https://www.jri.ir/ "Journal of Reproduction & Infertility" is owned, published, and copyrighted by ©2009 Avicenna Research Institute. No parts of this journal may be reproduced in any form or by any means unless properly referenced or sent a notification letter through www.jri.ir en Sterility effects of Neem (Azadirachta indica) extract on male rat Nowadays uses of synthetic pesticides has caused a lot of environmental problems. For this reason there is an effort to replace them with biopesticides. One of these ways is the use of plant bioproducts. Various studies on Azadirachta indica (Neem) have proven that the seed extract of this plant has reversible infertility and spontaneous abortion properties. In this study we are trying to determine the effective dose of its seed extract for sterility of rodent pests. In this survey, 24 male wistar rats with 4-5 months old (weighing about 150-200 grams) were selected randomly. They were divided into 4 subgroups each containing 6 rats. The Neem extract (Neem Azal 1%) was fed to 3 groups by gavage for six days. The first group was fed with water and others were fed with Neem extract (5mg/kg, 15mg/kg and 25mg/kg respectively). Hematological parameters were determined on 4th and 9th day of the experiment. On the 10th day two animals from each group were dissected for histological study of testes. Remaining animals were tested for fertility with fertile female rats. There were no significant differences between control and treated groups. After observing reproduction in female rats, these groups were excluded from study. There were no significant differences between control and treated groups in their hematological parameters except for MCH and hemoglobin on 4th (P<0.001, P<0.01 respectively) and 9th day (p<0.05) and WBC on 9th day (p<0.05) in third group, which showed an increase. There were no significant differences between serum testosterone levels. In group which received 15 mg/kg extract, reproduction occurred after 60 days (reproduction cycle in rats is 20-23 days). In group which received 25mg/kg extract, half of the animals died due to high doses of Neem extract and in the remaining half, reproduction occurred after 3 months. Histological results of testes indicated abnormality in spermatogenesis and sperms production in some of the semniferous tubules. Therefore after 60-90 days and repair of injured cells, reproduction is observed again. Base on the results of this study it seems that we can use Neem seed extract as an anti-fertility agent, considering its cost benefit ratio and suitable formulation, we can use it as rodent baits to control harmful agricultural rodents. In this way we have a new method of controlling deleterious rodents. https://www.jri.ir/article/79 Relation between third day LH level and ovarian response in IVF cycles Infertility treatment has reached to prominent improvements in recent years and new methods of ART have important role in these improvements. Several factors are considered for patient’s evaluation in these methods. For this purpose, we decided to evaluate the relation between third day LH with ovarian response in IVF cycles. This is a prospective study and 78 IVF candidates were chosen base on study requirements and were divided into two groups according to third day LH level. First group was consisted of 14 women with LH<3 mIU/ml, and second group was consisted of 64 women with LH>3. Patients had gone under treatment cycle base on long treatment plan with agonist gonadotropins and human gonadotropins. Then two groups were compared for number of follicle, number of retrieved oocyte, duration of ovarian stimulation, number of used gonadotropin ampules, number of resulted embryos, cancellation rate of cycles and finally pregnancy rate. Base on results and considering P value<0.05, significant differences were not observed between the two groups in third day LH, patient age, kind of infertility, cause of infertility and duration of infertility. In other hand, two groups did not show any significance difference in ovarian response, number of follicle and retrieved oocyte, stimulation duration, number of used ampules, cancellation rate of cycles and pregnancy rate. This reveals third day LH level is not associated with success rate in IVF cycles. https://www.jri.ir/article/80 Pregnancy rate following Metformin consumption in patients with PCOS under ART treatment Infertility with an incidence of about 15% has mainly been one of the community burdens that have even been threatening to the continuity of the family life. One of the most prevalent causes of women infertility is ovarian causes particularly PCOS. Since Metformin may improve quality and increase the number of ova, and likewise increase fertilization rate via reducing the level of insulin, this study was conducted with aim of investigating responses of patients with PCOS in the cycle of ART. This was a randomized clinical trial on 100 infertile patients with PCOS who referred to Shariati Hospital in Tehran during 1999-2000. The