ABSTRACT
Background: Polycystic ovary syndrome [PCOS] is a frequent condition in reproductive age women with a prevalence rate of 5-10%. This study intends to determine the relationship between PCOS and the outcome of assisted reproductive treatment [ART] in Tehran, Iran
Materials and Methods: In this historical cohort study, we included 996 infertile women who referred to Royan Institute [Tehran, Iran] between January 2012 and December 2013. PCOS, as the main variable, and other potential confounder variables were gathered. Modified Poisson Regression was used for data analysis. Stata software, version 13 was used for all statistical analyses
Results: Unadjusted analysis showed a significantly lower risk for failure in PCOS cases compared to cases without PCOS [risk ratio [RR]: 0.79, 95% confidence intervals [CI]: 0.66-0.95, P=0.014]. After adjusting for the confounder variables, there was no difference between risk of non-pregnancy in women with and without PCOS [RR: 0.87, 95% CI: 0.72-1.05, P=0.15]. Significant predictors of the ART outcome included the treatment protocol type, numbers of embryos transferred [grades A and AB], numbers of injected ampules, and age
Conclusion: The results obtained from this model showed no difference between patients with and without PCOS ac- cording to the risk for non-pregnancy. Therefore, other factors might affect conception in PCOS patients
ABSTRACT
Background: Women undergoing in vitro fertilization [IVF] cycles should successfully go through multiple points during the procedure [i.e., implantation, clinical pregnancy, no spontaneous abortion and delivery] to achieve live births. In this study, data from multiple cycles and multiple points during the IVF cycle are collected for each individual to model the effects of factors associated with success at different stages of IVF cycles in Iranian infertile women
Materials and Methods: This historical cohort study includes 996 assisted reproductive technology [ART] cycles of 511 infertile women. Covariates considered in this study were women's age, type of cycle [fresh or frozen embryo transfer], number of embryos transferred and having polycystic ovarian syndrome during IVF cycles. Generalized estimating equations were used for calculation of odds ratio [OR] and 95% confidence intervals [95% CI] of success at different stages during IVF cycles. Cluster-weighted generalized estimating equations [CWGEE] was also fitted to handle informative cluster size
Results: After adjusting for potential confounders, it was seen that receiving frozen embryo transfer was associated with higher odds of success compared to receiving fresh embryo transfer [adj OR: 2.26, 95% CI: 1.66-3.07]; however, cycles with fresh embryo transfer exhibited better results in clinical pregnancy compared to those receiving frozen embryo. Being in the age category of 38 to 40 was associated with lower odds of success compared to the reference category [<35] in CWGEE model [adj OR: 0.67, 95% CI: 0.45-1.00]. The number of embryos transferred was positively associated with the odds of success in CWGEE [adj OR: 1.21, 95% CI: 1.03-1.42] as well as the GEE model
Conclusion: Receiving frozen embryo was positively associated with odds of success compared to cycles with fresh embryo. The number of embryos transferred and women's age were significantly associated with odds of success
ABSTRACT
Background: chlamydia trachomatis [CT] with damaging effects on sperm quality parameters can often cause infertility in men
Objective: the main objective of this study was to determine the diagnostic value of polymerase chain reaction [PCR] and enzyme linked immuno sorbent assay [ELISA] for screening and detecting CT in semen samples of infertile men
Materials and Methods: in this cross-sectional study, 465 men referring to the clinical laboratory of Royan Institute were chosen for primary screening and detection of the presence of CT. 93 samples were normozoospermia with normal sperm parameters i.e. sperm number, motility and morphology [Asymptomatic] and 372 had abnormal sperm parameters [Symptomatic] in semen analysis. ELISA test was performed as the screening test. Samples with optical density [OD] >0.200 were selected as the case and asymptomatic samples with OD <0.200 were selected as the control group for the confirmatory test. PCR assay was used to confirm the serological results
Results: in the case groups [n=62], 4 out of 32 symptomatic samples [12.5%], and 1 out of 30 asymptomatic samples [3.3%] revealed positive results in PCR. No PCR positive sample was observed in the control group [n=34]. The final results revealed that considering OD >0.400 as the ELISA positive, the diagnostic value of CT ELISA positive insymptomatic and asymptomatic infertile patients were 0.019 [7 of 372] and 0.021 [2 of 93], respectively. There was no relationship between the presence of CT infection and different sperm abnormalities
Conclusion: the anti-CT IgA ELISA test may be introduced as an appropriate tool for screening purpose in the seminal plasma to select suspicious samples for PCR confirmatory tests
