Background: In vitro Fertilization (IVF) is an important alternative for infertile couples, there is an increase in the number of children conceived by IVF worldwide. Objective: The aim of this study was to assess the risk of birth defects and adverse outcome among infants and children conceived by in vitro fertilization in Sulaimani-Iraq. Patients and Methods: This case-control study was carried out on 160 children, 75 were product of IVF(using ICSI) and 85 were product of natural conception. Data collected regarding mother age, father age, duration of infertility before pregnancy with the index child, any complication during pregnancy, age of the child, gender, mode of delivery, gestational age, weight at delivery, history of neonatal admission and it’s cause, admission to hospital after neonatal period, and history of surgical operation. All children were examined for any gross anomaly, cardiovascular, respiratory, gastrointestinal, skeletal, urological and neurologic abnormality. Results: IVF was a risk factor for prematurity (OR, 7.844 95% CI 3.025 - 20.339) , LBW (OR, 4.645 95% CI 2.038 -10.587), Congenital anomaly (OR, 1.362 95% CI 0.720 - 2.576), predominance of male gender (OR, 1.340 95% CI 0.719-2.498), neuro-developmental delay(OR,1.333 95% CI 0.672-2.646), admission to NICU (OR,1.703 95% CI 1.052-2.758 ), C/S delivery (OR, 1.972 95% CI 1.507-2.581), and childhood hospitalization (OR, 1.193 95% CI 0.838-1.696), also there was statistically significant association with multiple pregnancy. Conclusions: IVF carries increased risk of LBW, prematurity, congenital anomaly, neuro-developmental delay, admission to NICU, childhood hospitalization, C/S as a mode of delivery and predominance of male gender.
Various types of anesthetic techniques were described for oocyte recovery. Different anesthetic agents have been used with different effects on oocyte quality and embryonic development and studies on the potential toxicity of general anesthesia ended up with conflicting results. Many experiments as well as human studies documented the existence of anesthetic agents in the follicular fluid (FF) with possible adverse effects on the oocyte quality and subsequent embryo development. Ketamine and remifentanil were used for the studied groups to compare oocytes and embryos characteristic of infertile women during oocytes retrieval under general anesthesia: one group receiving ketamine, midazolam, and propofol and the other group receiving remifentanil, midazolam and propofol. 60 infertile females were undergoing intracytoplasmic sperm injection categorized in two groups, group I received midazolam, remifentanil and propofol; whereas, group II received midazolam, ketamine and propofol. There was highly significant difference in mean abnormal oocyte between ketamine and remifentanil groups. Grade III embryos were significantly limited to ketamine group. FF ketamine and remifentanil were not significantly correlated to any of oocyte characteristics or embryo characteristics. Anesthetic agents, ketamine and remifentanil, were detected in the FF of infertile women and within recommended doses. Ketamine resulted in adverse effects on oocyte and embryo quality in comparison with remifentanil represented by greater percentage of abnormal oocytes and that bad quality embryos were limited to ketamine group.
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.
The toxic effect of drugs and environmental chemicals on the human reproductive system has become a major health concern. Lead is recognized as the most dangerous of the toxic metals and a major threat to the biological systems of both human and animals. In this study we detect the effect of two types of antioxidants: flaxseed and zinc, on the toxicity of low dose of lead acetate on reproductive organs of male mice, this study was conduct. Two groups of mature male mice,exposed to low dose of lead, were administered either zinc sulphate (0. 5mg/kg body weight/day) or flaxseed oil (2.5% of total daily food intake), for 6 weeks. The results showed that lead caused a significant reduction in the total body weight, testicular weights & adverse effects on sperm parameters, while the concomitant administration of antioxidants caused elevation in these weights with significant improvement in sperm quality as compared to the only lead treated group. It is concluded that lead, like all other heavy metals, could induce oxidative stress and the concomitant administration of antioxidants (zinc or flaxseed) can ameliorate the toxic effect of lead on reproduction.
The aim of any given ICSI cycle is to achieve normal response and avoid poor or hyper response. A part from ovarian hyper stimulation syndrome (OHSS), pregnancy rate in hyper responder females usually low which could be related to the adverse effect of hyper estrogenic state on oocytes, embryos quality and uterine endometrium. To evaluate the effect of hyper response on ICSI outcome represented by oocytes, embryos quality, fertilization and pregnancy rates. Study showed that total number of retrieved oocytes, mature, immature oocytes, total embryos, good quality embryos and blastocyst count were significantly higher in hyper followed by normal and poor responders respectively. Fertilization rate was significantly higher in both hyper and normal responders than poor ones, while pregnancy rate was significantly higher in hyper responders 47.6% followed by normal 40.7% and then poor ones 16.7%. Conclusions: Irrespective of abnormal hormonal milieu, excessive ovarian response and higher number of produced oocytes improve ICSI outcome in hyper responder females by increasing the chance of getting higher number of embryos, good quality embryos and even blastocyst numbers which in turn increase the chance of pregnancy.
