methods: Semen samples were collected from 19 fertile individuals who were selected from embryo-donor volunteers and 57 infertile individuals who had abnormal sperm parameters according to world health organization criteria. Sperm parameters using computer assisted sperm analysis and the quantitative KLC3-gene expression using the real-time PCR method were measured. Results: Our results revealed a significant correlations between sperm concentration with relative expression of KLC3 only in infertile groups (r=0.45, p=0.00). A significant correlation was not found between KLC3 expression and sperm motility; however, the relative expression of KLC3 was significantly higher in asthenozoospermic compared to non-asthenozoospermic individuals. Conclusion: Low expression of KLC3 may result in improper function of midpiece, which has important function in sperm motility. The results of this study show that aberrant expression of KLC3 might be associated with phenomena like oligozoospermia and asthenozoospermia. This article is extracted from student’s thesis. 689 The effect of the melatonin on cryopreserved mouse testicular cells Saki Ghasem Mirhoseini Mehri Hemadi Masoud Khodadadi Ali Beygom Talebpour Amiri Fereshteh Cellular and Molecular research Center, School of Medicine. Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran Infertility and Perinatology Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Petroleum and Environmental Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Department of Anatomy, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 1 1 2016 14 1 23 28 01 10 2017 04 10 2017 Background: After improvements in various cancer treatments, life expectancy has been raised, but success in treatment causes loss of fertility in many of the survived young men. Cryopreservation of immature testicular tissues or cells introduced as the only way to preserve fertility. However, freezing has some harmful effects. Melatonin, a pineal gland hormone, has receptors in reproductive systems of different species. It is assumed that melatonin has free radical scavenger properties. Objective: The aim of this study was to evaluate the effects of melatonin on the cryopreserved testicular cells in mouse. Materials and Methods: Cells from 7- 10 days old NMRI mice testes were isolated using two step enzymatic digestion. The testicular cells were divided into two groups randomly and cryopreserved in two different freezing media with and without the addition of 100 µm melatonin. Finally, apoptosis of the cells was assayed by flow cytometry. Also, lactate dehydrogenase activity test was performed to assess the cytotoxicity. Results: The results of lactate dehydrogenase showed the nearly cytotoxic effect of melatonin. The results of flow cytometry showed increase in apoptosis in the cryopreserved cells in the media containing melatonin compared to the control group. Conclusion: The present study shows that melatonin has an apoptotic effect on cryopreserved mouse testicular cells. 690 Examining the sexual function and related attitudes among aged women: A cross- sectional study Jamali Safieh Rahmanian Afifeh Javadpour Shohreh Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran Department of Nursing, Faculty of Nursing and Midwifery, Jahrom University of Medical Sciences, Jahrom, Iran Department of Nursing, Faculty of Nursing and Midwifery, Jahrom University of Medical Sciences, Jahrom, Iran 1 1 2016 14 1 29 38 01 10 2017 04 10 2017 Background: Sexual function and its subsequent satisfaction are among the most important aspects of women’s life. However, this instinct could be influenced by some factors such as diseases, drug using, aging, and hormonal and physiologic changes associated with menopause, and sexual behavior. Objective: The aim of this study was to describe the prevalence rates of sexual dysfunction, and related attitudes among aged women in Jahrom, Iran. Materials and Methods: This cross-sectional study was conducted on 746 postmenopausal women aged between 50 and 89 years old who had referred to obstetric and gynecologic clinic in Jahrom, from April to October 2014. Female Sexual Function Index questionnaire was used order to assess the sexual function. The cases were classified into three categories according to the attitude scores: negative (17-32), medium (33-38), and positive (39-48). One-way ANOVA test was used to determine the relationship between FSFI and attitude scores. Results: The participants’ mean±SD age was 60.10±6.89 years and the total mean score of FSFI was 19.31±8.5. In addition, 81.5% of the women had sexual dysfunction (FSFI< 26.55) and only 147 women (18.5%) had normal sexual function (FSFI> 26.55). Almost 62.1% the women displayed a negative attitude towards sexuality and only 18.8% women had positive attitude. Feeling of dyspareunia (p= 0.02), lubrication (p< 0.0001), orgasm (p= 0.002) and satisfaction (p= 0.002) were significantly different between three categories of attitudes regarding sexuality, respectively.  