subjects were randomly categorized in to 2 groups (A=44 and B=46 women). Ten patients were eliminated from study due to ignoring the treatment plan. Group A received Metformin at a dose of 500 mg t.i.d in addition to induction of ovulation with long protocol. The results were analyzed using t-test and X2 and P<0.05 was considered as significant. Results showed that average level of estradiol in group A was 2159±1056pg/ml and 2842±1050pg/ml in group B, with a significant difference (P=0.002). We administered 23±7.6 ampules of HMG for the subject’s in group A and 31.34±8.12 ampules for those in group B (P=0.001). The difference in number of oocytes was not significant, where as we found a significant difference in the number of germinal vesicle (P=0.047). There were no significant differences in course of treatment, numbers of oocytes and the number of pregnancy between 2 groups. Considering the findings of this study by using Metformin, we improve the quality of ova in patients with PCOS. This happens due to the effect of Metformin through reducing insulin resistance and hyperandrogenism in patients with PCOS leading to a prominent drop in estradiol levels in serum that in turn lowers the need for administration of HMG and result in improving oocyte quality https://www.jri.ir/article/81 Role of serum ßHCG measurement in prediction of Empty Follicle Syndrome One of important matter in treatment of patients who need in vitro fertilization and embryo transfer to uterus is retrieval of good quality and enough number of oocytes. Unfortunately, in some cases though ovary had good appearance in ultrasound and hormonal aspect, no oocyte was retrieved after HCG injection, which this condition is known as empty follicle syndrome. The aim of this study is to determine the relationship between serum ßHCG and empty follicle syndrome (EFS) in infertile women undergoing ovulation induction. This research was a prospective and case control study over 1009 patients, which 135 patients were omitted due to different reasons and amongst 874 remaining patients, 23.3% had undergone IVF and 76.7% of them had undergone intracytoplasmic sperm injection. All patients with HMG and GnRHa treatment had undergone long protocol. Then the numbers of mature oocytes were assessed during treatment and level of serum ßHCG was measured on time of HCG injection and oocytes retrieval and it was compared with retrieved oocytes. In evaluation of results of this study, no oocytes were found in 34 (3.9%) patients (group I) and less than 50% matured follicles were found in 92 (10.5%) patients (group II) and finally more than 50% matured follicles were found in 748 (85.5%) patient (group III). Mean level of serum ßHCG was (154.6±107) in group I, (141.7±90.4) in group II and (156±56.6) in group III, 36 hours after HCG injection. The results showed no significant difference between βHCG and EFS (P=0.194). https://www.jri.ir/article/82 Early complications of menopause among women in Tehran Life expectancy has increased dramatically in developing countries such as Iran. Menopause as a relatively recent phenomenon brought about new challenges. Early complications of menopause can greatly influence the quality of life. Current study aimed at investigating early complications of 441 menopausal women who lived in Tehran using cluster sampling method. The mean age of menopause was 48.51±4.45. Following variable were included in the study: age, age of menorah, education status, marital status, breast feeding, history of oral contraceptive usage and hormone replacement therapy, exercise, calcium intake (diet/drug) and smoking. Using Jones standard questionnaire, the early complication of menopause were asked by interview. The mean value for total score of these complications were 12.1±6.8, 60.3% of which had severe complication. Exercise was found to reduce the rate of complications significantly (P=0.001). To reduce the early complication of menopause, a fundamental change in menopausal women’s life-style is suggested among which exercise is a must. https://www.jri.ir/article/83 Continuation rate of contraceptive methods and causes of their discontinuation in Zahedan Although significant success is obtained on birth control in recent decades, but considering limitation of financial sources to control population growth, it seems necessary to conduct more studies on quality usage of contraceptives. Aim of this study is to evaluate contraceptive continuation rate and main factors for their discontinuation in Zahedan in year of 2000. 