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 Effect of human sperm MTT viability assay on outcome of intraycytoplasmic sperm injection Sperm MTT Viability Assay has been shown to be a suitable test for differentiation of viable from non-viable sperms. In this procedure MTT is converted to observable purple MTT Formazan by mitochondrial dehydrogenase in the midpiece region and therefore viable sperms can be distinguished which makes this test suitable for ICSI. Therefore, in order to study the effect of MTT positive sperms on fertilization, cleavage and blastocyst formation, 109 fresh human oocytes (metaphase II) were divided in to two groups; one group was injected with MTT positive sperms and the other one was taken as control. The results of study showed that there is not significant difference with respect to fertilization, cleavege and blastocyst formation between these two groups. Therefore, if MTT proves to be nether mitogenic nor teratogenic, sperm MTT viability assay might be useful for ICSI in patients with absolute or severe asthenospermia, especially in cases with tail abnormality. https://www.jri.ir/article/97 Central obesity in women and its association with serum level of testosterone and estradiol Central obesity is an important cause of hyperlipidemia, hypertension, diabetes mellitus and coronary heart disease. The relationship between sex hormones, especially androgens, and body fat distribution in women is controversial. This study investigated the relationship between sex hormones, such as total testosterone DHEA-S, LH, FSH, esteradiol and insulin, with Body Mass Index (BMI) and Waist to Hip Ratio (WHR) in 176 women with age: 25.8±6.0 years (18-43) and BMI: 27.3±4.4 (17-51 kg/m2). Serum level of sex hormones including total testosterone, estradiol, FSH, LH, Dehydroepiandrosterone Sulfate (DHEA-S) were measured by radio immuno assay. Our findings showed that WHR was positively correlated with serum level of testosterone (r=0.15, P=0.05) and it was negatively related to serum level of estradiol (r=-0.1, P=0.05). Sex hormone concentrations were not different in obese and normal weight women, but women with central obesity (WHR>0.85) had significantly higher levels of testosterone (2.4±0.7 vs 2.1±0.7 nmol/L, P=0.001) and lower levels of serum estradiol (24.1±8.7 vs 57.6±14.5 pmol/L, P=0.009) than women with low WHR (WHR<0.85). In conclusion, these data showed that high serum testosterone and low serum estradiol levels were associated with upper body fat distribution in women. Serum level of estradiol versus testosterone possibly affects body fat distribution in women. https://www.jri.ir/article/98 Correlation between asymptomatic urethritis with bacteriospermia in seminal plasma of fertile and infertile men Urogenital infection can influence the fertilization potential of the spermatozoa, which may lead to male infertility. The symptomatic urethiritis can change the semen parameters, however the role of asymptomatic urethirtis in fertility is still obscure. In this descriptive investigation, a total of 148 samples from urethra and semen of fertile as well as 146 samples from urethra and semen of infertiles men were examined for the presence of 5 bacterial species including streptococcus group A., Entercoccus, E.coli, coagulase positive and negative Staphylococcus. The rate of infection of urethra and semen of fertile men were 49.22% and 29.05%, respectively. The aforementioned rates were 34.9% and 60.27% for infertile men. The seminal infection was significantly different between two groups of fertile and infertile (p<0.01). The results showed that the most common pathogen in semen of fertile and infertile men was Entrococcus with prevalence of 32.60% (14 cases), and 42% (37 cases), respectively. A total of 90 out of 131 samples contaminated with bacteria showed high rate of Leuckocytes (pyospermia). The remaining 41 infected samples lacked or had low number of leuckocytes. In conclusion, bacteriospermia is significantly higher in seminal samples of infertile than fertile men (p<0.01). Therefore, the pathogens involved in urethritis may be involved in male infertility. In addition, seminal culture is necessary for detection of bacteria presence in the semen, and thus it is important to note that presence or absence of Leukocyte in semen may not represent the urogenital infection. https://www.jri.ir/article/99 Comparison of hysterosonography and hysterosalpangiography in the diagnosis of intrauterine abnormalities in infertile women Uterine abnormalities are found in approximately 34-62% of infertile women. Because of this relatively high prevalence of uterine abnormalities, evaluation of uterine cavity is performed in the primary evaluation of infertility. The purpose