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 normal pregnancy on plasma levels of lipoprotein (a) Introduction: Lipoprotein (a) [Lp(a)], a cholesterol- rich particle in human plasma is an indepe-ndent risk factor for atherosclerosis. In addition to diabetes mellitus and renal failure, normal and complicated pregnancy may affect the plasma levels of this lipoprotein. Since the effect of pregnancy and its complication on plasma level of Lp(a) is race dependent, the aim of present study was to evaluate the effect of pregnancy on plasma Lp(a) level in a group of normal preg-nant women living in Yazd City. Materials and Methods: The study groups included 94 normal pregnant women (with a mean age 24.6 ± 4.33 years) and 51 non-pregnant women (mean age 26.2±6.73 years). Fasting blood samples were collected in the morning and sera were stored at –70 °C until Lp(a) was assayed. Statistical analysis included, U-test and Wilcoxon-test for comparison of Lp(a), t-test for compa-rison of lipids, Kruskal-Wallis-test for comparison of variables in four groups (first, second, third, trimesters and control) and Pearson correlation test, for correlation of Lp(a) to other variables. Results: plasma Lp(a) levels in study group did not correlate significantly with age and other lipids, and in the pregnant group, (Mean±SD, 25±22.5 mg/dl) were significantly (p=0.01) higher than controls (18±13.5 mg/dl). Lp(a) plasma levels did not show any significant correlation with age, cholesterol and triglyceride levels. Plasma Lp(a) levels in the second half of pregnancy (31±22.4 mg/dl) was higher than the levels in the first half (20±16 mg/dl). Comparison of plasma Lp(a) in the third trimester and control showed a significant elevation in the third trimester. Conclusion: The results of the present study indicate that like most other reports, plasma Lp(a) levels increased during normal pregnancy in our study population, and the elevation is more pronounced in the second half of pregnancy. Since very high levels of plasma Lp(a), may affect placental circulation, more studies are needed to clarify the possible role of this lipoprotein in complicated pregnancies such as pre-eclampsia, history of low birth weight and repeated fetal loss. https://www.jri.ir/article/162 Characterization of a human spermatozoa surface antigens recognized by HS56 monoclonal antibody Introduction: Surface antigens of ovum and sperm have key role in the fertilization process. In this regard, study of these molecules and their biochemical, biophysical and physiological characteristics could be helpful in understanding the mechanism of fertilization. Moreover, many cases of infertility with unknown ethiology have been revealed to have defects in these molecules. This will further emphasize on the importance of molecules involved in fertilization. The aim of this study was to characterize the sperm sur-face antigen recognized by the monoclonal antibody HS56. Materials and Methods: Clone HS56 with known specificity to human sperm antigen were injected perit-oneally into the balb/c mice and the produced antibody was purified over protein- G affinity chromato-graphy column. The isotype of the monoclonal antibody (mAb) was determined by Enzyme-Linked Immu-nosorbent Assay (ELISA). Surface antigens extracted from human sperm by lithinm 3,5 diiodosalicylate (LIS) method were run on SDS-PAGE and the molecular weight of antigen recognized by HS56 mAb was determined by western blotting. For localization of this antigen, indirect immunofluorescence staining was performed. Finally involvement of this antigen in acrosome reaction was tested by inhibition assay. Wil-coxon test was used for statistical analysis. Results: By LIS extraction method many sperm antigens were isolated and seen on SDS-PAGE using ELISA, It was found that LIS extraction was a useful method for isolation of antigen recognized by HS56 mAb. The subclass of the mAb HS56 was shown to be IgG1. The molecular weight of the antigen was determined to be about 56±2 KDa and the molecule included disulfide bond (s) in its structure. The antigen of interest was localized on acrosome and midpeace region of human sperm. Finally our results showed that this antigen had no effect on acrosome reaction (P=0.11). Conclusion: Although the HS56 antigen does not play an important role in acrosome reaction, its further characterization with regard to sperm-oocyte binding may reveal a role in fertilization process. https://www.jri.ir/article/163 Electron microscopic study of folliculogenesis after exposure to electromagnetic field Introduction: Humans are continuously exposed to harmful environmental factors, such as electromagnetic fields (EMF) produced by home appliances, diagnostic tools and industrial instruments. The adverse effects of electromagnetic field on biological systems has been shown by epidemiologic and experimental studies. However, the results about the exact mechanism of its actions and its effects on different organs are not conclusive. The present study is designed to investigate morphological effects of EMF on ovarian