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Vol. 15 No. 2 (2025)

Published December 31, 2025 Pages: 1-117
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Articles in This Issue

Articles
Effect of monosodium glutamate on female reproductive histology in mice embryo
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Abstract

Monosodium glutamate (MSG) is a widely used flavor enhancer in many foods. However, excessive consumption during pregnancy may adversely affect embryonic development and reproductive functions. This study aimed to investigate the effects of maternal MSG consumption during pregnancy on pregnancy outcomes and the reproductive system of female offspring in mice. Thirty adult pregnant female mice, aged 42–49 days, were used in this study. The animals were equally divided into two groups: an experimental group (G1) and a control group (G2). The experimental group received MSG extract orally at a dose of 1 mg/kg body weight dissolved in 1 ml of distilled water (D.W.) throughout the three weeks of pregnancy, whereas the control group received 1 ml of distilled water alone for the same duration. After delivery, litter size and litter weight were recorded. Forty days after birth, the weights of the female reproductive organs were measured, and the diameters of the ovaries and oviducts were assessed. In addition, blood samples were collected for the evaluation of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels in both groups. The experimental group showed a significant reduction in litter size and a significant decrease in litter weight compared with the control group. Female offspring born to MSG- treated mothers also exhibited a significant decrease in reproductive organ weight, ovarian diameter, and oviduct diameter. Furthermore, significant reductions in the levels of FSH, LH, and estradiol were observed in the experimental group. Maternal consumption of MSG during pregnancy may negatively affect pregnancy outcomes and impair the development and function of the reproductive system in female offspring.

Articles
The difference of birth weight in pregnancy with and without preeclampsia
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Preeclampsia-eclampsia still continues to be one of the major causes of maternal and fetal mortality and morbidity. Recent evidence suggests that there may be several underlying causes or predispositions leading to develop this syndrome, which not only affects the mother but significantly affects the fetal growth and development.The objective of the study was to assess the difference in birth weight in pregnancy with and without preeclampsia . A case – control study at Al-kadhmya teaching hospital The study included 200 pregnant women with singleton viable gestation presented in labor who were admitted to hospital.A comparison of 100 women in the preeclamptic group and 100 women in the non-preeclamptic group in terms of maternal age, parity, gestational age at delivery, placental weight, and fetal birth weight and sex. Detailed obstetric and general medical history was taken and general and obstetric examination performed. The newborn infants were carefully examined and weighed, and the APGAR score was assessed after delivery. The fresh placenta was examined and then weighed with the membranes and cord attached.At low placental weight, preeclampsia had significant association with low birth weight (35%). However, at high placental weight, preeclampsia had non-significant association with high birth weight (4%). Birth weight of neonatal case group was close to birth weight of control group especially at late onset of preeclampsia but this was not significant statistically .Preeclampsia is multisystemic disorder and it is (the disease of theories) these result suggest that preeclampsia may represent different entities with different degree of placental involvement and different degree of fetal growth and development.

Articles
The Impact of Hyaluronic Acid Endometrial Wash on Transforming Growth Factor Serum Level and Pregnancy Outcome in ICSI
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Fertility is a fundamental function of reproductive health that is under the control of different hormones, cytokines, and growth factors. Transforming growth factor superfamily is a group of cytokines necessary for blastocyst implantation as they regulate endometrial stromal cell proliferation, and promote embryonic adherence to the receptive endometrium. Hyaluronic acid molecule (HA) is a long, unbranched polysaccharide that plays a delicate function in reproduction. Hyaluronic acid regulates gametogenesis, folliculogenesisi, and implantation, thereby was oroposed to improve the rate of successful pregnancy.This study is a prospective clinical trial that includes 80 infertile Iraqi women aged (18-40 years) scheduled for fresh ICSI program. The study sample had been divided into 2 groups based on the type of intervention performed on the day of oocytes retrieval. The Hyaluronic acid group and the control group. For each participant, twice measurement of the serum level of transforming growth factor were done , the first measure was done on day of oocytes retrieval, while the second measure was performed on day of embryo transfer. A comparative statistic was made to examine the effect of hyaluronic acid intrauterine wash on the serum level of transforming growth factor and pregnancy rate.Hyaluronic acid intrauterine wash exerts a significant reduction in transforming growth factor serum level, and a significant improvement in the pregnancy outcome compared to the control group.

