Recurrent miscarriage can be defined as two or more consequence unsuccessful clinical pregnancies and confirmed by ultrasonography or histopathological examination and consider the most common clinical complications reproduction, and it affects (2%–5%) of reproduction couple. The present study included 140 women who were already diagnosed with recurrent miscarriage. Following complete clinical workup, including history, examination and investigations, enrolled women were classified into two main subgroups, explained group ( n = 85) and unexplained group ( n = 55). In this study, the result showed no significant difference found between the two subgroups explained and unexplained regarding age and the body mass index. In the obstetric history characteristics of women enrolled in the current study, there is no significant difference between the explained and unexplained group according to gravity, parity, and the number of abortions. Additionally, no significant difference according to gestational age and types of abortion but found significant in the type of complete abortion between the explained and unexplained group. Results showed that recurrent miscarriage rates increased in women with positive anti-phospholipids, in addition, a significant difference in the type of complete abortion between the explained and unexplained group of recurrent miscarriage women.
Background: Analysis of human reports and comparison with results of exper-imental animals indicate that the effects of progesterone on human not analo-gous to experimental animals fetus, many studies showed that exposure to pro-gesterone during developing of genital tract of human fetus was not teratogenic. Other studies which performed on laboratory animals found association between progesterone administration during gestation and genital malformation. Objectives: to explore the effect of progesterone in 10.2mg/kg intraperitoneal injection in mice on testis development and anogenital distance. Materials and Methods: ten pregnant mice divided into five mouse control group that injected10.2mg/kg sesame oil and treated group that injected proges-terone at dose 10.2mg/kg/day allover gestation to the seventh day postnatally, mice offspring sacrificed, the anogenital distance, weight and diameter of testis were measured ,histological slides were prepared and examined for histopatho-logical change and measurement of seminiferous tubules diameter, germinal epithelium thickness and interstitial space were done . Results: the current study found anogenital distance decrement and histopatho-logical changes in mice offspring testis as hemorrhage or congestion of blood vessels ,irregular shapes of seminiferous tubules with atrophy, detachment of spermatogenic cells from basement membrane, death of spermatogenic cells and destruction of Sertoli and leydig cells ,it is also showed wider interstitial tissue and thinner germinal epithelium. Conclusions: The present study indicate study that progesterone injected in mice at dose 10.2 mg/kg /day (the equivalent human dose allover gestation was em-bryotoxic and teratogenic, it may cause feminization of male offsprings repre-sented by decrement the anogenital distance in mice and hypospadias in human .
Background: Immunological infertility is expected to be the reason of infer-tility in 9-36% of the concerned twosomes. The major cause of immunological infertility is the creation of anti-sperm antibodies (ASA), which influence the capability of insemination of spermatozoa. It has been detected that anti-sperm antibodies (ASA) are present either systemically in blood or locally in seminal plasma of approximately 10% of infertile male patients. Immunity to sperm can cause infertility; humoral antibodies directed against sperm did not necessarily impair fertility unless the circulating antibodies are also present within the re-productive tract and on the living sperm surface. Hormonal imbalance and sperm autoimmunity have been considered as two systems that play in near association and affect each other. Testosterone is the Steroid hormone necessary for the de-velopment and maintenance of secondary sexual characteristics as well as initi-ation and maintenance of Spermatogenesis .It was known that males with abnor-mal seminal fluids have lower concentrations of the testosterone hormone. Objectives: To study the serum & seminal plasma antisperm antibodies levels in relevance to levels of testosterone in serum and seminal plasma accordingly to sperm function parameters in different groups of infertile patients. Subjects,Materials and Methods: Blood and semen samples were collected from (80) subjects (60) infertile patients (20Asthenozoospermic, 20 Oligozoospermic,20Azoospermic) and 20 Normozoospermic subjects .The anti-sperm antibody and testosterone levels were measured by using Enzyme Linked Immunosorbent Assay (ELISA). Results: The Antisperm antibodies were positive in serum of normozoospermic, asthenozo-ospermic, oligozoospermic and azoospermic men respectively are about 10%, 5%, 20%,5% and in the total group was 10% positive. The ASA in seminal plasma of normozoospermic men, asthenozoospermic men, oligozoospermic men and azoospermic men respectively are 0%, 0%, 5%, 5% and in the total groups 2.5%.These findings lead to no possibility to make clear correlations with the studied hormones. There was significant increase (P<0.05) in the levels of testosterone in serum and seminal plasma in comparison between normozoospermic and infertile men subgroups. There was significant decrease (P<0.05) in the levels of pro-gesterone in serum and seminal plasma in comparison between normozoospermic men and infertile men subgroups, the highest levels were observed in asthenozoospermic subgroup. The study showed that 10 patients (12.5%) out of 80 patients showed a positive ASA positive in serum or seminal plasma of all groups. The result was considered positive if the value was ≥60 RU / ml .On these basis and regarding that screening criteria the positive ASA group showed the association with the low levels of testosterone in both types of the samples(serum and seminal plasma), these results was exhibited a high significant difference when compared with negative ASA group. Conclusion: Determination of the relevance of the levels of testosterone and anti-sperm anti-bodies in the serum and seminal plasma, which in turn is important to determine the type of infertility especially the immunological type.