follicles, at cellular level, using electron microscope. Materials and Methods: For this purpose, 30 adult female wistar rats were used (15 as control and 15 as experimental group). The rats in experimental group were exposed to 3 milli Tesla EMF for 4h/day for 4 months. After the experimental period, the ovaries eblated from both experimental and control groups, after proper fixation and processing, the thin sections were studied by transmission electron microscopy (TEM). Morphometric studies were carried out on electron micrographs using measurements and counting techniques. The data were analysed using students T- test. Results: Electron micrographs revealed that in EMF exposed group, in comparison to control group, the oocytes had shrunk and the thickness of zona pellucida and the number of penetrated microvilli were significantly (P<0.001) reduced (4.470.42 vs. 3.240.25 as 9.80.56 vs. 4.130.83 respectively). In the cytoplasm of oocytes from the experimental group the lamella were condensed. The granulosa cells from the EMF-exposed rats showed nuclear condensation and chromatin margination and several vacuoles appeared in their cytoplasm. The other morphological changes inclued; disappearance of mitochondrial cristaes, appearance of apoptotic signs such as separation from neighboring cells and appearance of apoptotic bodies. These changes were associated with an increase of macrophages. Conclusion: Our results suggest that EMF-exposure inhibits follicular growth and oocyte maturation by affecting cellular function, membrane changes and inducing apoptosis. It is concluded that EMF exposure, by the above mechanisms, could interfere with normal process of oogenesis and lead to subfertility. https://www.jri.ir/article/164 Effect of Dexamethasone on ovarian response in infertile women aged over 35 years undergoing IVF/ICSI program Introduction: Poor ovarian response to exogenous gonadotrophins occurres in 9-26% of ART cycles. Ovarian reserve decreases by ovarian aging which is an important factor in decreasing ovarian response to gonadotrophins but there are other probable methods which are reported as affecting factors on ovarian response to gonadotrophins such as high dose of gonadotrophins, adjuvant therapy with growth hormone and glucocorticoids. In this study, we aimed to evaluate the role of Dexamethasone, as an effective factor on ovarian response, in infertile women aged over 35 years who referred to Royan institute. Material and methods: In this clinical trial, 72 infertile women, aged over 35 years, who referred to Royan institute to undergo IVF/ICSI program, were selected. Patient were divided into two groups in each group, 36 patients were studied. Laboratory tests including serum FSH, LH, Total Testosterone, Estradiol, Prolactin and thyroid function tests were performed on third day of menstrual cycle. Standard long protocol began on 21st day of menstrual cycle. Simultaneously, in triple blind method, each woman received either 2 tablets containing Dexamethasone or placebo. After 2 weeks, ovarian stimulation was started using 3 HMG ampoules from 2nd day of menstrual cycles and its dose was increased according to ovarian response. If the size of at least three follicles was more than 18 mm, HCG (10000 IU) was administrated after Estradiol measurement. After 36-38 hours of HCG administration, oocyte was retrieved by transvaginal sonography guidance. Embryo transfer was done after 48 hours. SPSS version 11.5 was used for data entry and results were analyzed by Paired t test and Chi-square. P v<0.05 was considered as significant statistical level. Results: There were no statistical differences between the groups in age, duration of infertility, Body mass Index (BMI), hormonal tests, number of retrieved oocyte and percent of transferred embryos. However, the difference between the groups in the number of used HMG ampoules [in Dexamethasone group 30.6±13.39 versus 41.65±18.34 in placebo group] was statistically significant (P<0.05). Conclusion: Although there was no statistical difference between Dexamethasone and placebo groups in number of retrieved and fertilized oocytes but the number of used HMG ampoules in Dexamethasone group was statistically lower than the placebo group and this difference can imply the positive effect of Dexamethasone on ovarian response to gonadotrophins so that utilization of Dexamethasone as an adjuvant for standard treatment is recommended in patients over 35 years old who are known at risk of low ovarian response. https://www.jri.ir/article/165 Comparison of complications in abdominal hysterectomy versus vaginal hysterectomy Introduction: Hysterectomy is one of the most common operations in the world. It is divided into two main abdominal and vaginal categories. Each type has usually specific indications but sometimes they have common indications. The main causes of abdominal hysterectomy are uterine fibroma, AUB, resistant PID, endometriosis, gynecologic malignancies, adenomyosis with vaginal bleeding, pelvic pain and cervical CIN and the most important indication for vaginal