Evaluation of sexual dysfunction prevalence in infertile couples.

INTRODUCTION: The physical health and emotional well-being of many individuals and couples of reproductive age are significantly affected by infertility. Sexual function is one of the important components of health and overall quality of life. AIMS: To determine the prevalence of sexual dysfunction in infertile couples. METHODS: In a cross-sectional study, in a tertiary university hospital, sexual dysfunction was assessed in 100 infertile couples. Sexual Function Questionnaire (SFQ) and International Index of Erectile Function (IIEF) questionnaire were administered. MAIN OUTCOME MEASURES: Prevalence of sexual dysfunction in infertile couples based on the score of the domains of SFQ and IIEF. RESULT(S): The SFQ score was within the normal range in all five domains in only 7% of women. The prevalence of female sexual dysfunction was highest and lowest in arousal-sensation (80.2%) and orgasm (22.8%) domains, respectively. Only 2% of male participants have had severe erectile dysfunction (ED). CONCLUSIONS: The prevalence of dysfunction in arousal-sensation and arousal-lubrication in our study was found to be higher than the results reported from Iranian normal population. The prevalence of any degree of ED in our study was higher than the prevalence reported for normal population and infertile men. The role of demographic factors, relationship parameters, and infertility per se in the prevalence of sexual dysfunction in infertile couples remains to be determined.

Pretreatment Beck Depression Inventory score is an important predictor for post-treatment score in infertile patients: a before-after study.

BACKGROUND: The experience of infertility can be extremely stressful. Some of the risk factors for depression in infertility are being female, repeated unsuccessful treatment cycles or a 2 to 3 year history of infertility, low socioeconomic status, foreign nationality, lack of partner support, life events and previous depression. In this study, we analyzed the Beck Depression Inventory score at the beginning and the end of infertility treatment, to determine which factors may influence the BDI score after treatment of infertility. METHODS: In a before-after study, in a university-affiliated teaching hospital, 251 women who had been visited for assisted reproductive technology infertility treatment participated in the study. BDI score was assessed before and after treatment of infertility. RESULTS: The mean BDI score rose after unsuccessful treatment and dropped after successful treatment. Those with lower education levels had a higher BDI score before treatment. BDI score after treatment was positively correlated with pretreatment BDI scoreand duration of infertility. CONCLUSION: BDI score after treatment was strongly connected to the BDI score before treatment, the result of therapy and to the duration of infertility. The influence of duration of infertility on BDI score after treatment of infertility is weak. So a simple method to screen patients at risk of depression after infertility treatment is determining pretreatment BDI score and predicting the result of infertility treatment by other risk factors.

The Effect of Exercise in PCOS Women Who Exercise Regularly.

PURPOSE: To determine the prevalence of polycystic ovary syndrome (PCOS) in women who exercise regularly. METHODS: All women under age 45 from an industrial company who had past history of exercising more than 6 months enrolled in this cross-sectional study. Prevalence of PCOS and comparison of BMI between PCOS and non-PCOS subgroups was done. The diagnosis of PCOS was based on the revised 2003 Rotterdam ESHRE/ASRM consensus criteria and exclusion of related disorders. RESULTS: The prevalence of PCOS in was 8.8%; 95% CI: 8.5%-9.1%. In obese subjects, mean BMI differed significantly between PCOS and non-PCOS women (29.3 ±3.3 kg/m(2) vs. 27.8 ± 2 kg/m(2), P=0.03). In lean subjects, there was no statistically significant difference in terms of BMI between PCOS and non-PCOS women (21.4 ± 1.9 kg/m(2) vs. 21.2 ± 2 kg/m(2), P>0.05). CONCLUSION: Obese PCOS patients show more difficulty in losing weight by exercise than lean PCOS patients. The role of hormonal alterations and PCOS per se in the responsiveness of weight loss to exercise remains to be determined.

Comparison of unilateral and bilateral transfer of injected oocytes into fallopian tubes: a prospective, randomized clinical trial.

OBJECTIVE: To assess whether pregnancy rate differs in unilateral vs. bilateral transfer in "immediate transfer of injected oocytes into the fallopian tubes." DESIGN: Prospective randomized clinical trial. SETTING: Tertiary university hospital. PATIENT(S): The study population included 160 patients presenting with male factor infertility who fulfilled the criteria for immediate transfer of injected oocytes into tubes. INTERVENTION(S): Four injected oocytes were transferred into two tubes (study group) or one tube (control group). MAIN OUTCOME MEASURE(S): Implantation rate, clinical pregnancy rate, multiple pregnancy rate, and incidence of pregnancy with unknown location (PUL). RESULT(S): A total of 72 (45%) pregnancies were achieved. There were 32 pregnancies (1 PUL, 4 multiple, and 27 singletons) in the bilateral transfer group and 40 pregnancies in the unilateral transfer group (1 PUL, 7 multiple, and 32 singletons). No significant difference was found in the implantation rate, clinical pregnancy rate, multiple pregnancy rate, and incidence of PUL. CONCLUSION(S): This study demonstrates that no difference in outcome occurred between unilateral and bilateral transfer in microinjected oocytes intrafallopian transfer (MIFT). Therefore, along with the same outcome parameters, unilateral transfer is the preferred method of MIFT.

Comparison of success rates in the medical management of ectopic pregnancy with single-dose and multiple-dose administration of methotrexate: a prospective, randomized clinical trial.

OBJECTIVE: To assess whether success rate differs in single-dose versus multiple-dose administration of methotrexate (MTX) in medical management of unruptured ectopic pregnancies. DESIGN: Prospective randomized clinical trial. SETTING: Tertiary university hospital. PATIENT(S): The study population included 108 patients presenting with unruptured ectopic pregnancies who fulfilled the criteria for medical management. INTERVENTION(S): A single dose (study group) or multiple doses (control group) of MTX were administered IM. MAIN OUTCOME MEASURE(S): Success rate of medical management in each group. RESULT(S): Of the 54 patients on the single-dose protocol, treatment was considered successful in 48 patients (88.9%). Of the 54 patients on the multiple-dose protocol, 50 participants responded to the treatment (92.6%). The difference between success rates in the two groups was not statistically significant (P=.7; odds ratio 0.64; 95% confidence interval 0.17-2.4). In the single-dose and multiple-dose groups, 15 (27.8%) and 20 (37%) patients, respectively, had complications (P=.3). CONCLUSION(S): The results of our study showed that single-dose treatment with MTX could be as successful as multiple doses. The incidence of complications did not differ between the two groups. It appears that single-dose treatment could be the first line of treatment in selected patients.

The effects of L-carnitine on sperm parameters in smoker and non-smoker patients with idiopathic sperm abnormalities.

PURPOSE: To determine the effects of L: -carnitine on sperm parameters in patients with idiopathic sperm abnormalities. METHODS: In an academic reproductive care center, 170 patients including 48 smokers and 122 non-smokers participated in a before-after study. Men were given 1 g of L: -carnitine orally 3 x daily for 3 months. Sperm assessment was done before and after the treatment. Main outcome measures were sperm concentration, motility, and morphology before and after the treatment. RESULTS: L-Carnitine was effective in improvement of percentile of motile sperms, grade A sperms, and normal-shaped sperms. L-Carnitine significantly improved percentile of motile and grade A sperms in non-smokers. Only the change in the median percentile of normal forms was within the significant range in smokers. CONCLUSIONS: The results of this study indicate that smoker patients should not be excluded from the treatment with L-carnitine based on smoking alone.