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 Biological and Biochemical Characteristics of Human Umbilical Cord Mesenchymal Cells Introduction: Stem-cell therapy has recently been proposed as a useful technique in the treatment of various illnesses, particularly degenerative diseases.Human Umbilical Cord Mesenchymal cells (hUCM) are among the stem cells which have received more attention in recent years.The current study was designed to investigate the culture conditions of these cells and to study some biological and biochemical properties of these cells, such as alkaline phosphatase activity, colony formation properties in hanging drops culture and the growth rate in various cell concentrations.Materials and Methods: Human umbilical cord was collected following a healthy cesarean section at the operation room of Afzalipour Educational Hospital. Matrix fragments were cultured by organ explant method. The attached cells at confluence of >80% were sub-cultured in new culture dishes and were seeded at a 1×106 density for morphologic evaluations. Upon colony formation of the cells, they were further stained to detect alkaline phosphatase enzyme activity. Furthermore, cells at a 1×105 density were cultured in hanging drops for 48 hours and subsequently alkaline phosphatase activity was evaluated in the resultant colonies. In addition, cells were seeded at various densities in 96-well culture plates and cell activity was measured by Wst-1 cell proliferation assay kit following 48 hours of culture incubation.Results: HUCM cells formed alkaline phosphatase positive colonies in culture, as well as in hanging drops. Cell activity was correlated with cell population at the start of cell cultivation. Increased concentration of cells at the beginning of culture led to increased cell activity upon 48 hours of incubation.Conclusion: HUCM cells expressed alkaline phosphatase enzyme in vitro and constituted colonies in hanging drops. In addition, hUCM cells showed higher activity when cultured in larger populations. It seems that hUCM cells resemble both embryonic and some adult stem cells. Therefore, further study on the characteristics of these cells could provide a basis for their application in regenerative medicine. https://www.jri.ir/article/353 Effects of Spironolactone on Pituitary-Gonadal Axis Hormones in Adult Female Rats Introduction: Spironolactone is a diuretic drug with aldosterone-antagonistic properties, used in the treatment of hypertension, congestive heart failure, cirrhosis, kidney disorders, and hirsutism. Some studies have reported decreased libido and menstrual disorders as the side-effects of this medication. The present study was done to investigate the effects of spironolactone on pituitary-gonadal axis hormones.Materials and Methods: Five groups of rats, each including nine adult females and with an average weight of 180 – 200gr, were selected. The control group received no drugs, while the sham group received spironolactone solvent (Normal saline), and the three experimental groups were put on oral spironolactone 25, 50 and 100mg/kg of the total body weight for 14 days. Hormonal measurements, including luteinizing hormone (LH), follicle stimulating hormone (FSH) and progesterone were performed by radioimmunoassay (RIA) after the test interval.Results: The mean values for FSH (mIU/ml) were 0.11±0.01, 0.14±0.02, 0.38±0.06, 0.16±0.02 and 0.18±0.03 for the three experimental (at 25, 50 and 100mg/kg doses of spironolactone), sham and the control groups, respectively with significant increase in the third experimental group in comparison to the controls. LH concentrations (mIU/ml) were 0.130.01, 0.190.02, 0.140.02, 0.130.02 and 0.120.02 respectively with significant increases at 50mg/kg spironolactone intake. Estrogen concentrations (pg/ml) were 99.921.03, 143.722.5, 139.132.01, 131.932.04 and 125.246.37, whilst progesterone concentrations (pMol/ml) were 100.224.9, 72.615.09, 79.419.7, 62.126.02 and 66.527.6 respectively with no significant changes in the experimental, sham or the control groups. Conclusion: Spironolactone had significant and dose-dependent effects on LH and FSH hormones. However, the medication neither had any negative effects on the concentration or production of sex steroids nor on the function of the gonads. Therefore, its intake does not interfere with hormonal and subsequently gonadal functions. https://www.jri.ir/article/354 Effects of Ovulation Induction and Ovarian Puncture on CRP Levels in Subjects Undergoing IVF/ICSI Introduction: Controlled ovarian hyperstimulation (COH) is an important factor in IVF/ICSI success rates. CRP is a serological marker for systemic inflammation and it increases following hormonal stimulation. Probable inflammation following ovulation induction and ovarian puncture, in regards to CRP changes, might affect the outcomes of IVF programs. The present study was conducted to determine the effects of ovulation induction and puncture of ovaries on serum CRP levels in IVF/ICSI candidates. Materials and Methods: This observational, descriptive-analytical study was performed at Avicenna Infertility Clinic during 2006 – 2007. COH was performed on 70 infertile patients who were candidates for IVF/ICSI, using standard long GnRH agonist protocol. Peripheral blood was drawn four times during the treatment cycle on the first day of stimulation and the days of HCG injection, ovary puncture, and embryo transfer. Non-serosanguinous follicular fluid samples were taken at the time of ovum pick up from each individual too. CRP levels were measured in follicular fluid and serum using competitive ELISA methods.Results: Serum CRP levels increased along with the stimulation cycle, from the first day of the procedure to the day of HCG injection but significant increases were seen in 