hysterectomy is uterine prolaps. Considering the importance and prevalence of hysterectomy and its side effects, we decided to compare the complications of vaginal versus abdominal hysteric-tomy to try to define more solid criteria for selecting hysterectomy method for the candidate patients. Materials and Methods: This is a case-control (retrospective) analytic study.Data was collected from March 2001 until March 2003 of patient who had hysterectomies in GYN Department of Yahyanejad hospital in Babol. Of the 339 women who had undergone hysterectomy, 57 (16.8%) had received vaginal and 282 (83.2%) abdominal hysterectomy. The Variables Considered included age, days of hospitalization, decrease in hemoglobin concentration and other early side effects of hysterectomy. The data was analyzed by SPSS software Program using 2, t- test and fisher's exact test and multiple logistic model. Results: The mean age of the Patients who had undergone hysterectomy was 58.512 years for Vaginal and 44.697.9 years for abdominal hysterectomy. The overall Complication rates were 23.7% and 5.3% (p=0.01) for abdominal and Vaginal hysterectomies, respectively. Fever was the main complication after surgery with a frequency of 18.4% and 3.5% for abdominal and vaginal hysterectomies, respectively. The decrease in hematocrit was lower in abdominal (2.392.05%) than in vaginal (3.761.32%) hysterectomy (p<0.001). Conclusion: The results indicate that the overall complications in vaginal hysterectomy are less than abdominal which may suggest that vaginal hysterectomy may be an appropriate alternative for abdominal hysterectomy. https://www.jri.ir/article/166 Reasons for choosing withdrawal method among women at reproductive ages in Rasht Introduction: Withdrawal as one of the traditional family planning methods has been prevalent for a long time and its history dates back to pre-Islam period. Two groups have usually been using this method more often. On the one hand, illiterate people who have had little knowledge about the modern methods of family planning, and on the other hand, highly educated people who either had knowledge or had fear of side effects of modern methods. The frequency of using traditional methods in Gilan is the highest in Iran (30%), and about one third of contraceptive methods in Gilan include withdrawal. The proportion of unwanted pregnancies is high among those who use withdrawal in this province as well. The aim of this survey is to study the effective reasons and factors in choosing withdrawal method among couples in Rasht which result will be used for designing a comprehensive family planning program. Material & Methods: Both quantitative and qualitative methods were used in this study. In the quantitative method, the Iran Fertility Transition Survey data was used. In the analysis, statistical tests such as 2, analysis of variance, and logistic regression analysis were employed. Qualitative method in this study included in-depth interview and focus group discussion. Of women under the coverage of the three health centers in Rasht city, 27 women who had used withdrawal were randomly selected and interviewed. In addition, two focus group discussions were conducted, one with provincial health officers (7 health officers employed in Provi-ncial as well as city health departments), & one with field officers (5 field officers and 3 health volunteers) in Rasht. Results: The results showed that around 70% of rural women as against 57% of urban women were using modern methods of contraception. In general, 38.3% of all women using contraceptives were using traditional methods at the time of IFTS. There was a statistically significant correlation between place of residence and method (withdrawal or modern) used. Among all independent variables included in logistic regression analy-sis, number of children ever born, duration of marriage, and source of knowledge of contraception were signi-ficant and remained in the final model. The results of qualitative method revealed that couples use withdrawal in order to avoid side effects of modern methods. The wide use of withdrawal in Rasht can be attributed to the understanding of men of the health situation of their wife. Conclusion: Expansion and the improvement of quality of family planning services can have significant effects on the selection of modern contraceptives. However, given the inclination of couples towards using withdrawal, this method should also be officially recognized by family planning centers as a family planning method and the necessary training should be provided for this method. Since the high proportion of unwanted pregnancies have occurred while couples were using this method, trainings should aim to increase the awareness of women of their menstrual cycle and emergency contraceptives particularly in urban areas. https://www.jri.ir/article/167 Effect of group counseling program for women on spouse communication regarding family planning in Zahedan health care centers in 2002 Introduction: Couple communication is one of the most important factors for accepitng family planning