Effect of maternal polycystic ovary syndrome (PCOS) on screening of aneuploidy in the first and second trimesters.

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and hormonal disorder in women. This study aimed to assess the effect of maternal PCOS on screening of aneuploidy in the first and second-trimesters. METHODS: This case-control study was conducted in Arash Hospital and Nilou Laboratory in 2017-2018. The screening test was conducted on 90 PCOS and 90 healthy mothers. Finally, the first and second-trimester screening was compared between the two groups using Chi-square, Mann-Whitney's U and students T tests and regression model by SPSS 21. P < 0.05 was considered as statistically significant. RESULTS: Free Beta-Human Chorionic Gonadotropin (Free-ß-HCG) (P = 0.04), inhibin-A (P = 0.001) and Alpha Fetoprotein (AFP) (P = 0.02) levels were higher in the PCOS women comparing to the healthy women but there was no significant difference between the mean of HCG, Plasma Protein A (PAPP-A), and Unconjugated Estriol (UE3) between the two groups. Pre-eclampsia (P < 0.001) and trisomy 18 risks in quad screening were higher in the PCOS women (P = 0.002) than the control group; however, trisomy 13, trisomy 18 and trisomy 21 risks, Smith-Lemli-Opitz Syndrome (SLOS) and Neural Tube Defect (NTD) risks were not different between the two groups. The logistic regression model showed that the first- and second-trimester screening of aneuploidywas related to PCOS. CONCLUSIONS: There was a significant difference in the mean of free-ß-HCG, inhibin-A, AFP level, and the risks of pre-eclampsia, SLOS and trisomy 18 between the two groups but no significant association was found in the mean of HCG, PAPP-A, UE3, NTD and other aneuploidies between the two groups. PCOS may affect the first- and second-trimester screening tests and pregnancy health. It may also require correction in the calculation of risks related to the first- and second-trimester screening for aneuploidy.

Relationship between postpartum depression and plasma vasopressin level at 6-8 weeks postpartum: a cross-sectional study.

Postpartum depression (PPD) is the most important postpartum mood disorder due to its significant effect on both the infant and family health. Arginine vasopressin (AVP) has been suggested as a hormonal agent involved in the development of depression. The purpose of this study was to investigate the relationship between the plasma concentrations of AVP and the score of Edinburgh Postnatal Depression Scale (EPDS). This cross-sectional study was conducted in 2016-2017 in Darehshahr Township, Ilam Province, Iran. In the first phase, 303 pregnant women, who were at 38 weeks, met the inclusion criteria, and were not depressed (according to their EPDS scores) were included in the study. In the 6-8 week postpartum follow-up, using the EPDS, 31 depressed individuals were diagnosed and referred to a psychiatrist for confirmation. The maternal venous blood samples of 24 depressed individuals still meeting the inclusion criteria and 66 randomly selected non-depressed subjects were obtained to measure their AVP plasma concentrations with ELISA assay. There was a significant positive relationship between plasma AVP levels and the EPDS score (P = 0.000, r = 0.658). Also the mean plasma concentration of AVP was significantly higher in the depressed group (41.35 ± 13.75 ng/ml) than in the non-depressed group (26.01 ± 7.83 ng/ml) (P < 0.001). In a multiple logistic regression model for various parameters, increased vasopressin levels were associated with increased odds of PPD (OR = 1.15, 95% CI = 1.07-1.24, P = 0.000). Furthermore, multiparity (OR = 5.45, 95% CI = 1.21-24.43, P = 0.027) and non-exclusive breastfeeding (OR = 13.06, 95% CI = 1.36-125, P = 0.026) were associated with increased odds of PPD. Maternal gender preference (having a baby of desired and desired sex) decreased the odds of PPD (OR = 0.13, 95% CI = 0.02-0.79, P = 0.027 and OR = 0.08, 95% CI = 0.01-0.5, P = 0.007). AVP seems to be a contributor to clinical PPD by affecting the hypothalamic-pituitary-adrenal (HPA) axis activity. Furthermore, primiparous women had significantly lower EPDS scores.

Psychological Predictors of Sexual Quality of Life Among Iranian Women With Vaginismus: A Cross-Sectional Study.