Conclusion: Our data showed that sexual disorders were highly prevalent among postmenopausal women. The most affected problems were arousal, dyspareunia, and lubrication. More than half of the women had negative attitude towards sexual function consequently this could affect their sexual function. So, it seems screening of sexual dysfunction for finding the causes in women should be the main sexual health program. Also, it would be important to emphasis the role of physicians and experts on education and counseling in this subject. 688 Comparison of pregnancy rate between fresh embryo transfers and frozen-thawed embryo transfers following ICSI treatment Basirat Zahra Adib Rad Hajar Esmailzadeh Sedigheh Jorsaraei Seyed Gholam Ali Hajian- Tilaki Karimollah Pasha Hajar Ghofrani Faeze Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Department of Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Department of Social Medicine and Health, Babol University of Medical Sciences, Babol, Iran Department of Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 1 1 2016 14 1 39 46 01 10 2017 04 10 2017 Background: The use of assisted reproductive technology (ART) is increasing in the world. The rate, efficacy and safety of ART are very different among countries. There is an increase in the use of intra cytoplasmic sperm injection (ICSI), single fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET). Objective: The objective of this study was to compare pregnancy rate in fresh ET and FET. Materials and Methods: In this retrospective cross-sectional study 1014 ICSI-ET cycles (426 fresh ET and 588 FET) from 753 women undergoing ICSI treatment referred to Fatemezahra Infertility and Reproductive Health Research Center in Babol, Iran from 2008 to 2013 were reviewed. Results: There were no significant differences between biochemical pregnancy rate (23% versus 18.8%, OR 1.301; 95% CI .95-1.774), gestational sac (95.6% versus 100% in FET, OR 0.60; 95% CI 0.54-0.67), and fetal heart activity (87.2% versus 93.6% OR .46; 95% CI .16-1.32) in fresh ET and FET cycles, respectively. P< 0.05 was considered statistically significant for all measures. Conclusion: Although, the result showed no significantly difference between the fresh ET and the FET cycles, however the embryos are able to be stored for subsequent ART. Therefore, we recommend FET cycles as an option alongside the fresh ET. 686 Silymarin protects plasma membrane and acrosome integrity in sperm treated with sodium arsenite Eskandari Farzaneh Momeni Hamid Reza Department of Biology, Faculty of Science, Arak University, Arak, Iran Department of Biology, Faculty of Science, Arak University, Arak, Iran 1 1 2016 14 1 47 52 01 10 2017 04 10 2017 Background: Exposure to arsenic is associated with impairment of male reproductive function by inducing oxidative stress. Silymarin with an antioxidant property scavenges free radicals. Objective: The aim of this study was to investigate if silymarin can prevent the adverse effects of sodium arsenite on ram sperm plasma membrane and acrosome integrity. Materials and Methods: Ram epidydimal spermatozoa were divided into five groups: spermatozoa at 0 hr, spermatozoa at 180 min (control), spermatozoa treated with silymarin (20 μM) + sodium arsenite (10 μM) for 180 min, spermatozoa treated with sodium arsenite (10 μM) for 180 min and spermatozoa treated with silymarin (20 μM) for 180 min. Double staining of Hoechst and propidium iodide was performed to evaluate sperm plasma membrane integrity, whereas comassie brilliant blue staining was used to assess acrosome integrity. Results: Plasma membrane (p< 0.001) and acrosome integrity (p< 0.05) of the spermatozoa were significantly reduced in sodium arsenite group compared to the control. In silymarin + sodium arsenite group, silymarin was able to significantly (p< 0.001) ameliorate the adverse effects of sodium arsenite on these sperm parameters compared to sodium arsenite group. The incubation of sperm for 180 min (control group) showed a significant (p< 0.001) decrease in acrosome integrity compared to the spermatozoa at 0 hour. The application of silymarin alone for 180 min could also significantly (p< 0.05) increase sperm acrosome integrity compared to the control. Conclusion: Silymarin as a potent antioxidant could compensate the adverse effects of sodium arsenite on the ram sperm plasma membrane and acrosome integrity. 