of this study was to compare the diagnostic accuracy of hysterosonography with that of hysterosalpangiography for the evaluation of abnormalities of uterine cavity of infertile women. Sixty six infertile women were prospectively evaluated with hysterosalpangiogram (HSG) and hysterosonogram (H/S) as a part of their infertility workup. The result of each examination was compared with what was obtained by hysteroscopy as a golden standard. The results of H/S agreed with hysteroscopy in 95.5% (K=0.86) while HSG agreed with hysteroscopy in 87.9% (K=0.64) of cases. Sensitivity of H/S was 85.7% and its specificity 98.1%, while sensitivity of HSG was 71.4% and its specificity 92.3%. Hysterosonography was in general more accurate test and appeared to be an acceptable first-line evaluation for intrauterine structure. We recommend use of hysterosonography as a noninvasive, easy, inexpensive, effective and well-tolerated method of investigating the intrauterine cavity in infertile women instead of hysterosalpangiography. https://www.jri.ir/article/100 Comparison of PCT after vaginal and oral bromocriptine use in women with hyperprolactinemia and infertility Hyperprolactinemia is the most common cause of amenorrhea and infertility. Oral bromocriptine is the drug of choice for the treatment of hyperprolactinemia. Due to complications of its oral use, vaginal bromocriptine has been introduced as an effective and safe method. There is limited information regarding possible side effects of vaginal bromocriptine on motile sperm count in PCT results. Thus, in this clinical cross-sectional study, we sought to determine possible effects of vaginal bromocriptine on motile sperm count in PCT after resumption of ovulatory cycle in outpatients in reproductive age with hyperprolactinemia and complaints such as galactorrhea, menstrual irregularity and infertility. After exclusion of all confounding factors, the patients were divided in two groups. The study group (n=11) was treated with vaginal bromocriptine 2.5mg daily, and the control group (n=15) was treated with oral bromocriptine 2.5-5mg daily. Treatment duration needed for marked reduction in prolactine and also initiation of menses and ovulatory cycles were evaluated in both groups. After restoration of ovulation, PCT was done on 13-14th day of cycle in the presence of good cervical mucus, 8-12 hours after coitus. The numbers of motile sperm count atozoa/HPF in both groups were recorded and statistically compared with Mann Whitney U test. Treatment durations needed for initiation of ovulatory cycles in study group and the control group were 4-8 (mean5.5) weeks and 4-7 (mean 5.8) weeks, respectively with no statistical difference (p>0.05). PCT results showed 11-20 (mean15.3) motile sperm/HPF with progressive forward movement in study group, who were treated with vaginal bromocriptine. By using oral bromocriptine, PCT showed 10-23 (mean 14.4) motile sperm/HPF with progressive forward movement in the control group. There were no statistical difference in PCT results between these two groups (p>0.05). These results suggests the hypothesis, that vaginal bromocriptine has no adverse effects on motile sperm count in PCT, and vaginal bromocriptine can be used safely without possible adverse effect on sperm function in women with hyperprolactinemia and infertility. However, larger studies with more cases are necessary to confirm this hypothesis and to determine if vaginal bromocriptine has any effect on fertility in both groups. https://www.jri.ir/article/101 Effect of massage on reducing pain and anxiety during labour Labour pain is one of the most severe forms of pain that each women may experience during her life. Severe pain makes stress response with harmful effects on both mother, and her fetus. This study was carried out to evaluate the effect of massage therapy on relieving pain and its harmful sequel such as anxiety during labour. This clinical trial was performed on sixty nulliparous women selected randomly who were expected to have a normal childbirth in the Jiroft city hospital. Cases were randomly assigned to experimental (n=30) and control (n=30) groups. The experimental group received massage intervention. The nurse-rated Present Behavioral Intensity (PBI) was used as a measure of labour pain. Anxiety was measured by the Visual Analogue Scale for Anxiety (VASA). The intensity of pain and anxiety between these two groups were compared in the latent phase (cervix dilated 3-4cm), active phase (cervix dilated 5-7cm) and transitional phase (cervix dilated 8-10cm) of labour. In both groups, there was an increase in pain intensity and anxiety level as labor progressed. Results of T-test analysis demonstrated that the experiment group had significantly lower