Background: Vaginismus is an involuntary contraction of muscles around the vaginal and one of the most common sexual disorders among women. It is often associated with psychological problems, leading to poor sexual quality of life (SQOL). This study aimed to determine SQOL predictors in women with vaginismus. Methods: In this cross-sectional study, convenience sampling was used to enroll 236 individuals with vaginismus among all women visiting sexual health clinics of Tehran, Iran in 2018. The data were collected using the Sexual Quality of Life-Female (SQOL-F) Questionnaire, Hospital Anxiety and Depression Scale (HADS), and Rosenberg Self-Esteem Scale. The data were analyzed using the General Linear Model (GLM). Results: The mean (SD) SQOL score of the participants was 56.82 (20.18). There was a significant direct correlation between the participants' self-esteem and their SQOL (r = 0.54, p < 0.001). However, the participants' SQOL had significant inverse correlations with the variables of anxiety (r = - 0.48, p < 0.001) and depression (r = -0.47, p < 0.001). Based on the GLM results, the variables of anxiety, depression, self-esteem, and duration of disorder predicted SQOL, and explained 42.3% of the variance of SQOL in the participants. Conclusion: The results indicated that psychological factors such as anxiety, depression, and self-esteem are predictors of SQOL in women with vaginismus.

The role of personal factors in quality of life among Iranian women with vaginismus: a path analysis.

BACKGROUND: The aim of this study was to provide a path model for assessing the direct and/or indirect effects of psychological/behavioral parameters on health-related quality of life among women with vaginismus. METHODS: A cross-sectional study was conducted on a sample of 236 women with vaginismus disorder attending to sex clinics in Tehran, Iran from April 2017 to March 2018. Data were collected using a demographic questionnaire, the marital satisfaction scale, the hospital anxiety and depression scale, the rosenberg self-esteem scale, the body image concern inventory, the short-form health survey (SF-12) and the female sexual quality of life questionnaire. In addition to descriptive statistical data, the fitness of the proposed model was investigated using path analysis. RESULTS: The results of path analysis demonstrated that the final model had a good fit to the data (Chi-Square/degrees of freedom (Normed Chi2) = 2.12, root mean square error of approximation = 0.069, goodness fit index = 0.99, both comparative fit index = 0.99 and Tucker-Lewis index = 0.96). In this model, anxiety and depression significantly predicted health-related quality of life as measured by the SF-12. CONCLUSIONS: Anxiety and depression are important components in predicting health-related quality of life among those suffering from vaginismus.

Metabolic parameters in cord blood of neonate of mothers with obese and non-obese PCOS and controls: retrospective cohort study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by reproductive disorder and increased risk of metabolic syndrome. This study aimed to assess the metabolic parameters in the cord blood of neonate of mothers with obese PCOS and comparison with non-obese PCOS and controls. METHODS: This retrospective cohort study was conducted in Arash and Kamali Hospital in 2017-2018. The biochemical test was conducted on 78 neonates from obese PCOS mothers, 78 neonates from non-obese PCOS mothers, and 78 neonates from healthy mothers. Finally, cord blood lipid profile and insulin and blood sugar were determined by specific kits. Correlations between variables were compared with chi-square, Mann-Whitney's U, Kruskal-Wallis H tests and regression model by SPSS 23 and P < 0.05 was considered significant. RESULTS: Triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were higher in cord blood of newborn of obese PCOS women than non-obese PCOS and controls (P = 0.02, P < 0.001, respectively). Also, the mean insulin was higher in cord blood of neonate of non-obese PCOS women than in obese PCOS and controls (12.26 ± 12.79 vs. 11.11 ± 16.51 vs. 6.21 ± 10.66, P = 0.01). But in the study, there was no significant difference between the mean of umbilical cord low-density lipoprotein cholesterol (LDL), total cholesterol and blood sugar in three groups. The logistic regression model showed that metabolic parameters were related to PCOS. CONCLUSIONS: In the present study, there was a significant difference between the mean of umbilical cord HDL, cholesterol, and the insulin level in the three groups. But, there was no significant association between the mean of blood sugar, LDL, and TG in the groups. The metabolic disorder in PCOS might affect cord blood lipid and insulin and adulthood health.