methods. Women are the principal source of information about fertility regulation for their partners and communication between partners appears to be a prerequisite for the acceptance of contraceptive methods. Different studies and observations have shown that couple communica-tion and family planning coverage are limited due to traditional and cultural concerns in Zahedan city. This study investigates the effect of group counseling with women on spouse communication about family planning. Materials and methods: A quasi-experimental study (before and after) was conducted in Zahedan in 2002. Forty four women )in fertility age) with two or more children who had not used contra-ceptive methods were selected by non- random sampling from 3 urban health centers. After comp-leting questionnaires by researcher about women and their husbands and determination of their educational needs, women were divided into 5 groups (8-9 members) and each group participated in 3 counseling sessions (based on their educational level). One month after intervention, the resu-lts were analysed by questionnaires and check- list forms using Wilcoxon, Mc-nemar and chi-square tests. Results: Wilcoxon test demonstrated that frequency of spouse communication before and after intervention were significantly different (P<0.00001). Moreover, Chi-square test showed a signifi-sant difference after intervention between use of contraceptive methods and spouse communica-tion about family planning (with P<0.01 for women and P<0.05 for their husbands). After inter-vention 43% of cases selected one of the contraceptive methods and Mc-nemar test showed significant difference (P<0.00001). Conclusion: On the base of study results appropriate counseling for women can improve spouse communication regarding family planning. Therefore, it is suggested that couple communication skills should be reinforced by suing instructional programes. https://www.jri.ir/article/168 Survey of women’s knowledge, Attitude and practice regarding prevention of common genital tract infection in Kerman health care centers in 2003 Introduction: Disease impedes normal and proper growth, and prevents health maintenance and health promotion. Therefore, necessary activities to prevent disease in the community should be considered as high priority issues in health and treatment programs. Genital tract infections are among diseases that threaten women’s health, thus preventing these infections is very important to control these diseases in the community. As prevention and control of STDs until 2010 is one of the major slogans of WHO and considering the increasing prevalence of these diseases in different societies, the need for education and consultation on sexual behavior and effective prevention of genital tract infectious diseases, especially STDs, must be considered as the core of any reproductive and sexual health care program. Since knowledge plays an important role in the people’s attitude and practice, obtaining knowledge and change in the attitude could eventually lead to the desired practice, too. This discriptive study carried out to asses knowledge, attitude and practice of women who referred to Kerman health care centers about prevention of common genital tract infections in 2003. Materials and Methods: The sample size included 305 women who were chosen by tow- stage cluster and by continuous nonprobability sampling method. The instrument for data collection was a researcher-made questionnaire with four parts including: demographic characteristics (14 questions), knowledge determina-tion (20 questions), attitude (12 sentences) and practice (16 sentences) about prevention of common genital tract infections. The questionnaire was used for data collection after through face to face interviews gaining nessesery validity and reliability. For data analysis, frequency table, t-test, spearman rank correlation cofficient, one way analysis of variance (ANOVA) and Tuckey test were used (α=0/05). Results: The results showed that women’s score for knowledge was 70% of total score, 80% for attitude and 80% for practice. There was a significant correlation between knowledge, attitude, and practice (P<0.01). Comparison of mean score of knowledge with demographic characteristics showed significant differences between knowledge and age groups (p< 0.05 ), level of education, level of spouse’s education and job (p<0.01). In comparision to mean score of attitude with demographic characteristics there was significant difference between attitude and level of education, level of spouse’s education, job (p<0.01), preventive method of pregnancy and previous information (p<0.05). Results also revealed that there was significant difference between mean score of practice with age groups (p<0.05), level of education, level of spouse’s education, job (p<0.01) and previous information (p<0.05). Conclusion: Results indicated that health services members have an important role in increasing knowledge and improving behaviours of community in prevention of common genital tract infection. https://www.jri.ir/article/169