82.2% of the cases following ovary puncture (respectively, 3.97±1.00g/ml, 5.54±2.26g/ml and 6.61±4.16g/ml; p<0.001). There were no significant correlations between serum estradiol and CRP levels.Conclusion: Controlled ovarian hyperstimulation and ovarian puncture potentiate systemic inflammation. Serum CRP levels increase during ovulation induction cycle and also after HCG injection, but not in all patients undergoing ovarian puncture. These inflammatory reactions may affect IVF/ICSI outcomes. https://www.jri.ir/article/355 Prevalence of Chlamydia trachomatis Infection in Fertile and Infertile Women; A Molecular and Serological Study Introduction: Chlamydia trachomatis is one of the most common sexually transmitted infections (STIs) in the world. About 80% of the infected women are asymptomatic, while ascending infections such as pelvic inflammatory disease (PID) and the resultant infertility due to fallopian tube occlusion are common manifestations. Due to the higher prevalence of C. trachomatis infection in infertile than fertile women and the importance of screening for this infection in different types of infertility, this study was undertaken to compare two serologic and ELISA methods for the diagnosis of the bacteria in the two groups.Materials and Methods: In this cross-sectional study, the participants included 233 infertile women attending Vali-e-Asr Infertility Clinic and 225 fertile women attending the Prenatal Clinic and Emergency Labor of Imam Khomeini Hospital. Each participant completed a researcher-devised questionnaire and subsequently 2 mls of peripheral blood for serological studies and 15 ml of the first catch urine (FCU) for molecular detection of the germ through Polymerase Chain Reaction (PCR) method were obtained.Results: PCR results showed C. trachomatis infection in 29 (13.8%) infertile and 19 (11.1%) pregnant participants with no significant statistical differences. Serological results showed presence of Chlamydia IgG in 20 (8.6%) infertile and 11 (4.9%) fertile participants and Chlamydia IgM was observed in 2 (0.9%) infertile and 4 (1.8%) fertile participants with no significant differences.Conclusion: The prevalence of C. trachomatis infection among fertile and infertile women by serological and molecular methods was not significantly different. However, considering the high specificity and sensitivity of PCR, it could be used as a noninvasive screening technique for C. trachomatis, compared to the invasive method of blood sampling. https://www.jri.ir/article/356 Sexual and Hormonal Profiles of Infertile Subjects with Non-Obstructive Azoospermia Introduction: Recent advances in the field of male infertility has led to a better understanding about the etiologies and genetic basis of azoospermia, as well as the availability of surgical sperm retrieval methods and intracytoplasmic sperm injection (ICSI) for its treatment. Nevertheless, the quality of life of these patients in general, and sexual function in particular, have not been explored adequately. The aim of this study was to evaluate the sexual function of infertile patients with non-obstructive azoospermia.Materials and Methods: In this descriptive study, as much as 300 infertile men with non-obstructive azoospermia, who referred to Avicenna Infertility Clinic, in Tehran, Iran, were enrolled into the study during October 2004 to November 2006. Afterwards, 21 men were eliminated from the study because they met the exclusion criteria. At first, sexual functions of the patients were evaluated by a questionnaire, including questions on libido, penile erection, seminal ejaculation, inter intromission interval, orgasm and frequency of sexual intercourse. Physical examination was carried out to evaluate signs of androgenic deficiency. Semen samples were analyzed according to the current World Health Organization laboratory manual. Serum luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin (PRL) concentrations were measured by immunoradiometric assays (IRMA) and serum testosterone measurement was done by radioimmunoassay (RIA). Conventional testicular biopsy by standard procedure was performed on both testes under local anesthesia for the candidates.Results: On the whole, 90% of the cases had normal sexual desire. Erectile function with the ability to engage in normal intercourse was normal in 80%. Normal ejaculate volume was seen in 75% of the cases. Inter intromission interval was normal in 42.5%, but it was very premature or very late in 10%. Orgasm was normal in 80% and slightly or significantly decreased in 15% and 5% of the cases, respectively. Patients with small testicles comprised 54.8% of the cases, whilst 125 (44.8%), 139 (49.8%) and 15 (5.3%) of the patients were normogonadotropic, hypergonadotropic and hypogonadotropic, respectively. Mean values for FSH, LH, Testosterone and PRL were 24.5±25.4mIU/ml, 9±7.2mIU/ml, 6.1±4.4ng/ml and 284±224ng/ml, respectively. Hypospermatogenesis with mature sperm was seen in 42 (15%) of the subjects upon testis biopsy. Histological examination showed testicular atrophy in 21.8%, maturation arrest in 22.2%, sertoli cell only syndrome in 40.8% and hyperplasia of Leydig cells in 11.8% of the cases.Conclusion: Sexual dysfunction in infertile patients with non-obstructive azoospermia is as more prevalent as the general population. In azoospermia, sexual dysfunction is not taken into account due to the dominant picture of infertility in these patients. However, special attention to sexual dysfunction will improve quality of life and effectiveness of infertility treatments. https://www.jri.ir/article/357 Attitude of Male and Female Subjects towards Oocyte Donation in Shiraz Introduction: Oocyte donation is an infertility treatment method in women undergoing cancer treatment, in premature ovarian failure, and menopause