pain reaction in all three phases (Phase1 P=0.000, Phase2 P=0.002, Phase3 P=0.000) and anxiety levels were significantly different between two groups only in latent phase (P=0.00). Eighty seven percent (n=26) of cases in experimental group expressed that massage was helpful, provided pain relief and psychological support during labour (P<0.40). Our findings suggest that massage is a cost effective nursing intervention that can decrease pain and anxiety during labour and nurses intervention to perform massage could have positive effect on delivery experience. It is suggested that massage be used for decreasing pain and anxiety during labour. https://www.jri.ir/article/102 Knowledge, attitude and practice of Afghan refugee women residing in Zahedan about family planning Considering the high number of Afghan refugees in Zahedan and the important issue of their life style, the present study was carried out to determine knowledge, attitude and practice of Afghan Refugee women residing in Zahedan about family planning. A sample of 397 married women was interviewed at their homes. Statistical analysis was performed using Chi-square, t-student and Kruskal Wallis tests by SPSS. Our findings indicated that there existed low marriage and pregnancy age and high rate of pregnancy and illiteracy among them. Most Afghan refugee women had knowledge about oral contraceptives and the most common contraception used by them was oral and injectable contraception. Forty eight and sixth percent were using no contraception, for which, intention to have more children, being pregnant and husband’s disagreement were mentioned as main reasons. Unwanted pregnancy was reported by 20.4% with improper use of contraception as its main reason. They believed that having son in the family (51.8%) and early marriage of daughters (57.8%) are necessary. There was a significant relationship between knowledge, attitude, practice with literacy, husband’s literacy, ethnicity, and their religion (P<0.001). Iranian health system presents health services to refugee Afghan women similar to Iranian women. It is necessary to continue those services and to provide effective training based on their changing needs. https://www.jri.ir/article/103 Biotechnology in the mirror of ethics Bioethics seems to be the most important branch of applied ethics. It concerns both philosophers and scientists. Such crucial questions as health care, ART, genetic engineering, abortion, euthanasia, suicide, trasplanation, population issues, animal rights and the like are just examples of questions are being dealt with in this decipline. Due to special nature of these questions, to offer a sufficient moral theory, in addition to seven criteria of applicability i.e., clarity, completeness, comprehensiveness, practicability as well as justificatory, output and explanatory powers, an internal urging power is needed. And that may be achieved by divine persuasion to follow rational moral principles which are comprehensible by human faculty. Accordingly, in the level of content moral principles are rational norms, but in the level of implementation divine command is an urging motivation to persuade human agents to act morally. And by this, we would have a non-divine command moral theory which gives considerable role to religious beliefs. Also in this article in addition to dealing with main moral theories, Kantian, utilitarianism, virtue ethics and religious approach to biotechnological issues and their implications in this field, I have offered certain moral principles which can be applied as guiding principles biotechnological questions. https://www.jri.ir/article/104 Stigma and infertility in Iran - coping skills About fourty years ago Goffman (1963) in his book pointed at stigmatizing as distressing condition which harm some people in their life. He described stigma as bodily signs designed to expose something unusual and bad about the moral status of signifier. This term is used more to mean disgrace than any bodily feature, it can include the wide range of characteristics which make a person odd or seen deviant. Men or women with infertility face stigma because of unability to have their own children. In this article some factors which involve to make stigmatized situations for infertile persons have been described. Clinical observations shows that cognitive distortions has eminent effect in creating stigmatized situation for infertility. The role of cognitive modification in decreasing stigma for these persons are explained. A single case who suffered from stigmatized situation is described here and some CBT techniques for her treatment have been introduced. Some methods for stopping social pressure on infertile people suggested. https://www.jri.ir/article/105