1743 women were chosen who were using one of birth control methods: OCP, IUD, injections and Norplant from beginning of 1998. The mean age of the women was 27±6 years and mean age of their husband was 33±8 years. Average number of their children were 2.8±2, 89.6% of them were housewife and 28.7% were illiterate. Oral contraceptive was the most popular method of contraception with frequency of 71.2%, and other methods included injection 12.9% , IUD 12.7% and Norplant 3.1% respectively. Kaplan Mayer technique showed that the highest continuation rates for LD (92%), Norplant (86%), IUD (82%), injection (53%) respectively at first year. At the end of three years continuation rate was Norplant users (78%), LD users (70%), IUD (60%) and injection (44%) respectively. Common reason for discontinuation of OCP and injection was change of method and common cause of discontinuation for IUD and Norplant was side effects. Contraceptive continuation was not significantly the level of women’s education and their husband’s, women’s job and their husband’s, number of children and age of last child. Contraceptive continuation in Cox model showed a significant relation with type of contraceptives and health centers. Therefore more studies are proposed for the reasons and proper consultation with women on time of contraceptive methods and up to first six months. https://www.jri.ir/article/84 Comparison of frequency of vaginal delivery with cesarean section and its causes in Shahroud (2000) Cesarean is performed as a routine surgery nowadays and not only many facilities, hospital beds and equipments and professional personnel are involved but also mortality rate and pregnancy complications are more common in women who have undergone cesarean than those who have vaginal deliveries. The aim of this study was to evaluate and compare the frequency of vaginal delivery, cesarean and its causes in Shahroud, so that finding would be used for proper planning to promote vaginal delivery. This is a cross-sectional study. Data gathering instruments are two questionnaires, which were prepared base on objectives of research. When their validity was determined, necessary information was gathered in 5 months. Results showed that total number of delivery in Shahroud were 1221 cases which 1.3% of deliveries were with vaccum 42.1% cesarean and 56.6% vaginal deliveries at this period. The most common causes of cesarean were previous history of cesarean (26.1%) willing to perform tubectomy (9.5%) and cephalopelvic disproportion (8.4%). Cesarean frequency in Shahroud is higher than accepted international statistics (20-22%). Considering that the most common cause of cesarean is history of previous cesarean and since many researches believe that vaginal delivery is safe after cesarean, we hope this outbreak of cesarean rate decreases in this town and consequently all over the country by public training to promote vaginal delivery. https://www.jri.ir/article/85 A fourteen year unconsummated marriage and its successful treatment (a case report) Unconsummated marriage (UCM) is defined as a marriage with no intercourse action. Different etiologies have been introduced as the causative agents including psychiatric, social and physical factors. The reported couple had under gone treatment due to 14 years history of UCM and wanting a child. During marriage and UCM follow up the wife had undertaken multiple surgeries for cervical dilatation, myomectomy, electrocautery and a course of psychotherapy. According to their please to have a child, 10 times IUI had been performed which were unsuccessful. Approximately after psychiatric assessment, couples were treated by sex therapy methods and then individual psychotherapy was performed for wife to reduce anxiety. After 5 months, pregnancy occurred via normal intercourse, which resulted in a term delivery. Combination of couple sex therapy and individual psychotherapy haven’t been used before to treat UCM. Other methods such as dual sex therapy, hypno-behavioral therapy and psychosomatic therapy have been used separately or in combination with urology and gynecologic treatments. Since inadequate knowledge about sexual relationship and dependency to paternal family are of the most important and frequent reasons of this disorder, it seems sexual relation education in educational and health centers in our country is necessary. https://www.jri.ir/article/86 Tuberculosis of breast in a woman with history of prolactinoma (a case report) Tuberculosis (TB) contains a broad range of clinical illnesses. It is the most frequent cause of death worldwide. TB was a global public health emergency from 1993 for world health organization. The world health organization estimated the eradication of tuberculosis until year of 2000, when detected the drug’s for tuberculosis treatment. But in later years AIDS pandemic increased the tuberculosis. Tuberculosis causes most of the time lung complication but also can infect other organs as well. Breast tuberculosis is a very rare infection that can be mistaken with breast cancer.This is a case report of female patient with 25 years age who has prolactinoma from three years ago and has milky and epudative discharge since one year ago. She had medical and surgical drainage. Since there was no response to treatment, biopsy was taken and pathologic evaluation demonstrated the granuloma with caseosis. Patient was treated with antituberculosis drug and there was no recurrent for one year follow up. https://www.jri.ir/article/87