2009 9 4 37 80

بررسی ارتباط سه پلی‌مورفیسم فاکتور 5 انعقادی و سندرم سقط مکرر The Relationship between Polymorphisms of Blood Coagulation Factor V Gene and Recurrent Pregnancy Losses 2 1 زمينه و هدف: یکی از مهمترین فاکتورهای مطرح در ایجاد ترومبوفیلی در زنان مبتلا به سقط مکرر، پلی‌مورفیسم‌های فاکتور 5 انعقادی است. ارتباط بین پلی‌مورفیسم FV Leiden و ترومبوفیلی در زنان مبتلا به سقط مکرر، تاکنون در مطالعات بسیاری بررسی و نتایج متفاوت و گاه متناقضی بدست آمده است. دو پلی‌مورفیسم جدید FV A4070G و FV A5279G، که باعث نقص فاکتور5 انعقادی می‌شوند، کمتر مورد توجه و مطالعه بوده‌اند. این مطالعه به منظور بررسی اثر این سه پلی‌مورفیسم بر میزان افزایش خطر ابتلا به سندرم سقط مکرر در زنان ایرانی انجام شد.روش بررسي: 100 بیمار با حداقل سابقه دو بار سقط، به عنوان گروه بیمار و 100 خانم بدون سابقه سقط و با حداقل سابقه دو زايمان موفق، به عنوان گروه کنترل انتخاب شدند. برای بررسی سه پلی‌مورفیسم FV Leiden، FV A4070G و FV A5279G، واکنش زنجیره‌اي پلی‌مراز (PCR) همراه با استفاده از آنزیم‌های محدودکننده (PCR-RFLP) طراحی شد. به منظور تجزیه و تحلیل آماری از آزمون‌هاي من‌ـ ‌ويتني، آزمون همبستگی اسپيرمن، مدل رگرسیون لجستیک یک متغیره و چندگانه به روش پس رو استفاده شد.نتایج: با توجه به نسبت افراد واجد موتاسیون FV Leiden در دو گروه (13% در گروه بیماران و 4% در گروه کنترل)، احتمال سقط مکرر در بیماران واجد این پلی‌مورفیسم بیشتر بود (نسبت خطر: 586/3 و 412/11-127/1 :CI 95%). برای پلی‌مورفیسم‌های FV A4070G و FV A5279G به ترتیب 14 نفر (14%) و 37 نفر (37%) از افراد گروه بیمار واجد این دو پلی‌مورفیسم بودند. در مقابل از 100 فرد گروه كنترل، به ترتیب تنها 4 نفر (4%) پلي‌مورفيسم FV A4070G و 7 نفر (7%) پلي‌مورفيسم A5279G را داشتند. احتمال سقط مکرر در بیماران واجد این دو پلی‌مورفیسم نيز در مقايسه با گروه كنترل بیشتر بود، به ترتيب (نسبت خطر: 273/3 و 523/10-018/1 :CI 95%) و (نسبت خطر: 803/7 و 603/18-273/3 : CI 95%). نسبت افراد دارای دو یا سه موتاسیون در دو گروه بیمار و کنترل نشان داد که بین دو پلی‌مورفیسم FV Leiden و FV A4070G، ارتباط متقابل دیده می‌شود. با بررسي اثر همزمان سه پلی‌مورفیسم بر شانس وقوع سقط مکرر، به كمك آزمون رگرسيون لجستيك چندگانه به روش پس‌رو مشخص شد که با بررسي دو پلی‌مورفیسم FV A4070G و FV A5279G، مي‌توان اثر همزمان هر سه موتاسيون را روي شانس وقوع سقط مكرر ارزيابي كرد.نتیجه‌گیری: براساس نتايج اين مطالعه هر سه پلی‌مورفیسم ژن فاکتور5 انعقادی با افزایش خطر سقط مکرر همراه است. بین دو پلی‌مورفیسم FV Leiden و FV A4070G، ارتباط متقابل وجود دارد. با بررسي دو پلی‌مورفیسم FV A4070G و FV A5279G، مي‌توان اثر همزمان هر سه موتاسيون را روي شانس وقوع سقط مكرر ارزيابي كرد و لذا بررسي وجود اين پلي‌مورفيسمها در زنان مبتلا به سقط مكرر توصيه مي‌گردد. 2 Introduction: Polymorphisms of coagulation factor V gene are the most important suspected causes of thrombophilia in women with recurrent pregnancy losses (RPL). In this study the association between three polymorphisms of factor V (FV Leiden, FV A4070G & FV A5279G) and RPL are sought in Iranian women.Materials & Methods: In this case-control study, 100 female patients with at least two recurrent abortions were selected as the cases, and 100 healthy women with a history of two successful deliveries as the controls. Peripheral blood samples were collected and DNA was extracted. PCR-RFLP method was used for genotyping the samples.Results: