Combination of neoadjuvant and adjuvant chemotherapy with FOLFOX compared with adjuvant chemotherapy in management of locally advanced rectal cancers: a randomized trial of a promising therapeutic approach.

BACKGROUND: Colorectal cancer (CRC) is a significant malignancy with widespread implications. Despite progress in surgical interventions for rectal cancer, improvements in overall prognosis remain disproportionate. Standard preoperative chemoradiation, while established as the standard treatment for the majority of rectal cancers, exhibits limited effectiveness in enhancing disease-free survival (DFS) and mitigating distant metastases, particularly in cases of locally advanced rectal cancer (LARC). METHODS: This randomised clinical trial assessed 286 patients with LARC in two paralleled groups. Group A underwent six courses of neoadjuvant MFOLFOX chemotherapy, chemoradiation, surgery, and six adjuvant chemotherapy cycles. Group B received concurrent chemoradiation, surgery, and twelve adjuvant chemotherapy cycles. Patient evaluations were achieved at multiple stages of treatment and follow-up. RESULTS: Group A had significantly lower local recurrence (11.64%) than Group B (21.74%, P = 0.025). The distant metastasis rate in Group A (8.90%) was lower than in Group B (20.29%) but was not significant (p = 0.143). More patients in Group A experienced downstaging (80.82% vs. 60.87%, p < 0.001). Specifically, 72.60% demonstrated downstaging of tumour invasion and 54.79% downstaging of lymph node involvement, compared to 57.25% and 41.30% in Group B (p = 0.009 and p = 0.025, respectively) as well as higher pCR rate (26.03% vs. 15.25%, p = 0.030) and three-year DFS rate (82.19% vs. 71.01%, p = 0.035) in group A compare to group B. CONCLUSION: This innovative strategy for LARC showed promising results with lower local recurrence and higher rates of downstaging and pCR. Treatment side effects were similar in both groups but less frequent in Group A. Anaemia was the most common haematological side effect (A: 58%, B: 68%), and peripheral sensory neuropathy was the most common non-haematological complication (A: 63%, B: 64%). These findings suggest this regimen could be a valuable therapeutic approach for LARC. TRIAL REGISTRATION: This trial was registered on 2023-12-08 within the IRCT.IR database under the number IRCT20210308050628N1.

Evaluation of the effect of teriparatide therapy on mandibular fracture healing in rats with medication-related osteonecrosis of the jaw.

OBJECTIVE: The aim of this study was to evaluate the effect of teriparatide therapy on mandibular fracture healing in rats with medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: To induce MRONJ, a total of 120 rats received intravenous zoledronate 0.06 mg/kg once a week for 6 weeks and their right mandibular first molar was extracted. Eighty of 94 rats with MRONJ were randomly selected and underwent unilateral mandibular osteotomy to replicate a fracture. After surgery, the rats were randomly assigned to T (teriparatide-treated) and C (control) groups. Group T (n = 40) received subcutaneous injection of 2 µg/kg/day teriparatide and group C (n = 40) received the same volume of normal saline until sacrifice. Four and 8 weeks after surgery, 20 rats in each group were sacrificed. Fracture healing was scored using a histological grading system (1 to 10). RESULTS: In group C, at 4 weeks and 8 weeks post-fracture, fibrous and cartilaginous tissues and scant bone formation at the fracture site and lacunae without osteocyte in adjacent mandibular bone were seen. In group T, substantial amounts of new trabecular bone rimmed by osteoblasts and some areas of remodeled mature bone were seen. After 8 weeks, extensive replacement of trabecular bone with mature bone occurred. Except between C4 and C8 groups, the healing score was significantly different between all subgroups. CONCLUSION: Teriparatide therapy successfully improved mandibular fracture healing in rats with MRONJ. However, this study was limited by the use of an animal model whose anatomy, physiology, and drug metabolism might be different from humans. CLINICAL RELEVANCE: The present study showed that teriparatide therapy may be used adjunctive to surgery in the treatment of mandibular fractures in MRONJ patients.

Study of Insulin-Loaded Chitosan Nanoparticle Effects on TGF-ß1 and Fibronectin Expression in Kidney Tissue of Type 1 Diabetic Rats.

