Articles in This Issue
Abstract
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Polycystic ovary syndrome signs and symptoms often begin soon after menarche. In some cases, PCOS develops later during the reproductive years, for instance, in response to substantial weight gain. The PCOS produces symptoms in about 5-10% of women of reproductive age(12-45 years) and it is one of the leading causes of female subfertility.Women with PCOS suffer not only from subfertility, but also from a high rate of early pregnancy loss. About 30-50% of clinically confirmed early pregnancy loss are associated with PCOS.In addition to early pregnancy loss, women with PCOS have increased risk of recurrent miscarriage ,which defined as 3 or more consecutive pregnancy loss before 20 week. Metformin hydrochloride, an insulin sensitizing agent, has been shown to have encouraging effects on several aspect of PCOS like insulin sensitivity, plasma glucose concentration & lipid profile.It is found that using Metformin during pregnancy in women with PCOS may reduce the pregnancy loss and also reduce the risk of gestational diabetes,intrauterine growth retardation(IUGR) & preterm labor. Aim of study: To evaluate the role of Metformin in women with recurrent miscarriage & its effect on other pregnancy complications in women with PCOS. Patients, Materials & Methods: A prospective study done at gynecology outpatient clinic of AL-Batool Teaching Hospital in Baquba-Diyala -Iraq, from September 2012 to September 2016. A total of 100 cases were studied, all have aconfirmed diagnosis of PCOS depending on the following criteria:1)Oligo or amenorrhea (8 or fewer cycles per a year) , 2) signs of hyperandrogenism 3)ultrasound features of PCOS.All should have history of 3 or more recurrent first trimester miscarriage & they were invistigated for other causes of recurrent miscarriage. All cases were followed before getting pregnant and received Metformin for enhancing fertility & when they become pregnant, they were divided into two groups: the 1st group stopped using Metformin once they get pregnant while the 2nd group continued to use Metformin in a dose of 500-1000mg per day throughout pregnancy .Both groups are followed to determine pregnancy outcome. Results: Patients who continued to receive Metformin during pregnancy had better pregnancy outcome regarding early pregnancy loss and recurrent miscarriage, gestational diabetes development, IUGR & preterm labor. Conclusions: Metformin use during pregnancy improve pregnancy outcome in patients with polycystic ovary syndrome.
Abstract
In present study, it was investigated the effect of clomiphene citrate on the ovaries reproductive hormones and embryos of mature female mice, were studied. Female mice treated with (5, 10,50 mg/kg ) daily for 7 days. Results cleared that cross section showed a significant increase (p<0.05) in multi follicular (different numbers )on the right and left ovaries of female mice. In other hand; there were a significant elevation (p<0.05) in the follicle stimulation hormone(FSH), estrogens and progesterone concentration, while, no significant changes were noticed in luteinizing (LH). Conclusions: Clomiphene citrate is the best initial treatment especially in relevance with ovulatory problems (dysfunction), and has a super stimulatory effect on ovulation, thereby increasing the number of recruited follicles in albino female mice rather than affecting the follicular steroidogenic function, and its induce multi follicle ovum forming. Similarly, it has positive affection on gonadotropene hormones, eventually it leads to a twin pregnancy. Combined c with appropriately timed IUI, Clomiphene citrate treatment also increases cycle fecundity in couples with unexplained infertility.
Abstract
Monosodium Glutamate (MSG) is the sodium salt of glutamate (simply glutamate, water and sodium) and is widely used as food additive and as flavoring agent to increase appetite. The present study was to evaluate the effect of daily oral admiration of (MSG) (100mg/kg/day) for 30day on reproductive system of males and females Swiss albino mice. Forty albino mice weighting about (25-30kg) were used in the present study. The animal were divided in two groups: control group (10 males and 10 females)(n=20) and treated group(males and females) n=20.The body weight of the animals detected at the beginning and the end of experiment. At 30 days animals sacrificed and ovaries, uterus, testis were removed and weighted, Samples of ovaries, uterus testis fixed in 10%formaline for histological study. The final result show highly significant increase in the body weight and show significant decrease in the weight of ovaries and testis. The histological study in the treated group of testis show suppression of spermatogenesis, degenerate of seminiferous tubules and congestion of blood vessels. The histological changes in the ovaries such as congested blood vessels of medulla, increased atretic follicles and uterus show necrosis in perimetrium , presence of lacunae in the uterine wall structure . Conclusions: Monosodium glutamate has negative effect on reproductive system for each sex. So that will effect on the fertility .Also the increased body weight could lead to increase the incidence of congestive heart diseases and diabetes mellitus.
