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 Ebstein Anomaly with Pregnancy: A Rare Case <p>Background: Ebstein anomaly is an uncommon, complex congenital malformation of the heart with prevalence of 0.3-0.5%. It occurs in 1% of congenital heart disease cases. It is characterized by dysplastic abnormalities of tricuspid valve which involves both basal and free attachments of the tricuspid valve leaflets, with downward displacement and elongation of the septal and anterior cusp which resulting in tricuspid regurgitation, the proximal part of the right ventricle is &quot;atrialised&quot;, becoming thin walled and poorly contractile, along with an enlarged right atrium. With this anomaly, fertility is usually unaffected, even in women with cyanosis. The average life expectancy at birth of patients with Ebstein anomaly is 25-30 years. Due to its rarity and varied clinical presentations associated with Ebstein anomaly during pregnancy, this case was presented in this paper.<br /> Case Presentation: A 24 year old G2A1 at 39 weeks 6 days gestation with a known case of Ebstein anomaly was referred to NEIGRIHMS in April 2017 for further management as our institute is having well equipped cardiac facilities. Her antepartum period was uneventful. Elective LSCS was done at 40 weeks 3 days and a healthy baby weighing 2.5 kg was delivered. Intra and postpartum period was uneventful.<br /> Conclusion: Due to varied clinical presentations associated with Ebstein anomaly during pregnancy, such women should undergo close surveillance with multidisciplinary approach during the antenatal period to be diagnosed in terms of complications and hence be treated accordingly.</p> https://www.jri.ir/article/10 To What Extent Are Cryopreserved Sperm and Testicular Biopsy Samples Used in Assisted Reproduction? <p>Background: Testicular biopsies and ejaculated spermatozoa are routinely cryo-preserved in many units but the fate of these samples has not provoked large interest. This prompted us to review our data accumulated during a period of 20 years (1997 to 2016).<br /> Methods: For patients with biopsies (group 1) or ejaculated spermatozoa (group 2), an attempt was made to evaluate whether the samples&nbsp; stored, had been discarded with the patient&rsquo;s consent or because the patient had died, or whether they had been transported to another laboratory. In each of these categories, a previous use in our program of assisted reproduction was assessed.<br /> Results: The total utilization rate in group 1 (n=95) was 53.7% and only 5.48% in group 2 (n=365). In both groups, deceased patients had not previously used their cryopreserved samples. In detail, the utilization rates for still banked, discarded and transferred samples were 84.2%, 50% and 27.3%, respectively in group 1 and 2.88%, 10.4% and 10%, respectively in group 2.<br /> Conclusion: The exact reasons for the low utilization rates of cryopreserved male gametes remain to be explored. A closer contact between sperm banking units and patients might be useful to discuss the need for further storage of the probes, their possible disposal or the prospects when a specific use for assisted reproduction is intended.</p> https://www.jri.ir/article/10013 Assessment of PGC1α-FNDC5 Axis in Granulosa Cells of PCOS Mouse Model <p>Background: Polycystic ovarian syndrome (PCOS) is a metabolic and endocrine disorder which is characterized by hyperandrogenism, anovulation or oligomenor-rhea and polycystic ovarian morphology. It is believed that modulation in metabolism of granulosa cells of PCOS patients may lead to infertility. One of the metabolic modulators is FNDC5 and its cleaved form, irisin. The axis of PGC1&alpha;- FNDC5 pathway is one of the main factors affecting cellular energy balance the purpose of this study was to evaluate this pathway in granulosa cells derived from PCOS mice model in comparison with control group.<br /> Methods: In the present study, PCOS mouse model was developed by injection of dehydroepiandrosterone (DHEA) hormone in 20 mice for a period of 20 days. Also, 20 uninjected mice were used as the control. Meanwhile, a vehicle group consisted of mice which received daily subcutaneous sesame oil injection (n=20). Relative expressions of PGC1&alpha; and FNDC5 in granulosa cells were evaluated by RT-qPCR. Analysis of gene expressions was calculated by the &Delta;&Delta;CT method and the relative levels of mRNA were normalized to GAPDH transcript levels. Differences in genes expression among three groups were assessed using one-way ANOVA, Tukey&#39;s Post Hoc test.