In diabetes, the increasing blood glucose levels through oxidative stress, with increase in inflammatory cytokines and growth factors, such as TGF-ß1, can cause long-term complications, including nephropathy. Subcutaneous injection of insulin is a common method used to treat Type 1 diabetes, which can lead to problems such as hypoglycemia and edema. In the present study, we examined the effect of insulin in its two injectable and oral forms on the expression of TGF-ß1 and fibronectin in kidney tissue of STZ diabetic rats. A total of 25 male Wistar rats were randomly divided into 5 groups: C: normal control, D: diabetic control, D+NP, oral insulin-loaded trimethyl chitosan nanoparticles (8 IU/kg), and subcutaneously injected insulin (8 IU/kg). The groups were treated from 8th to 10th weeks. After 10 weeks, FBS was measured. Also, the TGF-ß1 and fibronectin mRNA expression and serum TGF-ß1 protein were examined in the kidney tissue. Structural changes in the kidney tissue were studied using H&E staining. After 10 weeks of diabetes induction, the rats showed significant change in blood glucose, weight, serum TGF-ß1, Fibronectin and TGF-ß1 expression of kidney in diabetic groups (p < 0.05). Oral insulin-loaded trimethyl chitosan nanoparticles treatment, similar to injected insulin, significantly ameliorate blood glucose and rats' weight (p < 0.05). However, the reduction in fibronectin and TGF-ß1 expression and serum TGF-ß1 protein by both treatments was not statistically significant (p > 0.05). These data showed that oral insulin-loaded trimethyl chitosan nanoparticles were better therapeutic intervention than injected insulin for Type 1 diabetes.

Infantile extrapancreatic pancreatoblastoma: a report on a rare infantile abdominal mass.

Pancreatoblastoma is an extremely rare tumor in children, especially under 3 months of age. This tumor may arise from any portion of the pancreas, but in more rare cases the ectopic pancreas is the origin. We are reporting a 3-month-old boy who was presented with an abdominal mass. Computed tomography images revealed a huge lobulated mass anterior to the kidneys, with internal calcification and enhancement after intravenous contrast media injection. He underwent a complete surgical resection of the mass that was located in the transverse mesocolon without any connection with the pancreas. Pathologic studies specified that the disease was pancreatoblastoma. His parents refused any chemotherapeutic regimen but continued postsurgical follow-ups.

A rare intraosseous synovial sarcoma of the mandible: A case report.

INTRODUCTION: Synovial sarcoma is a relatively common high-grade soft-tissue sarcoma. This lesion accounts for 5-10 % of soft-tissue sarcomas, which tend to appear in the limbs, especially the lower limbs. Synovial sarcoma in the neck is rare and causes involvement of the head and neck in 6-7 % of cases. Intraosseous involvement of the mandible is rare. In this report, a rare intraosseous synovial sarcoma of the mandible is reported. PRESENTATION OF CASE: A 29-year-old man with a complaint of painless outgrowth of the gingiva in the posterior region of the left mandible. In the intraoral examination, an exophytic, firm, smooth and well-defined lobulated mass on the alveolar ridge, extending from distal of the second premolar to mesial of the second molar, was observed. On a radiographic examination, a radiolucent lesion with an ill-defined border was seen in the left body of the mandibular with perforation of the buccal cortex. In a histological examination, immunohistochemistry confirmed synovial sarcoma. The patient underwent surgery with wide margins, and radiotherapy after surgery. DISCUSSION: The main treatment method is surgery with a wide margin. Radiotherapy as an adjuvant treatment along with surgery is the second most common treatment method. Radiotherapy is recommended in cases of involvement of the margin of the lesion, size greater than 5 cm, and recurrence of the lesion. Chemotherapy after surgery has been used less frequently. CONCLUSION: Surgical resection with a wide margin is the main treatment. Adjuvant radiation therapy and chemotherapy can be helpful in tumor control, especially in monophasic cases.

Correlation of Clinical and Histopathological Features of Salivary Pleomorphic Adenoma.

