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 An Unusual Presentation of Endometriosis as an Ileocolic Intussusception with Cecal Mass: A Case Report <p>Background: Bowel endometriosis affects about 3.8-37% of women with endometriosis diagnosis. Most of the time endometriosis involves the recto-sigmoid .Right colon involvement is not common in endometriosis and also a few studies have reported obstructive endometriosis of bowel. Here, a case of endometriosis was reported with the ileocolic intussusception and cecal mass.<br /> Case Presentation: A 32y old woman was referred to Yas hospital due to severe low abdominal pain and vomiting. Ultrasonographic examination of her pelvis revealed bilateral ovarian cysts. Abdominal erect X-ray showed dilatation of small bowel segments. Diagnostic colonoscopy showed one small ulcer with the pressure effect of mass like lesion at cecum. The patient was taken to the operating room for excision of the mass; as a result the ileocolic intussusception was seen. After reduction, a firm mass was recognized at cecum so the ileocecal resection was performed. In pathologic examination of mass, endometriosis was reported. The postoperative period was uneventful.<br /> Conclusion: The diagnosis of bowel endometriosis is sometimes difficult. The case of bowel obstructive endometriosis is rare. Surgical excision of bowel endometriosis is necessary for symptomatic patients with bowel obstruction. Bowel endometriotic nodules are excised by nodulectomy or segmental resection.</p> https://www.jri.ir/article/10025 Male Infertility, Precision Medicine and Systems Proteomics <p>Precision medicine (PM) is an approach that has the power to create the best effect and safety of medicine and treatment with the least side effects for each person. PM is very helpful as sometimes due to inaccurate or late diagnosis or toxicities of the drugs irreversible side effect for patient&#39;s health are generated. This seemingly new and emerging science is also effective in preventing disease, due to differences in the genes, environment, and lifestyles of any particular person. PM can be a prominent criterion in infertility research. To achieve this goal, there should be information from a healthy human body, including genetic and molecular information. A PM is an evolution in health care, which is very helpful even economically. The guarantor of the PM success is the examination of the molecular profile of the patient, including genes, proteins, metabolites, <em>etc</em>. Therefore, genomics, proteomics, and metabolomics-based techniques are very important in this regard. Unfortunately, despite extensive studies on PM practice in various fields, male infertility has remained unresponsive. Given that around 20% of couples around the world suffer from infertility, and almost half of them are related to men&#39;s problems, the PM approach has a high potential for male infertility. In this study, with the help of proteomics and metabolomics, PM information on male infertility was explored.</p> https://www.jri.ir/article/30031 Development and Psychometric Properties of Menstrual Health Seeking Behaviors Questionnaire (MHSBQ-42) in Female Adolescents <p>Background: Lack of accurate menstrual knowledge, attitude, and practices leave female adolescents ignorant of the necessary health behaviors during menstruation. This study aimed to develop a menstrual health-seeking behavior questionnaire based on the theory of planned behavior to evaluate its psychometric properties in female adolescents in Tehran.<br /> Methods: This study was conducted on 578 female adolescents aged 12-15 years in Tehran. The first draft of the menstrual health-seeking behavior questionnaire containing 52 items was developed based on the theory of planned behavior (TPB). The content and face validity of the questionnaire was assessed by a panel of experts. Construct validity was also assessed using exploratory factor analysis (KMO=0.73) with varimax rotation. Cranach&#39;s alpha and test-retest were used to examine the reliability of the questionnaire. All statistical analysis was performed using SPSS 23.0 and AMOS 23.0.<br /> Results: The content and face validity of the 42 items were finally confirmed. Content validity index was greater than 0.73 for all six TPB constructs. Explanatory factor analysis yielded an acceptable fit for the six-factor model (RMSE=0.053, 95% CI 0.042-0.064). These factors jointly explained 65% of the variance in the outcome variables. Cranach&#39;s alpha coefficients ranged from 0.79 to 0.91, demonstrating an excellent internal consistency and high reliability of the questionnaire. Test-retest reliability was also satisfactory for all items (ICC=0.86-0.94).