Abstract
Background: The procedures of assisted reproductive technologies have been developed during recent years and have been revealed the need for new suitable and effective techniques of sperm treatment in the laboratory. Objectives: This study is designed to normozoospermic and asthenozoospermic compare the semen outcomes of two in vitro sperm activation techniques and evaluate their efficiency, namely; Glass wool filtration technique and a new technique of Glass wool filtration combined with Pentoxifylline. Subjects, Materials and Methods: Fifty five semen samples were collected from the patients, fifteen were obtained from normozoospermic men, forty were obtained from asthenozoospermic men who at tend the infertility clinic were involved in this study. Sperm parameters were assessed according to WHO (2010 and 1999). Post-activation of each sample were divided into two aliquots, the first one : using Glass wool filtration technique , the second : using Glass wool filtration technique with Pentoxifylline. Results: A significant increase of sperm motility, progressive sperm motility and morphologically normal sperm when using Glass wool filtration technique combined with Pentoxifylline as compared to Glass wool filtration technique. Regarding sperm agglutination and Round cells count the study showed the best results by decreasing their levels when using Glass wool filtration technique combined with Pentoxifylline as compared to Glass wool filtration technique alone. Conclusions: From the results of the present study, the sperm function parameters outcome when using glass wool filtration technique combined with Pentoxifylline were superior to other technique since it yields better sperm function parameters rather than the outcome of glass wool filtration ; respectively especially when using a low quality of semen samples such as decreased sperm function parameters (sperm motility) so it was fit in cases of asthenozoospermia which taken as an example of infertile group within this study.
Abstract
Background: Over 70 million couples suffer from infertility worldwide and the majority of those couples can be found in developing countries. Aims of study: This study aims to determine if there is any significant difference in levels of inhibin B and gonadal hormones in fertile and infertile men. Subjects, Materials & Methods: Clinical and hormonal characteristics related to male infertility factor of the infertile patients(n=75)and representative proven fathers as a control(normozoospermic ones)(n=25)were studied. All males attending infertility clinic at Baquba General Hospital, Diyala in Iraq. The study included the measurement of gonadal hormones levels by using (ELISA)method and it was also used in analyzing the inhibin B hormone. The VIDAS instruments were used for enzyme immunoassay measurements Luteininzing Hormone(LH),Testosterone(T) ;and Follicle Stimulating Hormone(FSH). The samples were analyzed and classified according to WHO criteria. Results: The results of this study showed that inhibin B hormone and other gonadal hormones in control (representative proven fathers-normozoospermic ones)as inhibin B (240.2±17.4)Pg/ml, LH (1.639±0.103)mIU/ml, Testosterone (0.6253±0.035)ng/ml and FSH (0.469±0.0103)mIU/ml. In asthenozoospermic ones as an example of infertile patients the results showed that inhibin B (76.9±8.99)Pg/ml, LH(1.4311±0.033)mIU/ml, T (0.5483±0.030)ng/ml and FSH (0.495±0.0124)mIU/ml. Except the inhibin B comparisons all of other non significant evaluated parameters & correlations within this study could be ascribed to the role of cascaded role of inhibin B with the gonadal hormones in spermatogenesis. Conclusions: It concluded from this study that decreased levels of inhibin B, LH,Testosterone, but increased levels of FSH hormones were shown in asthenozoospermia group as an example of infertile patients,and increased levels of inhibin B,LH and Testosterone but decreased levels of FSH were shown in normozoospermia as control.