Background: Obesity has been defined as abnormal or excessive fat accumulation that may impair health while the Body mass index (BMI) is a simple index of the weight-to-height ratio that is commonly used in classifying overweight and obesity in adult populations. Many semen parameters alteration can be ascribed to obesity like decreased sperm concentration, abnormal morphology, compromised chromatin integrity and abnormal motility. Many evidences showed an adverse effect of excess body fat on spermatogenesis. Methods: A total sample size composed of (70)infertile men were grouped into three groups according to published BMI ranges as follows: normal weight, overweight and obese.A single semen sample was collected for each infertile men.Heightin (m) and weight in (kg) were recorded on day of semen collection.BMI was calculated as BMI= Kg\m2. Sperm parameters evaluated according to World Health Organization guidelines.Quantitation of the IL-6 in seminal plasma were accomplished using commercially available ELISA kit. Results: In the current study, a positive correlation was found between body mass index and IL-6, on the contrary, a significant negative correlation was found among IL-6 level and progressive sperm motility and sperm concentration as well. Conclusion: There is an increase of IL-6 from the adipose tissue with increasing BMI. The IL-6 cause reduction of the sperm motility by increasing the level of ROS. The obesity reduces the spermatogenesis by androgenic deficiency results in low sperm concentration and motilitywhich it may be the main reason of their infertility.
Amino acids have the role in the process of proteins synthesis. They are an essential source of nitrogen atoms that have a role in the pathways of synthetic reaction pathways. The carbon skeletons of the amino acids are the source of energy in addition to their role as precursors in the paths of interactions. The amino acids analysis for the brain of the quail bird in different stage of de-velopment (10-16 days of incubation) in addition to the hatching stage (17th day) and the adult. Materials and Methods: Amino Acids Analysis The amino acids were separated from the embryos and adult brains of the quail bird Coturnix coturnix and were diagnosed based on standard amino acids, using high perfor-mance liquid chromatographic device (H.P.L.C.). Results: The results revealed that there are 16 amino acid: Aspartic acid, Glutamine, Ser-ine, Histidine, Threonine, Glycine, Arginine, Alanine, Tyrosine, Cysteine, Va-linine, Methionine, Isoleucine, Phenylalanine , Lysine, and the highest concen-tration of amino acid at age of [(13,13) days of incubation, adult, (13, 13, 16) days of incubation, adult, (13) days of incubation, adult, (13, 13, 11, 13, 13) days of incubation, adult, (13) days of incubation] respectively and the low concen-tration at age of [(14, 12, 10, 10,12,10,10,10,10, 14, 12, 12, 15, 10, 14, 10) days of incubation respectively]. Conclusions: It concluded from this that there was found 16 amino acid that were analyzed in the brains of the quail embryos at the stage (10-16) days of incubation and hatching stage (17) days of incubation and adult (Asp, Glu, Ser, His, Thr, Gly, Arg, Aln, Tyr, Cys, Val, Met, Ili, Leu, Phe, Lys, and Lys) the highest concentration of aging (13, 13, adult, 13, 13, 16, adult, 13, 13, 11, 13, 13, adult and 13) respectively, and less concentrated in ages (14, 12, 10, 10, 10, 10, 14, 12, 12, 15 10, 14, 10) days of incubation, respectively.