Regarding the prevalence of FV Leiden mutation in the cases and the controls, 13% and 4% respectively, the chances for recurrent pregnancy losses were more than 3.5 times higher in individuals with this polymorphism (OR: 3.586, 95% CI: 1.127–11.412). The frequencies of FV A4070G and FV A5279G were 14% and 37% in the case and 4% and 7% in the control groups, respectively and the chances for RPL were higher in cases with these two polymorphisms. The proportion of cases with two or three mutations in the gene in comparison with the controls, showed a significant correlation between FV Leiden and FV A4070G polymorphisms. Statistical analysis of the simultaneous effects of the three polymorphisms for RPL showed that evaluation of FV A4070G and FV A5279G could help assess the chances of the three mutations for RPL.Conclusion: The three polymorphisms in coagulation V gene are accompanied with increased risks for RPL. Evaluation for the three polymorphisms is suggested in the work up of women with RPL. 305 317 Raheleh R Torabi راحله ترابی Faculty of Basic Sciences, Science and Research Branch, Islamic Azad University Faculty of Basic Sciences, Science and Research Branch, Islamic Azad University Iran Mahyar M Ostad Karampour مهیار استادکرم‌پور Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Iran Afsaneh A Mohammadzadeh افسانه محمدزاده Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Soheila S Arefi سهیلا عارفی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Mohammad M Keramatipour محمد کرامتی پور Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Science Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Science Iran Saeed S Zarei سعید زارعی Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Iran Hojjat H Zeraati حجت زراعتی Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Mahmood M Jeddi-Tehrani محمود جدی‌تهرانی Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Iran mahjed@avicenna.ac.ir Blood coagulation factor VFV A4070GFV A5279GFV LeidenPolymorphismRecurrent Pregnancy LossThrombophilia 342.pdf Tulppala M, Ylikorkala O. 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بررسي اثر هورمون‌هاي FSH و استراديول در القاء اسپرماتوژنز در موش مدل آزواسپرمي Stimulatory Effects of Estradiol and FSH on the Restoration of Spermatogenesis in Azoospermic Mice 2 1 زمينه و هدف: در حال حاضر شيمی‌درمانی و پرتودرماني به عنوان روش معمول درمان انواع سرطانها در مردان، سبب اختلال در اسپرماتوژنز و در نهايت ايجاد آزواسپرمی و ناباروری می‌گردد. تا ساليان اخير، استروژن به عنوان هورمون زنانه مورد توجه بود؛ اما مطالعات جديد معرف نقش مهم آن در اسپرماتوژنز است. با توجه به نقش هورمون‌ محرک فوليکولی (FSH) در فرایند اسپرماتوژنز و اهمیت هورمون استرادیول در تنظیم ترشح آن، اين مطالعه به بررسی نقش این دو هورمون به‌خصوص استرادیول در القاء مجدد اسپرماتوژنز در موش‌هاي آزوسپرم شده توسط بوسولفان پرداخته است.