&nbsp;<br /> Conclusion: The results illustrate that the menstrual health-seeking behavior questionnaire is psychometrically adequate and highly reliable. This theoretically grounded questionnaire can be well applied in future interventions for female adolescents to assess their menstrual health-related knowledge, attitude, and practices.</p> https://www.jri.ir/article/30032 The Study of Association Between Polymorphism of TNF-α Gene’s Promoter Region and Recurrent Pregnancy Loss <p>Background: According to the literature review, polymorphisms of tumor necrosis factor alpha&rsquo;s (TNF-&alpha;) promoter region are probably the genetic risk factors of recurrent pregnancy loss. This study has investigated five single nucleotide polymorphisms in the TNF-&alpha; gene&rsquo;s promoter region to evaluate their relationship with recurrent pregnancy loss disorder.<br /> Methods: Blood samples were taken from 65 women with recurrent pregnancy loss (Case group) and 65 healthy women with a history of successful pregnancy (Control group). Polymerase chain reaction with high resolution melting (PCR-HRM) analysis was done to determine the promoter region of -308G/A, -850T/C, -238G/A, -1031T/C and -863A/C TNF-&alpha; polymorphisms. The data were assessed using logistic regression models. P values less than 0.05 were considered statistically significant.<br /> Results: Significant associations were found between recurrent pregnancy loss and -863C/A (p=0.000), -308G/A (p=0.045), and -238G/A (p=0.034) polymorphisms. TNF-&alpha; polymorphisms of -863C and -238G may be susceptible factors of recurrent pregnancy loss cases. The -308G polymorphism has an important role in maintaining pregnancy.<br /> Conclusion: The -863C/A and -238G/A TNF-&alpha; polymorphisms are possible genetic risk factors of recurrent pregnancy loss and might be its predictive markers.</p> https://www.jri.ir/article/30033 Veiled Truths: Iranian Women and Risky Sexual Behavior in the Context of Substance Use <p>Background: Substance use disorders and risky sexual behavior coexist for some women. Explanatory models of women&#39;s sexuality in the context of substance use are under study. This study aimed to explore how women&rsquo;s sexual behavior can become risky in the context of substance use.<br /> Methods: In this ethnographic inquiry, 25 women with substance use disorders (SUDs) were included at two Drop-In-Centers (DICs) in South Tehran. Observation, semi-structured interviews and field notes were used to collect data. Qualitative content analysis was used to attain the explanatory model of women&rsquo;s sexual behaviors in the context of substance use.<br /> Results: Three major themes emerged from the data analysis regarding their lives in the context of substance use; 1) life in the context of drug abuse, 2) negative self-perception, and 3) strive to survive. Subthemes were identified as loss of contact with family, social stigma, self-forgetfulness, worthlessness, low self-efficacy, and unsafe sexual context.<br /> Conclusion: Findings suggest that women with SUDs are highly interwoven with women&rsquo;s sexual health, facilitating a shift towards risky behaviors. Integration of safe sexual skills building programs with substance use treatment is needed.</p> https://www.jri.ir/article/30034 Association of Growth Factors Genes with Miscarriage <p>Background: The study was aimed to investigate the association of VEGFA gene polymorphic variants<em> -2578C&gt;A</em> (rs699947) and <em>-634G&gt;C</em> (rs2010963) and <em>TGFB1 </em>gene <em>915G&gt;C</em> (rs1800471) and gene expression level with miscarriage in the first trimester.<br /> Methods: 288 women with different courses of pregnancy and 61 chorionic tissue samples were involved in case-control study. Allele-specific polymerase chain reaction in real time was used for genotyping. Next, gene-gene interactions were analyzed using the multifactor dimensionality reduction method. <em>VEGFA</em> and <em>TGFВ1</em> genes expression levels were determined by RT-PCR.<br /> Results: It was found that SNP rs699947 was associated with the miscarriage risk change (p=0.05). The<em> CC</em> genotype was associated with reduced risk of abortion in the first trimester, and the <em>CA</em> genotype&nbsp; with increased risk. Genotypes <em>VEGFA -2578CС/VEGFА -634CG, VEGFA -2578AА/VEGFА -634CG</em>, and <em>VEGFA -2578CС/VEGFА -634CG/TGFВ1 936CC</em> were associated with lowered risk of miscarriage in the first trimester. mRNA level of <em>TGFВ1</em> was significantly higher in decidual tissue compared to chorionic tissue in normally progressing pregnancy (p=0.003). <em>VEGFA</em> gene expression level was directly correlated with the TGFВ1 mRNA level (R=0.60; р=0.038). In pregnancy loss, an inverse relationship was observed (R=-0.76; р=0.028).