Statement of the Problem: Salivary gland tumors represent about 3% of the head and neck tumors. Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Purpose: This study was conducted to investigate and describe some clinical and histopathological aspects of salivary pleomorphic adenomas with special reference to the epithelial and mesenchymal components. Materials and Method: In this retrospective study, one hundred tissue samples diagnosed as PA were sourced from archival tissue blocks between 2009 and 2019 in this retrospective study. Some clinical and demographic features, including age, sex, tumor size, and tumor location were recorded. This study included only samples taken by excisional biopsy. Then, the samples were histologically classified into three subtypes according to the proportion of epithelial and stromal components. The demographic and clinicopathological variables were statistically analyzed using Chi-square test or Fisher's exact test, considering a significance level of 5% (p< .05). Results: In the present study, most cases (61%) were found in females, representing a female-male ratio of 1.6:1. The peak incidence was seen in the 4th and 5th decades of life. In 87% of cases, PA occurred in major salivary glands. There was a significant difference between the age of the patient and squamous metaplasia (p= 0.036). There was also a significant difference between the size of tumor and the amount of myxoid stroma (p= 0.021). Extensive myxoid stroma was mostly seen in tumors larger than 3.37cm (p= 0.001). In addition, there was a statistically significant difference between capsular invasion and the development of squamous metaplasia (p= 0.001). Conclusion: In this study, there was a significant correlation between the gland type and capsular features and between the size of tumor and rate of squamous metaplasia. A detailed clinical and histopathological analysis of PAs may provide a better insight to the pathophysiology of the lesion, tumor cell differentiation, and prognostic factors.

Malignant Peripheral Nerve Sheath Tumor, a rare Intraosseous Malignancy in the Mandible of a Patient with Neurofibromatosis Type 1: A Case Report.

Malignant peripheral nerve sheath tumor (MPNST) is a rare malignancy of nervous tissue. The oral incidence of this lesion is extremely low. MPNST can occur sporadically or in association with neurofibromatosis. We report a rare intraosseous MPNST in the mandible of a 33-year-old female patient with neurofibromatosis type 1.

Intraoral Extranodal Natural Killer Cell/T-Cell Lymphoma of the Hard Palate.

Natural killer cell/T-cell lymphoma (NK/TL) is a rare subtype of non-Hodgkin's lymphoma (NHL) associated with the Epstein-Barr virus (EBV) and requires early detection, which can be very challenging. NK/TL often arises in the nasal cavity and can then spread to the oral cavity, but the case presented here is an unusual presentation of NK/TL in a 66-year-old edentulous male patient who initially presented an intraoral exophytic lesion in the palate that appeared within 3 months. We report the present case to highlight the challenges of reaching an accurate diagnosis given the diverse clinical manifestations of NK/TL.

Detection of Enterobius vermicularis in archived formalin-fixed paraffin-embedded (FFPE) appendectomy blocks: It's potential to compare genetic variations based on mitochondrial DNA (cox1) gene.

Acute appendicitis represents one of the most common causes of emergency abdominal surgery worldwide. Meanwhile, Enterobius vermicularis has been suggested as one of the probable causes of appendicitis. In this study, the morphological characteristics of the remnant pinworms and pathologic changes were explored in old-archived FFPE tissues of appendectomies. Moreover, we provide the first molecular identification, genetic, and haplotype variation of this nematode from the old-archived FFPE tissue section of appendectomy using the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Seventeen FFPE appendectomies with E. vermicularis infection, stored over 12-22 years, were collected from two different geographical areas of Iran. In the histopathological examination, tissue changes were observed in thirteen cases (76.4%) and inflammation in four blocks (23.5%). After DNA extraction, the cox1 gene was amplified in twelve (70.6%) cases using the nested polymerase chain reaction (PCR). Phylogenetic analysis and a median-joining network of 78 available cox1 sequences of E. vermicularis revealed 59 haplotypes. We identified five haplotypes that fell into type B. All Haplotypes are novel except for two haplotypes, Hap32 and Hap37, identical to E. vermicularis sequences from Iran, Greece, and Germany. The ranges of diversity distance and haplotype diversity within the isolates were 0-1.9% and HD:0.643-0.667, subsequently. Overall, the absence of inflammation or even tissue changes in some sections can suggest the possible non-inflammatory role of E. vermicularis in appendicitis. Although FFPE material suffers from PCR inhibition, we could successfully use nested PCR to characterize E. vermicularis in old-archived appendectomy blocks and suggest this method as a complementary diagnosis technique in pathology. While the predominant type was B in the Middle East and Europe, further studies on a larger sample size from different geographical regions could probably confirm the results obtained in the present study.

A case report of simultaneous occurrence of Wilms tumor and acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) is the most and Wilms tumor is the sixth most common malignancy in childhood. Genetic changes in WT1 or WT2 in Wilms tumor and a wide range of chromosomal mutations are reported in ALL that may predispose them to other congenital anomalies especially in Wilms tumor patients. Hospitalized patient was a 3-year-old girl with high-grade fever, petechia, and solid abdominal mass. The patient had anemia, thrombocytopenia, and leukocytosis in her initial homogram, and a large renal mass originated from left kidney in abdominal imagings. Bone marrow aspiration revealed ALL, and simultaneous kidney biopsy uncovered her Wilms tumor. Leukemia and Wilms tumor are 2 independent malignancies but occurred together in this patient. It is reasonable to investigate cellular and genetic relation of these 2 independent malignancies.