ABSTRACT
Objective: In assisted reproductive technology, it is important to choose high quality embryos for embryo transfer. The aim of the present study was to determine the grade A embryo count and factors related to it in infertile women
Materials and Methods: This historical cohort study included 996 infertile women. The main outcome was the number of grade A embryos. Zero-Inflated Poisson [ZIP] regression and Zero-Inflated Negative Binomial [ZINB] regression were used to model the count data as it contained excessive zeros. Stata software, version 13 [Stata Corp, College Station, TX, USA] was used for all statistical analyses
Results: After adjusting for potential confounders, results from the ZINB model show that for each unit increase in the number 2 pronuclear [2PN] zygotes, we get an increase of 1.45 times as incidence rate ratio [95% confidence interval [CI]: 1.23-1.69, P=0.001] in the expected grade A embryo count number, and for each increase in the cleavage day we get a decrease 0.35 times [95% CI: 0.20-0.61, P=0.001] in expected grade A embryo count
Conclusion: There is a significant association between both the number of 2PN zygotes and cleavage day with the number of grade A embryos in both ZINB and ZIP regression models. The estimated coefficients are more plausible than values found in earlier studies using less relevant models
ABSTRACT
Objective: Microdeletions of the Y chromosome long arm are the most common molecular genetic causes of severe infertility in men. They affect three regions including azoospermia factors [AZFa, AZFb and AZFc], which contain various genes involved in spermatogenesis. The aim of the present study was to reveal the patterns of Y chromosome microdeletions in Iranian infertile men referred to Royan Institute with azoospermia/ severe oligospermia
Materials and Methods: Through a cross-sectional study, 1885 infertile men referred to Royan Institute with azoospermia/severe oligospermia were examined for Y chromosome microdeletions from March 2012 to March 2014. We determined microdeletions of the Y chromosome in the AZFa, AZFb and AZFc regions using multiplex Polymerase chain reaction and six different Sequence-Tagged Site [STS] markers
Results: Among the 1885 infertile men, we determined 99 cases of Y chromosome microdeletions [5.2%]. Among 99 cases, AZFc microdeletions were found in 70 cases [70.7%]; AZFb microdeletions in 5 cases [5%]; and AZFa microdeletions in only 3 cases [3%]. AZFbc microdeletions were detected in 18 cases [18.1%] and AZFabc microdeletions in 3 cases [3%]
Conclusion: Based on these data, our results are in agreement with similar studies from other regions of the world as well as two other recent studies from Iran which have mostly reported a frequency of less than 10% for Y chromosome microdeletions
Subject(s)
Humans , Male , Young Adult , Adult , Infertility, Male/genetics , Gene Deletion , Azoospermia/genetics , Oligospermia/genetics , Cross-Sectional StudiesABSTRACT
Background: Infertility and its treatment can have a considerable effect on a person's quality of life [QoL]. The Fertility QoL [FertiQoL] questionnaire is currently the most frequently used instrument to measure QoL in people with fertility problems. This study aims to examine the reliability and validity of the FertiQoL in infertile Iranian women
Materials and Methods: This cross-sectional study included 155 women with fertility problems in a referral fertility clinic in Tehran, Iran from January to March 2014. A battery of instruments was used: FertiQoL, Satisfaction with Life Scale [SWLS], Hospital Anxiety and Depression Scale [HADS], and a demographic questionnaire. Construct validity of the scale was evaluated using confirmatory factor analysis [CFA]. We assessed internal consistency with Cronbach's alpha and convergent validity was examined by correlating the FertiQoL with SWLS and HADS
Results: The results of the CFA generally supported the four-factor model of Core FertiQoL and two-factor model of Treatment FertiQoL. Both FertiQoL modules and their subscales revealed acceptable internal consistency that ranged from 0.643 to 0.911. However, the FertiQoL might be improved if Q15 and T2 items were removed from the scale. These items had low loadings on the Relational and Environment factors which decreased their internal consistency. The FertiQoL and their subscales significantly correlated with both SWLS and HADS, which confirmed convergent validity
Conclusion: The Persian version of the FertiQoL is a valid, reliable instrument to measure QoL in infertile women and seems to perform as well as the original English Version
Subject(s)
Adult , Adolescent , Female , Humans , Middle Aged , Young Adult , Infertility, Female/psychology , Quality of Life , Surveys and Questionnaires , Cross-Sectional StudiesABSTRACT
Background: Infertility is a global public health issue and may adversely affect life satisfaction. One of the most widely instruments used to assess life satisfaction is the Satisfaction with Life Scale [SWLS]