<br /> Conclusion: The SNP rs699947 is associated with pregnancy loss in the first trimester. The MDR analysis data showed the significant relationship between <em>VEGFA </em>and <em>TGFB1</em> genes in two-locus and three-locus models. A change in the ratio of the concentrations of growth factors can disrupt the processes of cell division, apoptosis and angiogenesis processes.</p> https://www.jri.ir/article/30035 Analysis of Apoptosis in Cultured Human Vitrified Ovarian Tissue in the Presence of Leukemia Inhibitory Factor <p>Background: For improving the human ovarian tissue culture, this study was designed to assess the incidence of apoptosis in this tissue following vitrification and in vitro culture in the presence of leukemia inhibitory factor (LIF) as an anti-apoptotic factor.<br /> Methods: After collecting the ovarian tissue samples they were divided into non-vitrified and vitrified groups and cultured for 14 days in the presence and absence of LIF then morphological, ultrastructural and steroidogenesis studies, TUNEL and caspase-3/7 assays, and apoptosis analysis by real time RT-PCR were done in all groups. The data were analyzed by independent t-tests and the real time RT-PCR results were compared by one-way ANOVA (p-values of &lt;0.05 were considered significant).<br /> Results: No significant difference was observed between non-vitrified and vitrified groups in normality rate of follicles, the levels of hormones, TUNEL positive cells and caspase-3/7 activity. But in all LIF-treated groups, the levels of 17-&beta; estradiol and progesterone were higher and TUNEL signals and caspase-3/7 activity were lower than non-LIF treated groups. The expression of Fas and FasL genes was higher in vitrified group in comparison with non-vitrified group but the expression of other genes was not significantly different. In LIF- treated groups, the expression of pro-apoptotic genes was significantly lower and the expression of anti-apoptotic genes was higher than non-LIF treated group.<br /> Conclusion: The vitrification of human ovarian tissue did not increase the incidence of apoptosis at the morphological and molecular levels during long term culture and LIF improves the survival and development of cultured follicles.</p> https://www.jri.ir/article/30036 Evaluating the Potential of Three Sperm Surface Antigens as Egg-adhesion Biomarkers for Human Sperm Selection <p>Background: The selection of sperm with good genomic integrity and surface antigens is suggested for improving assisted reproductive technology (ART) outcome. The aim of this study was evaluating the heat shock protein (HSPA2), Dj-1 and serum amyloid P compound (SAP) three sperm surface proteomes as biomarkers for this purpose.&nbsp;<br /> Methods: In this study, semen samples were obtained from 114 men who presented at Avicenna Fertility Clinic for their treatment. The semen characteristics, DNA fragmentation Index (DFI), chromatin maturation index (CMI), biomarker levels, and their embryo quality were considered. The paired-samples t-test and independent-samples t-test were used for analyzing the data and p-values&lt;0.05 were considered significant.&nbsp;<br /> Results: Outcomes exhibited the major reduction in HSPA2, DJ-1 and SAP following reduction in sperm quality and DNA integrity (p&lt;0.001) with cut-off value of 14% (HSPA2), 12% (DJ-1) and 10% (SAP). The specificity of these three biomarkers was 95.2, 73.8 and 88.1%, respectively. Also, DFI (p&lt;0.001), CMI (p&lt;0.05), cleavage (p&lt;0.05), and embryos quality (p&lt;0.001) decreased significantly in abnormal spermiogram (ANS) group in compared with normal spermiogram (&not;NS) group. It was shown that DFI was 97.1% in HSPA2, 76.5% in DJ-1 and 94.1% in SAP, and CMI was 95.0%, 75.50% and 87.5%, respectively. The significant correlation was found between of the three biomarkers and CMI (p&lt;0.001), DFI (p&lt;0.001) and embryos quality (p&lt;0.001).<br /> Conclusion: By comparing the efficiency of these three biomarkers for selecting sperm with the lowest level of chromatin damages, it seems that selection based on HSPA2 has significance over others.</p> https://www.jri.ir/article/30037 PGS and the Critical Decision on Transfer of Defective Embryos https://www.jri.ir/article/30038