<br /> Results: Our results showed that expression of FNDC5 was significantly reduced in granulosa cells of DHEA-induced PCOS mice compared with control and vehicle groups (p&lt;0.05), while there was no significant differences in PGC1&alpha; expression among different groups.<br /> Conclusion: Down regulation of FNDC5 transcript level may contribute in metabolic disturbance of granulosa cells derived from PCOS ovary apart from PGC1&alpha; levels which remained unchanged.</p> https://www.jri.ir/article/10015 Angiotensin Type 2 Receptor Gene Polymorphisms and Susceptibility to Preeclampsia <p>Background: The purpose of the study was to determine the relationship between angiotensin II type 1 receptor at position+1166 (AT1R+1166A/C; rs5186) and angiotensin II type 2 receptor at position+1675 (AT2R+1675A/G; rs5194) gene polymorphisms with preeclampsia in an Iranian women population.<br /> Methods: 430 women were recruited in this study including 212 preeclamptics and 218 healthy women. PCR-RFLP method was used for genotyping the polymorphisms. Chi square and Fisher exact test were used for comparing case and control groups. The p&lt;0.05 was considered statistically significant.<br /> Results: The frequency of genotypes of the AT1R gene and AT2R gene was similar in preeclampsia and normal pregnancy. There were no significant differences in genotype and also allele frequencies between preeclamptics and healthy women regarding the two studied polymorphisms. AT1R/AT2R genotypes combination study indicated that there was a statistically significant difference between preeclamptics and healthy women. AC/AG combination was significantly decreased, while CC/AA combination showed significant increase in patients compared with the healthy women (p&lt;0.01).<br /> Conclusion: The present study showed that the genetic polymorphisms within AT1R and AT2R genes may be associated with susceptibility to preeclampsia in Iranian women.</p> https://www.jri.ir/article/10016 Zinc is an Essential Element for Male Fertility: A Review of Zn Roles in Men’s Health, Germination, Sperm Quality, and Fertilization <p>Zinc (Zn) is the second most abundant trace element in human, which can&#39;t be stored in the body, thus regular dietary intake is required. This review explained the physiological and pathogenesis roles of zinc in men&#39;s health and its potentials in germination, quality of sperm, and fertilization. Our investigation showed that Zn contained many unique properties in human, especially males. The antioxidant quality is one of them. Also, the increased reactive oxygen species levels in the seminal plasma of men who are both infertile and smokers influence the Zn content of seminal plasma in a way that physiology of spermatozoa can be affected as well. Moreover, Zn acts as a toxic repercussionagainst heavy metals and cigarette inflammatory agents. Zinc as a hormone balancer helps hormones such as testosterone, prostate and sexual healthand functions as an antibacterial agent in men&rsquo;s urea system. It plays a role in epithelial integrity, showing that&nbsp;Zn is essential for maintaining the lining of the reproductive organs and may have a regulative role in the progress of capacitation and acrosome reaction. In contrast, Zn deficiency impedes spermatogenesis and is a reason for sperm abnormalities and has a negative effect on serum testosterone concentration. Based on these findings, Zn microelement is very essential for male fertility. It could be considered as a nutrient marker with many potentials in prevention, diagnosis, and treatment of male infertility.</p> https://www.jri.ir/article/10019 Metabolic Fingerprinting of Seminal Plasma from Non-obstructive Azoospermia Patients: Positive Versus Negative Sperm Retrieval <p>Background: Non-obstructive azoospermia (NOA) occurs in approximately 10% of infertile men. Retrieval of the spermatozoa from the testicle of NOA patients is an invasive approach. Seminal plasma is an excellent source for exploring to find the biomarkers for presence of spermatozoa in testicular tissue. The present discovery phase study aimed to use metabolic fingerprinting to detect spermatogenesis from seminal plasma in NOA patients as a non-invasive method.