Primary intraosseous mandibular hydatid cyst: A case report and review of 97 cases of osseous cystic echinococcosis.

OBJECTIVE: In this study, we review the reported cases of hydatid disease of the bone in terms of etiology, pathogenesis, and histopathologic, serologic, and radiographic features and management of the disease. STUDY DESIGN: The present case study reports an extremely rare occurrence of intraosseous hydatid cysts in the orofacial region, wherein symptoms or signs of systemic hydatid disease were absent. We discuss the challenges encountered during the diagnosis and treatment of osseous hydatidosis and reviewed articles on osseous hydatidosis, including 97 cases. We also compare the aspects reported in previous cases of mandibular hydatid cyst with those of the present case. RESULTS: Hydatid cysts were found to be present in almost every bone of the skeleton in patients (mean age of 39.95 ± 19.67 years; range, 3-76 years). A slight male preference (58.8%) was observed. A history of rural lifestyle, animal bites, and trauma in the affected bone was reported. Only 5 reports on mandibular bone have been published previously, of which 3 were primary. CONCLUSION: Because of the lack of usual presentations and radiographic features, the presence of hydatid cysts in unusual anatomic locations makes differential diagnosis difficult. The potential risk of anaphylactic shock in susceptible individuals, high recurrence rate, and risk of secondary hydatidosis pose diagnostic and surgical challenges.

Optimization of fuzzy c-means (FCM) clustering in cytology image segmentation using the gray wolf algorithm.

BACKGROUND: Image segmentation is considered an important step in image processing. Fuzzy c-means clustering is one of the common methods of image segmentation. However, this method suffers from drawbacks, such as sensitivity to initial values, entrapment in local optima, and the inability to distinguish objects with similar color intensity. This paper proposes the hybrid Fuzzy c-means clustering and Gray wolf optimization for image segmentation to overcome the shortcomings of Fuzzy c-means clustering. The Gray wolf optimization has a high exploration capability in finding the best solution to the problem, which prevents the entrapment of the algorithm in local optima. In this study, breast cytology images were used to validate the methods, and the results of the proposed method were compared to those of c-means clustering. RESULTS: FCMGWO has performed better than FCM in separating the nucleus from the other dark objects in the cell. The clustering was validated using Vpc, Vpe, Davies-Bouldin, and Calinski Harabasz criteria. The FCM and FCMGWO methods have a significant difference with respect to the Vpc and Vpe indexes. However, there is no significant difference between the performances of the two clustering methods with respect to the Calinski-Harabasz and Davies-Bouldin indices. The results indicate the better efficacy of the proposed method. CONCLUSIONS: The hybrid FCMGWO algorithm distinguishes the cells better in images with less detail than in images with high detail. However, FCM exhibits unacceptable performance in both low- and high-detail images.

Effect of teriparatide on the healing of mandibular condylar osteochondral defects: a preclinical study.

This study was performed to evaluate the effect of teriparatide therapy on the healing of osteochondral defects of the mandibular condylar. Ninety-six rats underwent surgery to create a defect in the condylar head on one side of the mandible, and were divided into two groups. One group received subcutaneous injection of 2 µg/kg/day teriparatide, and the other group received normal saline until sacrifice. On postoperative days 20, 40, and 60, 16 animals from each group were sacrificed, and bone and cartilage healing was histologically evaluated and semiquantitatively scored (1-5). The mean difference in healing score of the cartilaginous and subchondral parts of the defect between the teriparatide and control groups at days 20, 40 and 60 were 0.438 and 0.438, 0.813 and 0.750, and 1.125 and 0.813, respectively. The healing scores of the osteochondral defects in the teriparatide group were significantly (p< 0.05) higher than that in the control group at days 40 and 60. This study has shown beneficial effects of teriparatide on the healing of condylar osteochondral defects in rats. Clinical trials are required to extrapolate these findings to humans.

Primary Intraosseous Malignant Glomus Tumor of the Finger with a Different Radiological Appearance: a Case Report and Review Literature.

Primary intraosseous malignant glomus tumor is very rare and is often presented as an osteolytic lesion. The present case study reports a malignant intraosseous glomus tumor of the index finger that was presented as an osteosclerotic lesion and invaded adjacent tissues, leading to ray amputation. We also reported result of a five-year follow-up and presented a short literature review for the lesion.