Background: Cadmium (Cd) is a heavy metal toxicant, present widely in our environment and workplaces.It is well known that cadmium causes adverse effects on male reproductive organs and reproductive functions in experimental animals. Objective: This experiment was designed to find out the effect of cadmium on some histological and hormonal parameters of the reproductive system of adult male rats. Methods: thirty mature albino male rat were used (Rattus rattus norvegicus albinus), as a mammalian model. these animals were divided into two groups, 15 rat / group after labeling them. The control group (G1) was orally administrated with distilled water during the 4 weeks period of the experiment and the experimental group (G2) was orally administrated with 20 ml cadmium chloride (200 mg/1L body weight) during the 4 weeks. First of all, the rat were anesthetized, after that blood aspiration using anesthetic cardiac puncture and the serum was separated and store at -20°C until assessment of FSH, LH and testosterone hormones. After that, the weight of reproductive organs (testis,epididymus and seminal vesicle) was recorded. These organs were fixed with 10% formal saline for histological study. Results: The statistical analysis shows a significant (P< 0.05) decrease in the weight of the testes and seminal vesicles when compared with control group. The results of the sperm parameters show a significant (P< 0.05) decrease in sperm concentration and a highly significant (p≤0.01) decrease in sperm motility in treated group as compared to control. The result of testicular sections in treated group shows a decrease in thickness of germ cells layer, widening of the central seminiferous tubules lumen and prominent germ cells population necrosis. Multiple vacuoles were seen within the tubules. Sertoli cells were abnormal in number and shape as compared to control. A peritubular fibrotic change had been seen also in the testicular sections. The result also shows a highly significant decrease in diameters of seminiferous tubules, primary spermatocytes, secondary spermatocytes, spermatids and increase in interstitial space when treated with cadmium compared with control group. The Levels of serum hormones shows a significant (P<0.05) decrease in the levels of testosterone and LH hormones mean in the treated group,while highly significant (ps0.01) increase in the FSH hormone mean in the treated group when compared to the levels mean of the hormone in the control group.. Conclusion: In conclusion, these findings suggest that cadmium administration with 20 ml cadmium chloride (200 mg/1L body weight) for 4 weeks during the adulthood induced damage in the reproductive organs and lead to impair the functions of sperm parameters and cause histological and hormonal alterations.
Background: Many plants have medical importance due to the presence an active compounds in plants extraction acting as a drugs for treatment of several diseases in human and animals. Euphorbia helioscopia extract was used to treat diabetes, removal the warts of the skin, stimulate the nervous system and also used against constipation. Objective: Study the effect of terpinoid extract of E.helioscopia on rat epididymal sperm activity and fertility efficacy of male rats. Methods: This study was conducted at Biol. Dept., College of Science/ University of Babylon and Medical College, Mahidol University- Thailand. The study was designed to purify the active compounds of the Terpinoid of Euphorbia helioscopia extract by Nuclear Magnetic Resonance (NMR), and studying their effects on sperm motility and grade activity of the epididymal sperms of the rats. Six main active compounds were isolated from the terpinoid extract of E. helioscopia due to the differences in color, weight and nature by using NMR. The main terpinoid compounds were named A,B,C,D,E and F. Two concentration (0.5 mg/ml and 1 mg/ml) of each active compound of E. helioscopia extract were added to sperm suspension in vitro and incubated for 30 minutes, then sperm motility and grade activity were assessed and the results were compared to those values before adding the active compounds (control). Results: The results showed that 0.5 mg/ml of C and D active terpinoid compounds caused significant (p<0.05) decrease in sperm motility compared to before adding the extract, while the same concentration of B,C,D,E and F active terpinoids compound caused a significant (p<0.05) decrease in grade activity. The addition of 1 mg/ml of terpinoid active compounds (C,D and F) caused a significant (p<0.05) decrease in sperm motility, while the grade activity significantly (p<0.05) decreased by adding B,C,D,E and F active terpinoid compounds compared to control. The sub - compounds (C1,C2,D1,D2,D3 and D4) had a powerful decreasing effect on the sperm motility and grade activity compared to control and other active compounds. Conclusion: It was concluded that terpinoid compounds of E. helioscopia extract have adverse effects on rat epididymal sperm activity.
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.