Background: Superovulation in mice causes a delayed embryonic development in vitro and in vivo, an increased abnormal blastocyst formation, pronounced fetal growth retardation. Objective: Morphometric measurements the dimensions (thickness, length) of fetal kidney and suprarenal gland during the later intrauterine life, after superovulation induction. Methods: Twenty five mature female mice Swiss-Webster mice, these mice were divided into two groups: experimental (G1) (15animal/group) and control group(G2) (10 animal/group). Superovulation was induced by intraperitoneal (IP) injection of 7.5 IU of PMSG,then followed by 7.5 IU of HCG after 48 hours. Ovulation was taken place between 122± hours after injection of HCG. One mature male mice was placed with three superovulated female mice for mating. Pregnant females were sacrificed on gestational day eighteen in all experimental groups. For morphometric study 20 mice embryos were fixed in Bouin>s fixative, longitudinal sections of whole embedded embryo were stained by H&E, the specimens independently read. The dimensions (thickness, length) of fetal kidney and suprarenal gland were evaluated. Results: The statistical analysis showed significant decrease (P<0.01) in weights of fetuses in comparison with control group. The study was showed significant decrease (P< 0.01) in fetal kidney dimensions at day 18 of intrauterine life, when it compared to the fetal kidney of non superovulated group(control group). There was also significant decrease (P< 0.01) in the morphometric measurements of fetal suprarenal gland dimensions. Conclusion: The study improve that there is a delay in growth of kidney and suprarenal gland in fetal mice that belongs to mother undergo to superovulation induction before pregnancy.
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.
Intrauterine insemination has an important role in the treatment of infertile couples. Usage of vaginal misoprostol therapy at the time of intrauterine insemination has been investigated, and its tolerability and effects on clinical pregnancy rates still questionable. To assess the effectiveness of vaginal misoprostol on some demographic characteristics and hormones level with a success rate of Intrauterine Insemination. the period of collection of patients extended from Sep. 2018 until May 2019. Eighty-one infertile couples who attended Al Nahrain University, High Institute for Diagnostic Infertility and Assisted Reproductive Technologies, and private fertility clinics were enrolled through this study. Divided into two groups, the next group received 100 µg vaginal misoprostol immediately after completion of the IUI procedure, while the control group was subjected to ordinary IUI procedure without adjunctive therapy. The mean of demographic data of body mass index, age, and duration of infertility was statistically insignificant in control, Misoprostol post-intrauterine insemination. The percentage of pregnancy rate in the control group 5.0% and it 19.5% in the Misoprostol post-intrauterine insemination group. Moreover, there are significant differences in pregnancy rates among all study groups. According to this study, there is no significant result of pregnancy occurrences correlated with, female age, male age, and body mass index, duration of infertility or type of infertility, hormone levels. Misoprostol use after intrauterine insemination has a positive impact on pregnancy outcome in the control group 5.0% and it 19.5% in Misoprostol post-intrauterine insemination group. Smaller doses (100 µg) of misoprostol can decrease side effects without affecting the outcome.
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.
Background: Metformin is anti-hyperglycemic effect due to decrease of hepatic glucose production. Another effect, leading decrease insulin resistance, regarded a safe drug, treatment of choice for overweight. Objective: To investigate the effects of 3 concentration of MF administered orally to male mice on sperm parameters as model for human being. Materials and Methods: In current study, 80 male mice were taken with age ranging between 1.5-2 month and weights ranging between 25-30 grams males classified into four groups of a control group (G1) and treated group (G2, G3 and G4) doses of MF were employed, 0.2, 0.4, 0.6 mg/mice daily to groups, given orally for 6 weeks and then the animals were scarified. Results Results have revealed a significant difference (P < 0.05) in sperm concentration for 3 groups compared to G1 group. Progressive motility (%) appeared with significant difference (P< 0.05) for G3 group as compared to other treated and G1 group. Furthermore, the result illustrated a significant decreased (P< 0.05) in the abnormal sperm morphology for G3 group compared with treated and control. However, sperm agglutination (%) confirmed that the G3 group exhibited highly statistical significant decrease (p≤0.001) compared to G1, G2 and G4. Conclusions From results of the present study, it was concluded that the administration of MF doses reduce sperm concentration .while, 0.4mg dose improve certain sperm parameters.