Histological assessment of the effects of teriparatide therapy on mandibular fracture healing: A preclinical study.

OBJECTIVE: This study was performed to evaluate the effects of teriparatide therapy on mandibular fracture healing in a rat model. SUBJECTS AND METHODS: A unilateral mandibular fracture, 5 mm posterior to the last molar tooth, was surgically created in 120 rats. Half of the animals received a daily subcutaneous injection of 2 µg/kg teriparatide while the control rats received normal saline, starting from the day of surgery until sacrifice. Twenty rats from each group were sacrificed on postoperative days 10, 20, and 30. The healing process was evaluated histologically and scored using a grading system (ranging from 1 to 10). RESULTS: On day 10 the fracture gaps of the control and teriparatide groups were mainly filled with fibrous tissue and new trabecular bone, respectively. On day 20 a large amount of new trabecular bone and some areas of fibrocartilaginous tissue were seen in the fracture gaps of the control rats. In the teriparatide group the fracture area was entirely filled with trabecular bone, which in some areas had been replaced by mature bone. On day 30 the fracture gaps of the control group were entirely bridged by new trabecular bone, while in the teriparatide group they was predominantly filled with mature bone. At all three time-points the mean healing scores for the teriparatide group (6.20 ± 0.70, 8.50 ± 0.69, and 9.85 ± 0.37, respectively) were significantly higher (p < 0.001) than for the control group (4.90 ± 0.55, 7.15 ± 0.59, and 8.90 ± 0.64, respectively). CONCLUSION: Based on the results of this study, teriparatide should be tested in humans in order to establish whether comparable results can be achieved.

Histological evaluation of the healing process of autografted mandibular bone defects in rats under treatment with zoledronate.

OBJECTIVE: This study aims to evaluate the healing process of autografted mandibular bone defects in rats treated with zoledronate (ZOL). SUBJECTS AND METHODS: A total of 180 Wistar rats were divided into four groups: group L received intravenous infusion of two doses of 0.06 mg/kg ZOL, nine weeks apart; group H received 0.06 mg/kg ZOL, while groups C and NC received normal saline at three-week intervals for nine weeks. Three weeks following the last infusion, a unilateral mandibular bone defect (5 mm) was created. Except in the NC group, all defects were repaired with autologous iliac bone graft. Fifteen animals from each group were sacrificed on postoperative Day 20, Day 40, and Day 60. Graft healing was scored using a histological grading system (ranging from 1 to 6). RESULTS: Histological evaluations performed on postoperative Day 60 showed that the mandibular defects were mainly repaired with fibrous tissue in the NC and H groups (93.00% ± 7.51% and 82.67% ± 13.08%, respectively) and with bone in the C and L groups (75.33% ± 14.20% and 92.67% ± 8.84%, respectively). The percentage of fibrous tissue and bone as well as the healing score of the NC and H groups were significantly different (P = 0.001) from those of the C and L groups. However, these were not different between neither the NC and H groups nor the C and L groups. CONCLUSION: Based on the results of the present study the hypothesis can be established that there also might be a dose-dependent effect of ZOL on the healing of bone grafts in humans. This hypothesis has to be verified or rejected in clinical trials.

Evaluation of teriparatide effect on healing of autografted mandibular defects in rats.

OBJECTIVE: To evaluate the effects of short-term teriparatide administration on healing of autologous bone graft in mandibular critical-size defects. SUBJECTS AND METHODS: A 5-mm mandibular bone defect was created and iliac bone graft was harvested in 135 rats. Rats were randomly divided into 3 groups of negative control (NC), control (C), and study (S). In groups S and C, iliac graft was placed in defect and 2 µg/kg/day teriparatide or saline, respectively, was administered for 20 days. In group NC, iliac graft was not transferred to the defect and saline was injected for 20 days. Twenty, 40, and 60 days after surgery, 15 rats in each group were euthanized and the healing process was histologically evaluated and scored using a grading system (1-6). RESULTS: In group NC, defects did not heal or were predominantly filled with fibrous tissue. At day 20, bone defects in both C and S groups contained a large area of graft particles, numerous collagen fibers and some areas of new trabeculae. At the day 40, defects in group S showed a larger bone graft area, more new bone formation, smaller connective tissue area, and a higher healing score compared to group C (P < 0.05). At day 60, most of the defect in group S was filled with graft particles and mature bone while in group C, new trabecular bone formation was still underway (P < 0.05). CONCLUSION: Teriparatide therapy improves healing of bone defects reconstructed with autograft by reducing bone graft resorption and enhancing new bone formation and maturation.