687 Effect of adding human chorionic gonadotropin to frozen thawed embryo transfer cycles with history of thin endometrium Davar Robab Miraj Sepideh Farid Mojtahedi1 Maryam Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Shahrekord University of Medical Sciences, Shahrekord, Iran Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 1 1 2016 14 1 53 56 01 10 2017 04 10 2017 Background: Embryo implantation process is a complex phenomenon and depends on fetal and maternal factors interaction. Endometrial thickness is needed for successful implantation. Objective: We designed this study in order to assess adding human chorionic gonadotropin (HCG) to the conventional protocol in endometrial preparation in women with thin endometrium and a history of in vitro fertilization–embryo transfer (IVF-ET) failure. Materials and Methods: The non-randomized clinical trial study (quasi experimental design) was performed on 28 patients. Participants were women who were candidate for frozen-thawed (ET) and had two previous failed ET cycles because of thin endometrial. HCG was administrated (150 IU, intramuscular) from the 8th day of cycle and when endometrial thickness reached at least 7mm HCG was discontinued and frozen thawed ET was done. Results: Totally 28 patients were included. The mean ± SD age of participants was 30.39±4.7. The mean of endometrium thickness before and after HCG were 5.07±0.43 and 7.85±0.52, respectively p<0.001. Also, there were five clinically and chemically pregnant women. Conclusion: The findings of the study suggested that adding HCG to the conventional preparation method was an effective protocol and significantly improved endometrial thickness and pregnancy outcomes in women with previous embryo transfer failure because of thin endometrium. 685 Psychometric properties of the satisfaction with life scale (SWLS) in Iranian infertile women Maroufizadeh Saman Ghaheri Azadeh Omani Samani Reza Ezabadi Zahra Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran 1 1 2016 14 1 57 62 01 10 2017 04 10 2017 Background: Infertility is a global public health issue and may adversely affect life satisfaction. One of the most widely instruments used to assess life satisfaction is the Satisfaction with Life Scale (SWLS). Objective: The objective of this study was to examine the psychometric properties of the SWLS in Iranian infertile women. Materials and Methods: In this descriptive cross-sectional study, a total of 125 infertile women referring to Royan Institute in Tehran were selected by convenience sampling method. The participants were administered the SWLS, the Hospital Anxiety and Depression Scale (HADS), and a demographic questionnaire. The psychometric properties of the SWLS were examined: construct validity using confirmatory factor analysis (CFA), reliability using Cronbach’s alpha and convergent validity by examining the relationship with HADS. Result: Results of the CFA indicated that a single-factor model provides a good fit to the data (χ2/df= 1.58; GFI= 0.975; CFI= 0.995; NFI= 0.985; RMSEA= 0.069 and SRMR= 0.027). The Cronbach’s alpha coefficient for SWLS was 0.887. Significant negative  correlations  were found  between  SWLS and HADS scores for anxiety (r= -0.410) and depression (r= -0.434), indicating an acceptable convergent validity. Conclusion: The SWLS has adequate psychometric properties for assessing life satisfaction in Iranian infertile women. 852 Comparison of sexual activity and life satisfaction in women with intended and unintended pregnancies Khodabakhshi Koolaee Anahita Zamani Mahnaz Moslanejad Leili Jamali Safieh Institute of Higher Education of Khatam, Tehran, Iran. Midwifery Clinic, Shahid Mostafa Khomaini Hospital, Shahhed Medical University, Tehran, Iran Mental Health Department, Research Center for Social Determinant of Health, Jahrom University of Medical Sciences, Jahrom, Iran Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran. 1 1 2016 14 1 63 64 04 10 2017 04 10 2017 Pregnancy and childbirth, as a part of the triple crises of life, such as puberty and marriage, are of considerable importance and could be matter of research. Like every other crisis, pregnancy is consisted of both physical and psychological changes. Besides, assisting in improvement of maternal health helps to understand these changes and their interactions, which create different clinical presentations in different people (1, 2). There are rare studies regarding the satisfaction of life and sexual function in these individuals. Health care for mothers during pregnancy and prevention of fears, anxiety, and stress are essential issues. Moreover, following