Background : With the rapid evolution of assisted reproductive technologies, more and more studies are concerned about the possible influential factors on the success rates of these procedures, with the efforts are now mainly directed toward defining these factors in a trial to increase these rates. Of these factors, inflammation is considered among the most remarkable and is in the focus of the updated studies. However, most of these studies are evaluating the role of inflammation in patients with polycystic ovarian syndrome(PCOS) , while the impact of this inflammation in insulin resistant non PCOS patients is underesti mated and not well evaluated . Objectives: This study is a trial to elucidate the importance of one of the inflam matory mediators , Tumor Necrosis Factor-alpha (TNF – α) , in insulin resistant patients undergoing IVF ( ICSI ) cycles . Patients and Methods: A group of 27non-PCOS infertile patients were select ed for this clinical randomized prospective study from patients attending the high institute for infertility diagnosis and assisted reproductive technologies / Al-Nahrain University and subjected to intra-cytoplasmic sperm injection (ICSI) procedure. BMI was measured for all patients and they were classified according to WHO classification into 3 groups : Acceptable , overweight and obese . Fast ing plasma level of glucose and insulin was investigated and insulin resistance index (HOMA) was calculated. Serum TNF-α has been measured using ELISA and the relation with insulin resistance was investigated. Finally, the pregnancy rate, as a primary reproductive endpoint was compared according to TNF -a and insulin resistance levels between different study subjects. Results: Of the 27 infertile patients , 17(63 %) were non obese and 10 (37%) were obese , 15(55.5%) were having HOMA index < 1.6 and 12 (44.5 %) were having HOMA index ≥ 1.6 . BMI was found to be positively correlated with high er HOMA index ( P = 0.01 and R= 0.4 in spearman correlation). Investigating the relation between TNF-α with BMI revealed that TNF-α levels are increasing with the increment in BMI, However , the difference in the mean TNF-α between the three BMI groups failed to achieve statistical significance (P=0.1). In contrast to that, when stratifying for HOMA index , TNF-α was significantly correlated with it ( spearman correlation R= 0.4 , P=0.01 ) , and patients with HOMA index ≥1.6 were found to have higher levels of TNF-α ( P = 0.03) and to be more obese ( P=0.02 ) than those with HOMA index <1.6.
Background: Citrullus colocynthis (CC) is an herbal medicine used in the treatment of a wide range of diseases. Recently, It has been studied on in vitro activation of mice sperms with no research concern the effect of this plant on the DNA normality following in vitro preparation of human semen samples. Objectives: The present study was aimed to examine the effect of adding CC in the medium used for in vitro sperm activation of asthenospermic men and related factors and to found out the effect of CC on the DNA status following the activation. Materials and Methods: Citrullus colocynthis aqueous extract (0.01mg/ml culture medium) was used for in vitro sperm activation . One hundred and ten semen samples were divided into two groups, the first group activated in vitro by adding CC extract to the culture medium Ham's F-12 (the treated group) and, the second group sperm activated in vitro with Ham's F-12 alone ( the control group). Results: In vitro activation of sperms with aqueous extract of CC has shown positive effect on sperm concentration, sperm motility, and grade activity of progressive forward movement. There was a significant (P<0.05) increase in certain sperm function parameters of asthenozoospermic in treated group compared with the control group .The study showed that the DNA fragmentation resulted from treated group were lower than that of control group. Conclusions: According to the results of present study, adding aqueous extract of CC to the human sperms activation culture medium leads to an improvement in certain sperm function parameters of asthenozoospermic men with no harmful effect on the human sperms DNA with decrease in DNA denaturation.