Articles
Comparison between Progesterone-Primed Protocol and GnRH Antagonist Protocol on Oocyte Yield and Fertilization Rate in PCOS Females
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Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility and is associated with an increased risk of premature luteinizing hormone (LH) surges during controlled ovarian stimulation. Progestin-primed ovarian stimulation (PPOS) using Medroxyprogesterone Acetate (MPA) has emerged as a convenient alternative to conventional gonadotropin-releasing hormone (GnRH) antagonist protocols. This study aimed to compare the effects of MPA-based PPOS and GnRH antagonist protocols on oocyte yield, maturation, fertilization, and embryo quality in women with PCOS undergoing ICSI . This prospective, randomized, open-label controlled clinical trial included 108 women with PCOS undergoing ICSI at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq, between 2023 and 2024. Participants were allocated to an MPA-based PPOS group (n=49) or a flexible GnRH antagonist group (n=59). Oocyte yield, metaphase II (MII) oocytes, fertilization rate, embryo quality, ovarian sensitivity index (OSI), gonadotropin consumption, stimulation duration, and LH profiles were evaluated.No significant differences were observed in baseline characteristics or hormonal profiles between groups. The MPA group showed a numerically higher number of retrieved oocytes (20.65 ± 7.50 vs. 13.39 ± 4.41; p=0.083) and MII oocytes (15.10 ± 5.20 vs. 11.24 ± 4.12; p=0.09), although these differences were not statistically significant. Fertilization rates were comparable between groups (72.4 ± 10.6% vs. 71.2 ± 11.3%; p=0.68), as were embryo quality, OSI, gonadotropin consumption, and stimulation duration. Both protocols effectively suppressed premature LH surges without premature ovulation or cycle cancellation. MPA-based PPOS appears to be an effective and practical alternative to GnRH antagonist protocols for PCOS patients undergoing ICSI, providing comparable fertilization and embryological outcomes with effective LH suppression. Its oral administration and potential cost advantages may be particularly valuable in resource- limited ART settings.

Articles
Improvement of pregnancy outcome in women undergoing intrauterine insemination (IUI) following Hysterosalpingo-Foam Sonography (HyFoSy) when compared to Hysterosalpingo-contrast Sonography (HyCoSy)
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Infertility is prevalent among couples in our community, and a considerable number of cases of infertility are caused by tubal factors. The hysterosalpingography (HSG) technique is one of the most important tools for determining the patency status of the tubes. Nevertheless, this method has certain drawbacks that can be addressed with a less invasive alternative, such as hysterosalpingo-contrast sonography (HyCoSy) and hysterosalpingo- foam sonography (HyFoSy) .By enrolling subfertile patients undergoing hysterosalpingo- foam sonography (HyFoSy) or hysterosalpingo-contrast sonography (HyCoSy) procedures and subsequently undergoing intrauterine insemination (IUI), this study sought to evaluate the pregnancy rate in a large single center prospectively . Between January 2024 and January 2025, 100 women who underwent IUI as a therapy modality for infertility at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in Kadhimiya city, Baghdad, were involved in this randomized controlled research. Those who underwent hysterosalpingo-contrast sonography with foam (HyFoSy) or HSG evaluation of the fallopian tube were included. The main results were a biochemical pregnancy test (blood test) and clinical pregnancy verified by ultrasonography at 6–8 weeks gestation . When comparing the HyFoSy and HyCoSy groups, the mean serum levels of estradiol, FSH, LH, prolactin, TSH, and testosterone did not differ significantly (p > 0.05). Differences in the mean length of infertility, the mean ova size, the mean ova count, the average endometrial width (ET), the average number of antral follicles (AFC), and the forms of infertility (p > 0.05). Sixty-eight percent of the HyFoSy group and forty percent of the HyCoSy group experienced successful pregnancies, with a significant difference (p = 0.005) . These results imply that HyFoSy might be better than HyCoSy when tubal evaluation is required before IUI, assuming they are validated in bigger multi-center trials. Future studies should investigate long-term results, such as live birth rates, and include a control group (IUI without prior tubal evaluation).