Background: Tribulus terrestris (TT), Phoenix dactilyfera (Pd) and Nasturtium officinale (No) were believed to have fertility-enhancing effects and given by herbalists in Baghdad to men who need to increase their fertility capacity. Objectives: To investigate the possibility that aqueous and ethanolic extracts of the plants mixture can counteract the adverse effect of theobromine on reproductive system of male mic. Materials and Methods: One hundred and twenty mature male mice were injected intraperitoneally with 250 mg/kg/day of theobromine for four weeks. Then the males were treated intraperitonially with different dose levels of aqueous and ethanolic extracts of a mixture of the three plants for four weeks to evaluate their effects on body weight, reproductive organs weight, sperm parameters, hormones level and reproductive performance. Results: Both extracts showed a significant enhancement in all parameters studied. Almost all these results showed a dose dependent pattem with the ethanolic extract being the more effective than aqueous extract in all parameters. Conclusions: Mixture of the three plants seems to counteract the action of theobromine on the reproductive system of male mice through enhancing the concentration and motility of spermatozoa, increasing epididymis and seminal vesicles weight which are an indicator of testosterone production which brought about the stimulation of all male reproductive organs.
Background: Sperm cells are well equipped with a powerful defense system of antioxidants, but an imbalance between the production of reactive oxygen species (ROS) and the available antioxidant-defenses result in oxidative stress. Therefore, antioxidants are supplemented extracellularly under in vitro conditions. Antioxidants are the main defense factors against oxidative stress induced by free radicals. Vitamin E is believed to be the primary component of the antioxidant system of the spermatozoa and is one of the major membrane protectants against ROS and lipid peroxidation (LPO) attack. It appears to be the first line of defense against the peroxidation of polyunsaturated fatty acids (PUFAs) contained in the cellular and sub-cellular membrane phospholipids because of its lipid solubility. Objective: The aim of the current study to evaluate effects of supplementing semen extender with vitamin E, at various concentrations (2, 6 and 12 IU/ml) on sperm motility, survival and morphology on the releases of free radicals and antioxidant enzymes within semen. Patients ,Materials and Methods: Twenty two patients were involved in the present study semen samples were obtained, and sperm count was assessed. The antioxidant (vitamin E) was formulated to be tested at three different levels as follow; 2, 6 and 12 IU/ml; Therefore, control and 3 antioxidant-containing extenders were prepared for semen dilution. The sample was divided into 4 aliquots. One volume of semen was added to 5 equal volumes of the designed extender. Extended semen samples (37˚C) were gradually cooled to 4˚C in the refrigerator and stored for 48 hours. A semen sample was taken out after 48h of storage, then warmed to 37˚C and checked for progressive motility, viability and abnormality. Sperm viability was assessed by Eosin Y. (0.5%)—Nigrosin (0.1%) staining mixture. A total of 200 sperm were assessed under oil immersion with a high-resolution (X100) objective. Sperm morphology was assessed by Hematoxylin-Eosin satin, at least 200 sperm were scored on randomly chosen field, under oil immersion with a high-resolution (X100) objective. Results: The highest post-thaw motility and sperm survival (44% and 51.7%) 48 h after storage at 4˚C (Table 1) were attained (P < 0.01) in the basal diluents containing 6 IU vitamin E. Likewise, the correspondent percentages of live spermatozoa were 59%. Contrariwise, percentage of sperm abnormalities for the previous treatment was 25% significantly (P < 0.05) decrease compares with basal diluents containing 2, 12 IU vitamin E. The lowest (P ≥ 0.05) survival (23.5%, Table 1) was found in the basal diluents containing 12 IU vitamin. Beyond 6 IU vitamin E, there appears to exert adverse effects on sperm viability and survival. Conclusions: For the best protection against the increased free radicals production during chilling-preservation of human semen, extenders must contain 6 IU vitamin E per ml. The intensive production of free radicals in seminal plasma was counteracted by the inclusion of vitamin E at the above mentioned concentrations.
Background: The effects of Lead and other essential metal like zinc and copper on the reproductive system have been previously reviewed. Objective: Our goal in this study was to estimate the levels of Lead, Zinc and Copper in patients with polycystic ovary syndrome and to confirm the effect of such metals on the female reproductive system at environmental exposure. Materials and Method: Fifty two women in their reproductive age (20-40) years old, which had been diagnosed as PCOS. Venous blood sample were taken from each patient and control, blood lead, zinc and copper were determined by atomic absorption spectrophotometer. Hormone assay were determined by ELISA (Enzyme Linked Immune Sorbet Assay) technique. Results: This study showed a significant increase of blood lead and serum zinc, copper (p<0.01), in addition to testosterone, lutenizing hormone, LH/FSH ratio and body mass index (BMI) (p<0.05) in patients with polycystic ovary syndrome when compared with control. Conclusions: On the basis of the observations of the present study, it can conclude that the increased levels of Lead as a result of the exposure to this metal may be a risk factor for the development of polycystic ovary syndrome in women and has adverse effects on female endocrine and reproductive function.