or in women who are known carriers for a serious autosomal recessive or X-linked disorder. Recipients of donated oocytes should have intact uterus to support embryo implantation and normal ongoing pregnancy. The objectives of this study were to evaluate attitude of male and female subjects towards oocyte donation and factors affecting these variables such as gender and education.Materials and Methods: This descriptive-correlative study was carried out in Shiraz, Iran, during spring 2008. The cases included 206 subjects (102 females and 104 males), single and married, with and without offspring and fertile and infertile subjects who filled a researcher-devised questionnaire, including questions on demography, attitude toward oocyte donation and conditions in which they might consider this kind of assisted treatment.Results: There were no statistically significant relationships between gender and attitude towards infertility treatment by oocyte donation. There was a relationship between attitude regarding oocyte donation and educational levels of the participants. There were significant differences between female and male subjects regarding medical conditions and conditions requiring this kind of assisted treatment (p<0.01); in conditions with female infertility, female subjects were more open to accept the procedure than men and men were reported to be more against any kind of treatment under any circumstances. There were no differences between women and men in cases of infertility due to age, parenting a disabled child or presence of inherited medical conditions in the family.Conclusion: Regarding the need for oocyte donation in some types of infertility, and the need to submit to the method by both couples, health centers should prepare the ground for proper consultations to provide correct information on the procedure and its legal aspects to help them accept or reject the method. https://www.jri.ir/article/358 The Influence of Modified Steps to Behavior Change Model on Oral Contraceptive Use Introduction: Family planning and birth control are the main goals of governments worldwide for population growth control and appropriate contraceptive use is a measure to reach these goals. Investing in health education for better contraceptive use and more reasonable allocation of existing resources are of great help in materializing the goals. Steps to Behavior Change (SBC) can be a good model to develop and evaluate family-planning programs. The aim of this study was to investigate the influence of family-planning education through modified SBC model on the reduction of unwanted pregnancies in oral contraceptive (OC) users. Materials & Methods: This clinical trial study was carried out at Mashad Urban Health Centers. Data gathering was done through interviews and completion of a researcher-devised questionnaire for 290 randomly chosen women from the aforementioned centers. The subjects were randomly divided into two case and control groups. The intervention was done based on modified SBC model and post-tests were given three and six months after the introduction of the model.Results: There were no significant differences between the two groups prior to the intervention, but significant differences in the mean values of knowledge, approval, intention, practice and advocacy were seen in the experimental group compared to the controls (p<0.001). Additionally, significant reduction in oral contraceptive side-effects and unwanted pregnancies were seen in the experimental group following the intervention. Conclusion: Following the success of modified SBC model in this study, it is suggested that attempts be made to improve the individuals’ self-efficacy to more competently use the provided health services. Developing self-efficacy in these subjects for better contraceptive use, can be effective in decreasing the cost related to unwanted pregnancies and misuse of contraceptive methods especially OCPs. https://www.jri.ir/article/359 Attitudes of Donors and Recipients toward Ethical Issues in Oocyte Donation Introduction: Oocyte donation is a routine procedure in the treatment of some types of female infertilities in most infertility clinics worldwide. Donors and recipients awareness about legal and ethical issues governing donation plays a significant role on the future of couples and resultant babies. This study aimed to assess the attitudes of oocyte donors and recipients with attention to their belief and desires on the premises to adopt better policies and make improvements in social and ethical impacts of oocyte donation. Materials and Methods: This descriptive study was conducted on 52 donors and 53 recipients of oocyte in Vali-e-Asr Reproductive Health Research Center. If the subjects were willing to participate in the study, interviews were carried out to collect demographic data and explore the opinion of the participants through oocyte donation questionnaire (ODQ).Results: Totally, 47% of the recipients and 40.4% of the donors requested their identity to be kept confidential and anonymous to the counterparting party. As much as 94.2% of the recipients and 56.9% of the donors were in favor of giving financial rewards to the donors. Sixty-four percent of the recipients and 30% of the donors were against informing the baby about the oocyte donation procedure.Conclusion: The legal, civil and ethical issues of oocyte donation should be clearly anticipated according to the registered guidelines. The precise dimensions of legal, religious and medical side-effects of the procedure should be clearly explained through counseling the donors and recipients before initiating the cycles. More extensive studies on donors and recipients attitudes on legal, religious, and social aspects of oocyte donation are suggested. https://www.jri.ir/article/360