Comparison of dietary micronutrient intake in PCOS patients with and without metabolic syndrome.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-age women. It is one of the risk factors of metabolic syndrome (MetS). These two syndromes have an inflammatory etiologic foundation along with oxidative stress. The present study aimed to compare the dietary intake of antioxidant micronutrients in PCOS women with and without MetS. MATERIALS AND METHODS: Overall, 42 participants eligible for this nested case control study were selected by the convenience sampling method. The case group included 14 PCOS patients with MetS and the control group included 28 PCOS patients without MetS. The dietary intake assessment of selenium, chromium, zinc, carotenoids, vitamin D and vitamin E was carried out by a 147-item Food Frequency Questionnaire (FFQ). PCOS and MetS were diagnosed using the Rotterdam criteria and NCEP ATP III, respectively. Statistical analysis was performed using SPSS16 software, T-test and Mann Whitney. Significant P-value was considered 0.05. RESULTS: Dietary intake of antioxidant micronutrients (selenium, zinc, chromium, carotenoids and vitamin E) was significantly lower in the PCOS women with MetS than in the control group (P < 0.05). CONCLUSION: Since the PCOS patients without MetS had more intake of the aforementioned micronutrients than those with MetS, it is assumed that the dietary intake of these nutrients could probably have a protective effect on MetS.

Prevalence of metabolic syndrome in four phenotypes of PCOS and its relationship with androgenic components among Iranian women: A cross-sectional study.

BACKGROUND: Polycystic ovary syndrome (PCOS) increases the risk of metabolic syndrome (MetS). Insulin resistance (IR) plays a major role in the pathophysiology of both PCOS and MetS. OBJECTIVE: This study was designed to compare the prevalence of MetS among different phenotypes of PCOS and its relationship with androgenic components. MATERIALS AND METHODS: 182 participants eligible for this five-group comparative study were selected by convenience sampling method. They were classified according to the Rotterdam criteria: clinical and/or biochemical hyperandrogenism (H) + PCOS on ultrasound (P) + ovulation disorders (O) (n = 41), clinical and/or biochemical H + PCOS on P (n = 33), PCOS on P + O (n = 40), clinical and/or biochemical H + O (n = 37), and control (without PCOS) (n = 31). MetS was measured based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Androgenic components included free-androgen-index (FAI), total-testosterone (TT) level and sex-hormone-binding-globulin (SHBG). RESULTS: A significant difference was observed between the study groups in terms of MetS prevalence (p = 0.01). In phenotype H+P+O, there was a statistically significant positive association between TG and TT, and a significant negative association between SBP and DBP with SHBG. In phenotype O+P, WC was inversely associated with SHBG. In phenotype H+O, FBS and TG were positively associated with FAI but HDL was inversely associated with FAI. Moreover, WC and DBP were positively associated with TT in phenotype H+O. No associations were detected between MetS parameters and androgenic components in other PCOS subjects (phenotype H+P) and in the control group. TT was significantly higher in the PCOS group suffering from MetS (p = 0.04). CONCLUSION: According to the research results, hyperandrogenic components are potent predictors of metabolic disorders. Thus, we suggest that MetS screening is required for the prevention of MetS and its related complications in PCOS women.

Comparison of the umbilical cord Blood's anti-Mullerian hormone level in the newborns of mothers with polycystic ovary syndrome (PCOS) and healthy mothers.

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases. At present, the cause of the disease is not fully understood, but many studies have shown that PCOS is associated with genetic and environmental factors. The present study aimed to assess the umbilical cord blood's Anti-mullerian hormone (AMH) level in the newborns of mothers suffering from PCOS comparing to healthy mothers. METHODS: This prospective cohort study was conducted on 120 pregnant women with PCOS, who were selected through Rotterdam criteria, and 60 healthy pregnant women as the control group. The subjects in each group were divided into obese and non-obese mothers according to their body mass index (BMI) before pregnancy. The cord blood samples were collected from the offsprings on the time of childbirth. Finally, the circulating concentrations of AMH in both sexes of the newborns were determined by specific assays. RESULTS: The research results showed that the blood level of AMH was higher in the neonates of obese mothers with PCOS comparing to the controls (P < 0.001). Mean AMH level was higher in male neonates born from non-obese PCOS mothers than in the controls (P < 0.001); however, there was not a significant difference in the level of AMH in female neonates between these two groups (P = 0.264). Also the level of the above biomarker was higher in both sexes of the neonates belonging to obese PCOS mothers compared with the neonates born from non-obese PCOS mothers (P < 0.001). CONCLUSION(S): It can be said that the cord blood AMH level of neonates from obese women with PCOS is higher than that in the newborns of non-obese PCOS mothers. Further longitudinal studies are needed to confirm the clinical findings of the present research.

