Factors Affecting Response to Infertility Treatment: Case of Iran.

INTRODUCTION: Infertility affects both women and men in all the countries. Infertility often has profound long-term or short-term impacts on the people involved and puts them at risk of familial and social pressures. According to WHO estimates, between 8% and 12% of all the couples worldwide experience some form of infertility during their reproductive life, i.e. 50‒80 million people are affected. The aim of this study was to evaluate the response to infertility treatment by taking into account factors such as age, hirsutism, menstruation and galactose among women in Kerman. METHODOLOGY: Of a total of 300 patient files evaluated 220 cases were flawless, of which the study factors were recorded. These data were estimated by Logit model. The dependent variable was the response to treatment (0 and 1) and the independent variables included age of men and women, hirsutism, menstruation, galactose, duration of the period no preventive measures were used and body mass index. After entering the data, model output was analyzed by using the STATA software. RESULTS: The results showed that of all the model variables, female age (prob=0.0065), menstruation (prob=0.04), hirsutism (prob=0.02), marriage age (in months) (prob=0.02) and BMI were significant and other variables were not significant. McFadden analysis for goodness of fit was 0.92. CONCLUSION: The study results showed that women should pay more attention to variables such as BMI, menstruation quality (regular and irregular) and aging because clinical disregard of any of the above can have a significant impact on the individual's fertility.

Incidence and correlates of maternal near miss in southeast iran.

This prospective study aimed to estimate the incidence and associated factors of severe maternal morbidity in southeast Iran. During a 9-month period in 2013, all women referring to eight hospitals for termination of pregnancy as well as women admitted during 42 days after the termination of pregnancy were enrolled into the study. Maternal near miss conditions were defined based on Say et al.'s recommendations. Five hundred and one cases of maternal near miss and 19,908 live births occurred in the study period, yielding a maternal near miss ratio of 25.2 per 1000 live births. This rate was 7.5 and 105 per 1000 in private and tertiary care settings, respectively. The rate of maternal death in near miss cases was 0.40% with a case:fatality ratio of 250 : 1. The most prevalent causes of near miss were severe preeclampsia (27.3%), ectopic pregnancy (18.4%), and abruptio placentae (16.2%). Higher age, higher education, and being primiparous were associated with a higher risk of near miss. Considering the high rate of maternal near miss in referral hospitals, maternal near miss surveillance system should be set up in these hospitals to identify cases of severe maternal morbidity as soon as possible.

Comparison of chlamydia infection prevalence between patients with and without ectopic pregnancy using the PCR method.

OBJECTIVES: Damage of the fallopian tube after sexually transmitted diseases like Chlamydia trachomatis, is an important risk factor for ectopic pregnancy (EP). The study was designed to assess the prevalence of C. trachomatis infection in patients with EP in the southeastern part of Iran. METHOD: The polymerase chain reaction (PCR) on fallopian tube tissue was applied to detect Chlamydia DNA in 42 patients with EP (EP group) and 87 patients without EP (control group) who underwent tubal ligation. The same protocol was performed with urine samples taken from the husbands in both groups. RESULTS: Out of all studied females, 5 patients in the EP group were PCR-positive for C. trachomatis and none of the control group subjects was PCR-positive for C. trachomatis infection (P<0.05). Among the husbands, the PCR result was positive in the urine of 19 males (9 in the EP group and 10 in the control group). All PCR-positive women had husbands with PCR positive urine samples. No significant difference was found between Chlamydia infection in the EP and the control groups regarding age, duration of marriage, contraceptive method and history of infertility surgery and pelvic pain. There was no significant difference between prevalence of EP in women based on the PCR outcome in the husbands. The Chlamydia infection in men did not show any relation to the number of marriages. CONCLUSION: Based on our findings, it can be concluded that Chlamydia is an important risk factor of the fallopian tube damage and EP in our society. Therefore, screening programs and treatment of Chlamydia infection are recommended in young women and high risk women and men.

The effect of Ramadan fasting on amniotic fluid volume.

OBJECTIVE: This cross-sectional study was carried out to assess the influence of Ramadan fasting on amniotic fluid volume. METHODS: For this purpose 2 groups of fasting (n=28) and non-fasting (n=25) pregnant women were investigated for amniotic fluid index (AFI) and deepest vertical pocket of amniotic fluid in November (Ramadan month) of 2001-2002 in Kerman Prenatal Clinics in Kerman, Iran. Mean of gestational age based on the last menstrual period and ultrasound reports were 29.6 +/- 5.8 week and 29.5 +/- 4.2 week in fasting and non-fasting groups. RESULTS: There was no significant difference between the 2 groups in age, gestational age, gravidity, parity and systolic/diastolic blood pressures. The mean deepest vertical pocket in fasting and non-fasting groups were 65.9 +/- 12.9 mm and 62.7 +/- 6.5 mm and there was no significant difference between the 2 groups in this regard. Mean AFI in fasting group (189.9 +/- 35.9 mm) and in non-fasting group (166.8 +/- 25.3 mm) showed a significant difference (p less than 0.05). CONCLUSION: Based on the results of the present study fasting in Ramadan has no significant effect on the decrease of AFI, deepest vertical pocket and amniotic fluid volume.

Determination of sensitivity and specificity of breast tumor diagnosis by primary health care providers (Behvarz) using clinical examination by obstetrician as a gold standard.

AIM: The aim of this study was to find a practical screening strategy to detect breast tumors in those who cannot refer to specialists due to problems, such as geographic location, and economical obstacles. METHODS: Considering the mentioned aim this study was designed to compare the sensitivity and specificity of diagnosis of breast tumors made by health care providers (Behvarz) with those made by specialists. For this, the results of examinations of Behvarzes and an obstetrician on 2000 women referring to the 17 health care centers of Kerman and Zarand cities were compared. RESULTS: Among the 2000 women examined by Behvarzes 170 cases were reported to have pathological signs (palpable mass) and 1830 cases were reported without any pathological sign. Among 169 cases diagnosed by physicians as having pathological signs, 162 cases had also been diagnosed by Behvarzes, and there were only seven cases diagnosed by physicians that had been missed by Behvarzes. There were eight cases diagnosed by Behvarzes as having pathological signs that were reported healthy by physicians. CONCLUSIONS: Based on these findings, the sensitivity and specificity of diagnosis of breast tumors made by Behvarzes was 95.8% and 99.56%, respectively, compared with those made by specialists. Considering the obtained results, the screening program for breast tumors by Behvarzes can be very helpful in early diagnosis of breast tumors.