Objective: The objective of this study was to examine the psychometric properties of the SWLS in Iranian infertile women
Materials and Methods: In this descriptive cross-sectional study, a total of 125 infertile women referring to Royan Institute in Tehran were selected by convenience sampling method. The participants were administered the SWLS, the Hospital Anxiety and Depression Scale [HADS], and a demographic questionnaire. The psychometric properties of the SWLS were examined: construct validity using confirmatory factor analysis [CFA], reliability using Cronbach's alpha and convergent validity by examining the relationship with HADS
Result: Results of the CFA indicated that a single-factor model provides a good fit to the data [X[2]/df= 1.58; GFI= 0.975; CFI= 0.995; NFI= 0.985; RMSEA= 0.069 and SRMR= 0.027]. The Cronbach's alpha coefficient for SWLS was 0.887. Significant negative correlations were found between SWLS and HADS scores for anxiety [r= -0.410] and depression [r= -0.434], indicating an acceptable convergent validity
Conclusion: The SWLS has adequate psychometric properties for assessing life satisfaction in Iranian infertile women
ABSTRACT
Background: Due to the worldwide increase in infertility, it is both necessary and im-portant to have assisted reproductive technology [ART] registries. In Iran, donation and surrogacy programs are approved by decrees from religious scholars. ART has been used since 1984 in Iran and the first Iranian infant conceived by gamete intra-fallopian transfer [GIFT] was born in 1989. This report, however, is the first national report on Iranian ART centers
Materials and Methods: This cross-sectional study, conducted under the supervision of the Iranian Ministry of Health, presented a summary of the numbers and percentages of centers that provided infertility services in Iran, as well as the status of ART in Iran during 2011
Results: A total of 52 centers reported treatment cycles and performed approximately 29000 intrauterine insemination [IUI], in addition to 35000 in vitro fertilization [IVF] and intra-cytoplasmic sperm injection [ICSI] cycles
Conclusion: Iran has considerable potential to provide IVF services for both Iranians as well as other nationalities throughout the region. This proves the need for a national center that will implement a registry system
ABSTRACT
This study compared neonatal outcome and maternal complications in multiple pregnancies after assisted reproductive technologies [ART] to spontaneous pregnancies. In this cross-sectional study, we reviewed medical records of 190 multiple pregnancies and births conceived by ART or spontaneous conceptions between 2004 and 2009 in Women Hospital. Obstetric history and outcomes were recorded and compared between these two groups. SPSS version 13 was used for data analysis. The results were analyzed using student's t test, chi square and logistic regression [p<0.05]. There were 106 deliveries from spontaneous conceptions and 84 that resulted from ART. Parity history and mode of delivery significantly differed between the two groups [p<0.001]. The ART group had significantly higher preterm labor and premature rupture of membranes [PROM] whereas pregnanc-induced hypertension [PIH] was higher in the spontaneous group [p=0.01]. Newborn intensive care unit [NICU] admission, duration of hospitalization, still birth and low gestational age were significantly higher in the ART group while neonatal jaundice was higher in the spontaneous group. Logistic regression analysis by considering neonatal complications as the dependent variable showed that respiratory distress syndrome [RDS], NICU admission and Apgar score were independent predictors for neonatal complications. Obstetric and neonatal outcomes must be considered in multiple pregnancies conceived by ART
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Infant, Newborn , Pregnancy Outcome , Reproductive Techniques, Assisted , Fertilization , Cross-Sectional StudiesABSTRACT
Immune-mediated recurrent pregnancy loss [RPL] has received more attention than any other single etiologic classification. Individuals with rare blood group P have an anti-pp1pk antibody in their serum, which causes recurrent abortion in the early stages. In this case series study, 11 patients with unexplained RPL who had anti-P antibody in their serum were treated by plasma exchange during their next pregnancies. To evaluate the efficacy of the treatment, we monitored fetal development using ultrasonography and intensive prenatal care. All calculations were performed with the SPSS version 16. All patients who were treated by plasma exchange progressed to live birth. The mean gestational age at the time of termination was 37.5 +/- 0.69 weeks. The mean weight of the newborns was 2729.09 +/- 389.88 g. None of the newborns required exchange transfusion. P-incompatibility is one rare but important cause of unexplained RPL and also a basis for therapeutic intervention via early antibody removal by plasma exchange