<br /> Methods: In this study, 20 men with NOA were identified based on histological analysis who had their first testicular biopsy in 2015 at Avicenna Fertility Center, Tehran, Iran. They were divided into two groups, a positive testicular sperm extraction (TESE(+)) and a negative testicular sperm extraction (TESE(-)). Seminal plasma of NOA patients was collected before they underwent testicular sperm extraction (TESE) operation. The metabolomic fingerprinting was evaluated by Raman spectrometer. Principal component analysis (PCA) and an unsupervised statistical method, was used to detect outliers and find the structure of the data. The PCA was analyzed by MATLAB software.<br /> Results: Metabolic fingerprinting of seminal plasma from NOA showed that TESE(+) versus TESE(-) patients were classified by PCA. Furthermore, a possible subdivision of TESE(-) group was observed. Additionally, TESE(-) patients were in extreme oxidative imbalance compared to TESE(+) patients.<br /> Conclusion: Metabolic fingerprinting of seminal plasma can be considered as a breakthrough, an easy and cheap method for prediction presence of spermatogenesis in NOA.</p> https://www.jri.ir/article/10020 Review of Trichomonas vaginalis in Iran, Based on Epidemiological Situation <p>Trichomoniasis, which is caused by <em>Trichomonas vaginalis</em>, is the most common non-viral sexually transmitted infection (STI) in the world including Iran. There were roughly 250 million new cases all over the world in a year. <em>T. vaginalis</em> as an important disease has been associated with HIV (in terms of exposure to sexually transmitted infection, STI) which increases the number of high-risk members, and thus it is an important public health problem. Additionally, this pathogen has been associated with serious health consequences. For instance, it may cause a woman to deliver a low-birth-weight or premature infant, and increase chances of cervical cancer. Because little information is available about the prevalence of <em>T. vaginalis</em> infection in Iranian population, this review was carried out to determine the prevalence of <em>T. vaginalis</em> among Iranian population. For this systematic review, data about epidemiology of <em>T. vaginalis</em> in different parts of Iran with different populations were systematically collected from 1992 to 2017 through the international databases such as PubMed, Scirus, ISI Web of Science, Scopus, EMBASE, Science Direct and Google Scholar and Islamic World Science Citation Center (ISC). National database searching included Iran Medex, Iran Doc, Magiran and Scientific Information Database (SID). A total of 39 clinical and laboratory investigations about the prevalence of Trichomoniasis from different regions of Iran were analyzed. The overall prevalence rate of <em>T. vaginalis </em>infection in Iranian population was estimated to be minimally 0.4% and maximally 42%. The present review showed that <em>T. vaginalis</em> infection rate is relatively high among the Iranian population. The control strategies, including personal hygienic education, simultaneous couple treatment, the sensitivity of diagnostic methods, appropriate preventive tool (condom) in sexual contacts could lead to the disruption of transmission.</p> https://www.jri.ir/article/10021 Decreased Expression of CDC25A in Azoospermia as the Etiology of Spermatogenesis Failure <p>Background: Spermatogenesis is a tightly regulated developmental process of male germ cells. The stages in spermatogenesis are mitosis, meiosis and spermiogenesis. One of the genes playing a role in meiosis is Cell Division Cycle 25A (CDC25A). Decreased expression of CDC25A is associated with failure of spermatogenesis and sperm retrieval. Infertility examination for azoospermia has been limited on histological examination. Hence, molecular research to find marker genes for infertility will improve the examination of testis biopsies.<br /> Methods: This research is a cross sectional study of 50 testicular biopsies with Johnsen scoring categories from scoring 2 to 8. Analysis of mRNA expression used qPCR and protein expression using immunohistochemistry. Statistical analysis with Spearman correlation was considered significant at p&lt;0.05.<br /> Results: The result showed that transcript level and protein expression of CDC25A decreased in score 5 of Johnsen scoring categories. Moderate Spearman rho correlation (r=0.546) between mRNA relative expression and protein expression of CDC25A was significant at p&lt;0.01.<br /> Conclusion: Decreased expression of CDC25A is associated with meiotic arrest as the etiology of spermatogenic failure in many azoospermic men.</p> https://www.jri.ir/article/10022 The 40th Anniversary of IVF: Has ART's Success Reached Its Peak? https://www.jri.ir/article/10023