The association between estradiol levels and cognitive function in postmenopausal women.

BACKGROUND: Levels of estradiol decreases as women arrive the menopausal transition and enter to a low, steady level during the early postmenopause. In addition, memory dysfunction are highly prevalent during this period. OBJECTIVE: Our study was designed to determine whether endogenous levels of estradiol are related to cognitive function in postmenopausal. MATERIALS AND METHODS: The cross-sectional study was conducted between November 2015 to February 2016 on 209 healthy postmenopausal women. The women filled out the Montreal Cognitive Assessment (MoCA) scale. Then, estradiol level was tested for association with cognitive function adjusted for factors supposed to confound this association. RESULTS: The prevalence of cognitive dysfunction; MoCA points ≤26 in our participants was 62.7%, and mean±SD of estradiol level was 14.92±10.24pg/ml in participants with cognitive dysfunction in comparison with 21.67±14.92pg/ml in those with normal cognitive function (p<0.001). There were significant association between MoCA points with estradiol level (p<0.001) and educational status (p<0.001). CONCLUSION: Estradiol replacement therapy in postmenopausal women with low endogenous estradiol levels and decreased cognitive function might be necessary.

Development and Psychometric Properties of The Delayed Childbearing Questionnaire (DCBQ-55).

The comprehensive assessment of delayed childbearing needs a valid and reliable instrument. Therefore, the aim of the present study was to develop an instrument to evaluate factors influencing delayed childbearing among women and to assess its psychometric properties. The current methodological study was performed in two phases of (i) qualitative instrument development, and (ii) quantitative psychometric assessment of the developed instrument. Face and content validity of the instrument was assessed by eligible women and a panel of experts. Construct validity was assessed using the exploratory factor analysis (EFA). For reliability, internal consistency reliability and intra-rater reliability analysis were used. The initial instrument developed from the qualitative phase consisted of 60 items, which were reduced to 55 items after the face and content validity processes. EFA (n = 300) using the Kaiser criteria (Eigenvalues > 1) and the scree plot led to a six-factor solution accounting for 61.24% of the observed variance. The Cronbach's alpha coefficient, Spearman's correlation, test⁻retest and intra-class correlation coefficients for the whole instrument were reported as 0.83, 0.86 and 0.81, respectively. The final instrument entitled the delayed childbearing questionnaire (DCBQ-55) included 50 items with six domains of 'readiness for childbearing', 'stability in the partner relationship', 'awareness about the adverse outcomes of pregnancy in advanced maternal age', 'attitude toward delayed childbearing', 'family support', and 'social support' on a five-point Likert scale. The DCBQ-55 as a simple, valid and reliable instrument can assess factors influencing delayed childbearing. It can be used by reproductive healthcare providers and policy makers to understand factors influencing delayed childbearing and devise appropriate strategies.

Evaluation of Influencing Factors on Tubal Sterilization Regret: A Cross-Sectional Study.

BACHGROUND: The aim of this study is to evaluate the menstrual pattern, sexual function, and anxiety, and depression in women with poststerilization regret, and potential influencing factors for regret following tubal ligation (TL) in Iranian women. MATERIALS AND METHODS: In this cross-sectional study, 166 women with TL were subdivided into two groups including women with poststerilization regret (n=41) and women without poststerilization regret (n=125). They were selected from a health care center in Guilan province (Iran) during 2015-2016. Menstrual blood loss was measured using the Pictorial Blood Loss Assessment Chart (PBLAC) and through a self-administered questionnaire. In addition, sexual function was assessed by the Female Sexual Function Index (FSFI), and psychological distress was measured by employing the Hospital Anxiety and Depression Scale (HADS). Student's t test and Chi-square test were used to reveal the statistical differences between the two groups. We used logistic regression to determine the influencing factors associated with regretting sterilization. RESULTS: Women with poststerilization regret had more menorrhagia (78 vs. 57.6%, P=0.03) than those who did not regret sterilization. A significant difference was found in sexual dysfunction in orgasm (P=0.02), satisfaction (P=0.004), pain (P=0.02), and total FSFI scores (P=0.007) between the two groups. Also, there was a significant difference between the two groups in anxiety, depression and total scores HADS (P=0.01). In the logistic regression model, age of sterilization [odds ratio (OR=2.67), confidence interval (CI): 1.03-7.81, P=0.04)], pre-sterilization counseling (OR=19.92, CI: 6.61-59.99, P<0.001), score of PBLAC (OR=1.01, CI: 1.004-1.01, P=0.001), the number of days of bleeding (OR=1.37, CI: 1.01-1.99, P=0.04), and the length of menstrual cycles (OR=0.91, CI: 0.84-0.99, P=0.03) were significantly associated with regretting sterilization. CONCLUSION: Complications due to sterilization are the main causes of regret; therefore, it is necessary to pay due attention to mentioning the probable complications of the procedures such as menstruation disorders, sexual dysfunction, and anxiety and depression in women during pre-sterilization counseling.