pregnancy, sanitation rules are the most important social requirements that include the following items: A) providing sanitary conditions during pregnancy with minimum physical and mental discomfort and maximum satisfaction and pleasure. B) delivery in the best possible position, having a healthy baby. C) providing the health of pregnant woman and guidelines for creating balance after childbirth (3). In general, women with unwanted pregnancy have reported lower level of all dimensions of sexual function, like; sexual stimulation, orgasm, and satisfaction. Thus, it is confirmed that there is a significant difference in sexual function between women with intended pregnancy and those with unintended pregnancy in just two sub-scales that aforementioned above. There are several reasons that changes in sexual function occur during pregnancy, both in women with intended pregnancy, and those with unintended pregnancy (4). There are certain critical stages in the life of every person that have a profound impact on the lives of individuals, including pregnancy that is one of the important periods of life. Because pregnancy for a woman looks like achieving sense of wholeness, perfection satisfies reproduction and the sense of being eternal. Although, it is an exceptional success in normal conditions, it makes the woman feeling happiness and satisfaction. So, she faces with many physical and behavioral changes (5). The lower quality of the relationship between husband and wife in the family and lack of attachment to the family and generally disorders in marital relationship can bring resentment and hatred about pregnancy. On the other hand, sexual relationship in pregnancy period alters due to the numerous physical and psychological changes. In other words, the roles of men and women turn into those of the mothers and the fathers (6). Unintended pregnancy refers to pregnancies happen without desire or intention of couples or without preplanning. When faced with an unintended pregnancy, many of the women attempt to take irrational actions. They take care of themselves less than they used to and they are likely to take actions to terminate pregnancy (7). Generally, unintended pregnancies occur for two reasons: non-use of contraceptives due to various personal and cultural reasons and the absence of fully effective contraceptive methods. According to one study, the women with unintended pregnancies suffer from lower psychological and physical recovery rates compared to women with intended pregnancies (8). Due to the nature of their pregnancies, mothers with unintended pregnancy face with numerous risks during pregnancy such as: delay, decrease or failure in admitting the authorized centers to receive sanitary cares of pregnancy period (use of folic acid, iron, diagnosis and treatment of chronic diseases, diagnosis and treatment of eclampsia), also mothers with unintended pregnancy increasing physical and sexual violence against them (9). The woman with intended pregnancy has long been waited for pregnancy and is happy and satisfied with her pregnancy. She prepares herself to be a mother and establishes an emotional relationship with her baby and gives special attention to the essential points that every pregnant woman should know and tries to accept her pregnancy and changes in family and social roles (10). Some studies have stated that women with unwanted pregnancy report higher physical and sexual abuse among their pregnancy and they decided to terminate their pregnancy. In addition, unintended pregnancy sometimes along with some strongly experience of Post-traumatic stress disorder (PTSD, symptoms of anxiety and depression. This associated symptoms impact the life satisfaction in unintended pregnancy (11). The results demonstrate a clear relationship between a woman's experience of physical violence from her husband and her ability to achieve her fertility intentions. Also there is a relationship between unintended pregnancies and domestic violence. Couples with unplanned pregnancies experience higher levels of sexual function problem before the birth of child. Couples with planned pregnancies have reported lower sexual problems during the pregnancy. While some researchers, as mentioned before, indicated the lower sexual functions in all sub-scales and general scores in women with unintended pregnancies than the women with planned pregnancies, but our results in this study was inconsistent with those findings. The women with unintended pregnancies reported lower sexual function in two scales than the women with intended pregnancy. In addition, there were differences in the life satisfaction in women with unintended pregnancies