Articles
Correlation Between Air Pollution Levels and Infertility Rates in Urban Areas of Iraq
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Iraq is one of the countries that have suffered from decades of heavy conflict, industrial activity, and little environmental regulation. As a result, notable environmental degradation has occurred. Urban environments, in particular, suffer severely from air pollution, which may be affecting reproductive health outcomes .This study examined the environmental pollution rates and infertility rates in 5 large urban areas in Iraq from 2019- 2023 .A cross-sectional ecological study was conducted across five large Iraqi cities. Air pollution data were obtained from monitoring stations and included PM2.5, PM10, NO2, SO2, and O3 measurements. Infertility rates were obtained from hospital records and fertility clinics. Statistical analysis was conducted employing Pearson correlation coefficients and multiple regression models .Overall, we found strong positive relationships between air pollution and infertility rates in both men (r=0.73, p<0.001) and women (r=0.68, p<0.001) with respect to PM2.5 concentrations. NO2 levels were also associated with decreased sperm quality parameters (r=-0.61, p<0.01). In areas where PM2.5 concentrations were >50 μg/m3, the infertility rates were 34% higher than those in areas with lower PM2.5 concentrations. Higher air pollution levels in urban Iraqi cities show associations with reproductive health outcomes. Meaning, there is an urgent need to address environmental health and policy reform in Iraq.

Articles
Endometriosis-Linked Immune Dysregulation and Its Effect on Assisted Reproductive Technology Outcomes: Insights from IFN-γ and IL-13 Cytokine Profiles
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Endometriosis is a chronic inflammatory gynecological disease and a leading cause of female infertility, characterized by Th1/Th2 cytokine imbalance. Interleukin-13 (IL-13) and Interferon-gamma (IFN-gamma) are cytokines mediating anti-inflammatory and pro- inflammatory pathways, respectively, and were investigated in this study in infertile women with endometriosis undergoing Intracytoplasmic Sperm Injection (ICSI).To explore the potential impact and prognostic value of Interleukin-13 (IL-13) and Interferon- gamma (IFN-gamma) on ICSI outcome and to confirm their role in endometriosis-related infertility .A prospective case-control study was conducted involving 80 infertile women aged 18-40 years, including (n=40) women laparoscopically confirmed with endometriosis and (n=40) infertile women without endometriosis serving as controls. Both groups enrolled in ICSI cycles, and on the day of oocyte retrieval, serum and follicular fluid were collected; then concentrations of IFN-γ and IL-13 were quantified using enzyme-linked immunosorbent assay (ELISA). Ovarian stimulation characteristics, oocyte maturity, embryo quality, maturation rate, fertilization rate, and pregnancy rate were compared between groups using appropriate statistical analyses to investigate their association with endometriosis and their impact on ICSI outcomes. Elevated IFN-γ and IL-13 levels in both serum and follicular fluid are strongly associated with impaired ovarian response and poor ICSI outcomes in women with endometriosis. These findings suggest that inflammatory cytokine imbalance contributes to reduced oocyte developmental competence and embryo quality. Assessment of IFN-γ and IL-13 may provide clinically valuable biomarkers for predicting ART outcomes and could facilitate individualized therapeutic strategies targeting immune-mediated reproductive dysfunction.