The effect of hormone replacement therapy on cognitive function in postmenopausal women: An RCT.

BACKGROUND: During the reproductive age, the human brain becomes a target for gonadal steroid hormones. Estrogens influence neural function through effects on neurons and affects indirectly the oxidative stress, inflammation, the cerebral vascular and the immune system. OBJECTIVE: To evaluate the effect of the traditional hormone replacement therapy (HRT) on the cognitive function in postmenopausal women. MATERIALS AND METHODS: In this randomized clinical trial, 140 postmenopausal women, from November 2014 to February 2015, were included. Women were randomly divided into two groups. Each woman in the case group took traditional HRT (0.625mg conjugated equine estrogens+2.5mg medroxyprogesterone acetate daily) plus one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months. Women in the control group received only one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months period. The Montreal Cognitive Assessment (MoCA) and Green Climacteric Scale (GCS) questionnaires filled out after the intervention and compared between the two groups. RESULTS: The mean points of the MoCA after the intervention indicate that all MoCA domains except for the orientation improved in the case group. There was a significant difference in the memory domain after the treatment between the two groups. MoCA domains and GCS were negatively correlated after the intervention ( r = - 0 . 235 , p = 0 . 006 ). CONCLUSION: The HRT has affected some of the MoCA factors. The effects of HRT on cognitive function should be studied in a large prospective study in a group of women in their early and late menopausal ages with periodic assessment of their cognitive function during these follow-up years.

In-vitro construction of endometrial-like epithelium using CD146+ mesenchymal cells derived from human endometrium.

Endometrial CD146+ cells were purified, using magnetic activated cell sorting, and then embedded and cultured in a collagen-matrigel scaffold on top of myometrial smooth muscle cells for 10 days. At the end of culture period, the differentiation and formation of the epithelial-like cells were confirmed by morphological and ultrastructural evaluations, and analysis by reverse transcription polymerase chain reaction of the specific expression of genes: osteopontin (SPP1), matrix metalloproteinase 2, zonula occludens 1, laminin alpha 2 and collagen type IV; and by western blotting of CD9 protein. The results showed that the human endometrial mesenchymal CD146+ cells were able to produce endometrial glandular tube-like structures in vitro. Ultrastructural observation revealed some projections on the apical surfaces, appearance of basal lamina-like structures on the basal surface, and tight junctions and desmosomes on the lateral surfaces of the epithelial-like cells. The expression of studied genes at RNA level and CD9 at protein level confirmed the formation of endometrial epithelial-like cells. This culture system may have potential applications in cell therapy and in studies on human embryo implantation.

Association between Nutritional Status with Spontaneous Abortion.

BACKGROUND: Spontaneous abortion is the most common adverse pregnancy outcome. We aimed to investigate a possible link between nutrient deficiencies and the risk of spontaneous abortion. MATERIALS AND METHODS: This case-control study included the case group (n=331) experiencing a spontaneous abortion before 14 weeks of pregnancy and the control group (n=331) who were healthy pregnant women over 14 weeks of pregnancy. The participants filled out Food Frequency Questionnaire (FFQ), in which they reported their frequency of consumption for a given serving of each food item during the past three months, on a daily, weekly or monthly basis. The reported frequency for each food item was converted to a daily intake. Then, consumption of nutrients was compared between the two groups. RESULTS: There are significant differences between the two groups regarding consumed servings/day of vegetables, bread and cereal, meat, poultry, fish, eggs, beans, fats, oils and dairy products (P=0.012, P<0.001, P=0.004, P<0.001, P=0.019, respectively). There are significant differences between the two groups in all micronutrient including folic acid, iron, vitamin C, vitamin B6, vitamin B12 and zinc (P<0.001). CONCLUSION: Poor nutrientions may be correlated with increased risk of spontaneous abortion.