Genomic variants within the long non-coding RNA H19 confer risk of breast cancer in Iranian population.

OBJECTIVE: The long non-coding RNA (lncRNA) H19 is an imprinted lncRNA with acknowledged roles in carcinogenesis. METHODS: In the current study, we genotyped two single nucleotide polymorphisms (SNPs) within H19 in 111 breast cancer patients and 130 age-matched healthy subjects using tetra primer-ARMS-PCR technique. The T allele of rs2839698 conferred breast cancer risk in the assessed population (OR (95% CI) = 2.52 (1.75-3.64), adjusted P value = 1.3E-6), while and the T allele of rs217727 had a protective effect (OR (95% CI) = 0.42 (0.27-0.66), adjusted P value = 2.8E-4). Both SNPs were associated with breast cancer risk in recessive, dominant and co-dominant models. The T C haplotype (rs2839698 and rs217727) significantly increased risk of breast cancer (OR (95% CI) = 2.4 (1.65-3.45), adjusted P value = 1.2E-5), while the C T haplotype had a protective role (OR (95% CI) = 0.31 (0.18-0.52), adjusted P value = 2.03E-5). The present study highlights the role of H19 SNPs in conferring risk of breast cancer in Iranian population. Future studies with larger sample sizes are required to verify these data.

Interleukin (IL)-8 polymorphisms and risk of prostate disorders.

Prostate cancer (PCa) and benign prostate hyperplasia (BPH) as two prevalent age-related disorders in male have some shared genetic and immunological underlying mechanisms. However, researchers have aimed at identification of specific biomarkers with the ability to differentiate between these disorders. In the present study, we genotyped the rs4073, rs2227306 and rs1126647 single nucleotide polymorphisms within IL-8 gene in 530 individuals including 130 PCa patients, 200 BPH patients and 200 male controls. The rs2227306 alleles and genotypes were distributed equally in the three study groups. The frequency of the A allele of the rs4073 was significantly lower in PCa group compared with BPH group (OR (95% CI) = 0.62 (0.46-0.84), adjusted P value = 0.006). This allele was negatively associated with PCa risk in dominant model (OR (95% CI) = 0.53 (0.34-0.83), adjusted P value = 0.02). When comparing PCa and BPH groups, the rs1126647 was associated with PCa risk in recessive model (OR (95% CI) = 2.14 (1.23-3.72), adjusted P value = 0.02). The A T A haplotype (rs4073, rs2227306 and rs1126647 respectively) was less frequent in PCa group compared with BPH group (OR (95% CI) = 0.4 (0.22-0.75), adjusted P value = 0.03). Consequently, our data demonstrated significant differences in allele, genotype and haplotype frequencies of IL-8 variants between BPH and PCa patients which might imply distinct role for this chemokine in the pathogenesis of these disorders. Future studies are needed to elaborate the underlying mechanism of these observations.

Evaluation of the Standardization in Semen Analysis Performance According to the WHO Protocols Among Laboratories in Tehran, Iran.

BACKGROUND AND OBJECTIVE: Infertility refers to the failure in achieving pregnancy of a couple after one year of regular sexual intercourse without using a protection method. The purpose of this research work was to evaluate the current status of the test and quality control performance in semen analysis in selected laboratories. MATERIAL AND METHODS: The semen analysis was performed in the Laboratory of Andrology in terms of macroscopic examination which include volume, color, viscosity, pH and acidity, and in terms of microscopy: the rate of sperm movement, the exact number of sperms per ml of semen, the percentage of sperm viability and movement, the presence of germ cells and white blood cells. Several questions for each part of the test were selected and answered by the director of the laboratories or andrology section supervisor. RESULTS: There was a wide range in the performance of selected medical laboratories in Tehran regarding the standards of semen analysis according to the World Health Organization (WHO) Laboratory Manual for the examination and processing of human semen, fifth edition in 2010. They followed the instructions related to the sample collection in about 70% of the evaluated parameters, initial macroscopic examination in about 87% of the selected subjects, and the microscopic evaluation of sperm in about 65% of the test parameters. CONCLUSION: some laboratories do not follow the instructions of the WHO in performing semen analysis, and most of them do not follow the suggested methods in all parts of the test.