Abstract
Background: Obesity, defined by the World Health Organization (WHO) as “abnormal or excessive fat accumulation that may impair health .The effects of obesity on male reproduction have been less well studied than those on female reproduction, but there is a growing body of evidence suggesting that obesity has an adverse effect on male reproduction However, a little is known about the effect of obesity on male reproductive system and infertility. Infertility is defined as inability to achieve conception within one year. It has not yet been clearly established how excess adiposity relates to the biological changes that underlie male infertility, although there are several theories worth exploring. The endocrine abnormalities associated with obesity in women are well known with an increase in androgen metabolism and changing in reproductive hormones in over weight and obese men. Objective: The study aim at assessing the role of obesity in infertile males through measurement of BMI, some of sex hormones. Methods: This study was carried out in Tikrit Teaching Hospital, on the adult male population aged 17-45 years, from September 2013 to April 2014. The recruited cases divided into 90 infertile obese male and 30 normal weights infertile as pathological control group and 30 normal weight fertile men as normal control group.The serum samples willed collect of the patients and measure the concentrations of the sex hormones (FSH, LH, INHB) by using ELISA technique. Body Mass Index Calculation Height (m) and weight (kg). Results: There was no significant correlation between BMI (30.1±93.45, 21.40±5.24,23.24±1.42)kg/m2 in patients group, pathological control group and control group and serum LH level (22.35±12.79, 19.31±9.94, 13.90±8.33) ml U/ml in all three group respectively. There was a significant negative correlation (P< 0.03) between BMI (23.24±1.42)kg/m2 and serum FSH level (7.10±3.77) ml U/ml, in control group. While there was no significant correlation between BMI (30.19±3.45,21.40 ±5.24) kg/m2 and serum FSH level (13.59±15.72, 11.58±14.06) ml U/ml in both patients' group and pathological control group respectively.There was no significant correlation between BMI (30.19±3.45, 21.40±5.24,23.2±1.42) kg/m2and serum INHB level in the patients group, pathological control group and control group (88.8±57.96, 108.51±78.39, 141.65±63.95) pg/ml respectively. Conclusions: The BMI did not correlated with some reproductive hormones (LH, FSH,INHB) in obese infertile males, but there was a significant correlation between the FSH and BMI in control group. In infertile obese group found the highest level of LH, FSH, and the lowest level of INHB comparing with other group in this study.
Abstract
The estimation of oocyte quality in human in vitro fertilization (IVF) is an important point for the embryologists. Oocyte selection and the identification of the best oocytes may help to limit an overproduction of embryos and to improve the results of oocyte cryopreservation programs. The follicular fluid (FF) can be provided easily during oocyte pick-up and known to represents an optimal source for non-invasive biochemical predictors of oocyte quality. However, till now no substance was found to be used as reliable markers of oocyte competence to fertilization, embryo development and pregnancy. Metabolism and ATP levels within the oocyte and adjacent cumulus cells are associated with quality of oocyte and optimal development of a healthy embryo. Lipid metabolism provides a potent source of energy and its importance during oocyte maturation is being increasingly recognised. Objectives: To determine the effect of lipids (Cholesterol. Triglyceride and HDL) level in serum and follicular fluid in predicting oocyte quality, embryo quality and outcome in patients undergoing intracytoplasmic sperm injection program Patients and Methods: Fifty eight (58) infertile women with an age range 21-41 years old undergoing intracytoplasmic sperm injection cycles were included in this study. Lipids (Cholesterol. TG and HDL.,) levels in serum and follicular fluid were measured by auto analyzer for biochemistry (Flexor El_200) and correlation with oocyte quality, embryo quality and ICSI outcome was done. Results: The results of this study showed no significant (p<0.05) difference in lipid levels in serum and follicular fluid between pregnant and non pregnant females as well as non significant correlation was found between lipid level in serum and follicular fluid in relation to oocyte quality and embryo quality. Conclusions: Serum and follicular fluid lipids are not good predictors of oocyte quality, embryo quality or ICSI outcome in women undergoing IVF/ICSI cycles. Accordingly, these biomarkers would be less reflective of the follicular environment and that the effect of maternal metabolic disorders on oocyte quality and fertility outcome is complex and of a multifactorial kind.
Abstract
Background: Male obesity is associated with physiological changes that can negatively affect male fertility. Obese men have demonstrated a 3-fold increase in the prevalence of oligozoospermia when compared with men with normal Body Mass Index (BMI). Objective: To find the correlation between Aromatase enzyme with the following hormones (follicle stimulating hormone(FSH), Luteinizing hormone(LH), Estradiol(E2), and testosterone) in the obese infertile male. Subjects, Materials and Methods: Seventy obese infertile male (patients) and twenty obese fertile male (control) are enrolled in this study. Aromatase enzyme, FSH, LH, E2 and testosterone hormones were measured in their serum. All serum samples were measured by ELISA method. Results: Median human cytochrome enzyme level was significantly higher in patients than in control group, 87.55+ 12.48 pg./ml versus 56.95+9.88 pg./ml, P= 0.014. In patients group, a significant positive correlation was found between human cytochrome enzyme, FSH, and LH. Conclusions: The present study showed clearly that male obesity negatively affects fertility through changes in hormone levels. The results suggest that increased estrogen because of aromatization in the fatty tissue, reflected through the increase in human cytochrome enzyme (aromatase), may be an important mechanism for the hypoandrogenemia and altered sperm parameters.