The effect of stem cell factor on proliferation of human endometrial CD146(+) cells.

BACKGROUND: Stem cell factor (SCF) is a transcriptional factor which plays crucial roles in normal proliferation, differentiation and survival in a range of stem cells. OBJECTIVE: The aim of the present study was to examine the proliferation effect of different concentrations of SCF on expansion of human endometrial CD146(+) cells. MATERIALS AND METHODS: In this experimental study, total populations of isolated human endometrial suspensions after fourth passage were isolated by magnetic activated cell sorting (MACS) into CD146(+) cells. Human endometrial CD146(+) cells were karyotyped and tested for the effect of SCF on proliferation of CD146(+) cells, then different concentrations of 0, 12.5, 25, 50 and 100 ng/ml was carried out and mitogens-stimulated endometrial CD146(+) cells proliferation was assessed by MTT assay. RESULTS: Chromosomal analysis showed a normal metaphase spread and 46XX karyotype. The proliferation rate of endometrial CD146(+) cells in the presence of 0, 12.5, 25, 50 and 100 ng/ml SCF were 0.945±0.094, 0.962±0.151, 0.988±0.028, 1.679±0.012 and 1.129±0.145 respectively. There was a significant increase in stem/ stromal cell proliferation following in vitro treatment by 50 ng/ml than other concentrations of SCF (p=0.01). CONCLUSION: The present study suggests that SCF could have effect on the proliferation and cell survival of human endometrial CD146(+) cells and it has important implications for medical sciences and cell therapies.

Menstrual Pattern following Tubal Ligation: A Historical Cohort Study.

BACKGROUND: Tubal ligation (TL) is recommended for women who have completed their family planning. The existence of the menstrual disorders following this procedure has been the subject of debate for decades. This study was conducted to identify the relationship between tubal ligation and menstrual disorders. MATERIALS AND METHODS: A historical cohort study was carried out on 140 women undergoing tubal ligation (TL group) and on 140 women using condom as the main contraceptive method (Non-TL group). They aged between 20 and 40 years and were selected from a health care center in Rudsar, Guilan Province, Iran, during 2013-2014. The two groups were comparable in demographic characteristics, obstetrical features and menstrual bleeding pattern using a routine questionnaire. A validated pictorial blood loss assessment chart (PBLAC) was also used to measure the menstrual blood loss. RESULTS: Women with TL had more menstrual irregularity than those without TL (24.3 vs. 10%, P=0.002). Women with TL had more polymenorrhea (9.3 vs. 1.4%, P=0.006), hypermenorrhea (12.1 vs. 2.1%, P=0.002), menorrhagia (62.9 vs. 22.1%, P<0.0001) and menometrorrhagia (15.7 vs. 3.6%, P=0.001) than those without TL. There is a significant difference in the PBLAC score between women with and without TL (P<0.0001). According to logistic regression, age odds ratio [(OR=1.08, con- fidence interval (CI):1.07-1.17, P=0.03)], TL (OR=5.95, CI:3.45-10.26, P<0.0001) and cesarean section (OR=2.72, CI:1.49-4.97, P=0.001) were significantly associated with menorrhagia. CONCLUSION: We found significant differences in menstrual disorders between women with and without TL. Therefore, women should be informed by the health providers regarding the advantages and disadvantages of TL before the procedures.

Characteristics of Human Endometrial Stem Cells in Tissue and Isolated Cultured Cells: An Immunohistochemical Aspect.

BACKGROUND: The aim of this study was to investigate the percentage of the stem cells population in human endometrial tissue sections and cultured cells at fourth passage. METHODS: Human endometrial specimens were divided into two parts, one part for morphological studies and the other part for in vitro culture. Full thickness of human normal endometrial sections and cultured endometrial cells at fourth passage were analyzed via immunohistochemistry for CD146 and some stemness markers such as Oct4, Nanog, Sox2, and Klf4 and the expression of typical mesenchymal stem cell markers CD90, CD105. RESULTS: 11.88 ± 1.29% of human endometrial cells whitin tissue sections expressed CD146 marker vs. 28±2.3% of cultured cells, CD90 and CD105 were expressed by functionalis stroma (85±2.4 and 89±3.2%) than basalis stroma (16±1.4 and 17±1.9%), respectively (P<0.05). Oct4 and Nanog-expressing cells comprise 1.43±0.08 and 0.54±0.01% of endometrial stromal cells in endometrial sections vs. 12±3.1% and 8±2.9% of cultured cells, respectively. They reside near the glands in the basal layer of endometrium. Sox2 and Klf4 were not commonly expressed in tissue samples and cultured cells. CD9 and EpCAM were expressed by epithelial cells of the endometrium, rather than by stroma or perivascular cells. CONCLUSION: The human endometrial stem cells and pluripotency markers may be localized more in basalis layer of endometrium. The immunostaining observations of endometrial cells at fourth passage were correlated with the immunohistochemistry data.

The Perspectives of Iranian Women on Delayed Childbearing: A Qualitative Study.

BACKGROUND: Delayed childbearing is a growing trend in Iran. PURPOSE: This study explores the perspectives of women on delayed childbearing. METHODS: A qualitative study using a content analysis approach was conducted on data acquired using private semistructured interviews with 23 women aged ≥30 years who were childless or pregnant for the first time in an urban area of Iran. RESULTS: Three main themes were developed using conventional content analysis: "personal inclination," "perceived beliefs about delayed childbearing," and "social support." CONCLUSIONS: Although women in Iran hold favorable attitudes toward childbearing, a wide range of sociocultural and economic factors encourage these women to postpone their first pregnancy. The findings of this study are relevant and important for nursing and midwifery policy making in countries with cultural and contextual backgrounds similar to Iran.

Clinical diagnosis of pelvic endometriosis: a scoping review.

BACKGROUND: Accurate and timely diagnosis of endometriosis is associated with confusion. Clinical manifestations, imaging techniques, biomarkers and surgical techniques are used as diagnostic approaches. This paper reviews current evidence on clinical manifestation in order to help practitioners and perhaps improve women's health. METHODS: A review of the literature on clinical diagnosis of pelvic endometriosis that appeared in the English language biomedical journals was performed using PubMed, Science Direct and Google Scholar. The search strategy included the combination of key words 'endometriosis' and 'diagnosis' or 'clinical diagnosis' in the titles or abstracts of articles. The search included all papers published during the year 2000 to 2014. Then, the findings were classified in order to summarize the evidence. RESULTS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, in all 51 papers were found relevant and included in this review. In general we found three categories of diagnostic approaches for clinical manifestation including: i) diagnosis via symptoms obtained from history taking, ii) diagnosis via signs obtained from physical examination and iii) diagnosis via risk factors obtained from history taking. CONCLUSION: Diagnosis of endometriosis is a matter of concern. Since the disease is associated with diverse clinical symptoms and signs, deeper and more comprehensive consideration according to patient's history and clinical findings is recommended for early and more accurate detection in order to prioritize women for further investigation and contribute to its early management.

Use of mobile phone during pregnancy and the risk of spontaneous abortion.

BACKGROUND: Exposure to electromagnetic fields of cell phones increasingly occurs, but the potential influence on spontaneous abortion has not been thoroughly investigated. METHODS: In a case-control study, 292 women who had an unexplained spontaneous abortion at < 14 weeks gestation and 308 pregnant women > 14 weeks gestation were enrolled. Two data collection forms were completed; one was used to collect data about socioeconomic and obstetric characteristics, medical and reproductive history, and lifestyles. Another was used to collect data about the use of cell phones during pregnancy. For the consideration of cell phone effects, we measured the average calling time per day, the location of the cell phones when not in use, use of hands-free equipment, use of phones for other applications, the specific absorption rate (SAR) reported by the manufacturer and the average of the effective SAR (average duration of calling time per day × SAR). Analyses were carried out with statistical package state software(SPSS)v.16. RESULTS: All the data pertaining to mobile phones were different between the two groups except the use of hands free devices (p < 0.001). CONCLUSION: Our result suggests that use of mobile phones can be related to the early spontaneous abortions.