روش بررسی: در اين مطالعه 20 موش نر بالغ با دوز mg/kg30 داروي بوسولفان، آزواسپرم شدند. پس از اطمينان از آزواسپرمی، به سه گروه آزمايشی و يک گروه کنترل تقسيم‌بندی شدند. گروه اول هورمون FSH با دوز 5/7 واحد به صورت تزريق زير جلدی، گروه دوم هورمون استراديول با دوز g/kgµ5/12 به صورت داخل صفاقی و گروه سوم هر دو هورمون را تواماً و همزمان دريافت نمودند. گروه چهارم به عنوان کنترل، دارويي دريافت نكرد. تزريق اين هورمونها طی 10 روز متوالی (روزانه يك دوز) انجام گرفت و در روز يازدهم سطح تستوسترون خون اندازه‌گيری شد. يک بيضه از هر موش جهت آناليز DNA به روش فلوسايتومتری و بيضه ديگر جهت رنگ‌آميزی هماتوکسيلين‌ـ ائوزين و بررسی هيستولوژيک استفاده شد. آناليز آماری با استفاده از آزمون‌های كروسكال واليس، من‌‌ ويتني و دقيق فيشر انجام شد.نتايج: بيشترين ميزان افزايش تستوسترون، در گروه دريافت كننده هر دو هورمون مشاهده شد كه اختلاف معنی‌داری با گروه کنترل داشت (05/0p<). بيشترين ميزان افزايش در تعداد سلول‌های هاپلوئيد در گروه‌هاي سوم و چهارم مشاهده شد و اختلاف اين گروه‌ها نسبت به گروه کنترل معني‌دار بود (05/0p<). در گروه اول، افزايش اندکی در سطح تستوسترون سرم و تعداد سلول‌های هاپلوئيد بافت بيضه نسبت به گروه کنترل مشاهده شد که از لحاظ آماری معنی‌دار نبود. بررسی هيستولوژيک مقاطع رنگ‌آميزی شده بافت بيضه نيز نشان دهنده بازگشت مجدد اسپرماتوژنز در بيضه موش‌های آزواسپرم گروه‌هاي دوم و سوم بود (0001/0p<).نتيجه‌گيری: در مطالعه حاضر، تزريق مجزای هورمون FSH تأثيری در از سرگيری مجدد اسپرماتوژنز در موش‌های آزواسپرم نداشت؛ اما تزريق مجزاي استراديول نه تنها اثر مهاري روي اسپرماتوژنز نداشت، بلکه نقش تحريكي در بازيابی اسپرماتوژنز در موش‌های آزواسپرم داشت و تزريق همزمان FSH و استراديول اثر هم‌افزايي در القاء اسپرماتوژنز در بيضه موش‌های آزواسپرم داشت. 2 Introduction: Loss of spermatogenesis following chemo or radiotherapy for the treatment of malignancies leads to the patients temporary or permanent infertility. Restoration of sperma-togenesis after malignancy treatments is the main target of recent studies. Therefore, this study was undertaken to evaluate role of follicular stimulating hormone (FSH) and estradiol in the regeneration of spermatogenesis in azoospermic mice.Material and Methods: Busulfan, 30mg/kg, was used to induce azoospermia, in 20 male C57Bl/6 mice. Later on, the mice were divided into four groups of five animals. The animals on groups one to three received daily injections of FSH (7.5IU), estradiol benzoate (EB) (12.5μg) and simultaneous FSH and EB, respectively for ten days with no medication for the control group. On the 11th day, serum testosterone levels were measured. After sacrificing the animals, one testis of each mouse was fixed and processed for histopathological studies and the other was used for DNA flow cytometry to count haploid cells.Results: The highest increase in testosterone levels was seen with concomitant use of FSH and estradiol. The highest increases in haploid cells were seen in solitary use of estradiol and its concomitant use with FSH and resumption of spermatogenesis were observed histologically in these two kinds of administrations (p<0.001).Conclusion: FSH unlike estradiol did not restore spermatogenesis in azoospermic mice. Simultaneous use of FSH and estradiol had synergistic effects in the restoration of spermatogenesis in azoospermic mice. Therefore, the concomitant use of the two hormones may be considered for the restoration of spermatogenesis in men who have undergone treatments for malignancies. 317 325 Arefeh A Jafarian عارفه جعفریان Department of Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences Department of Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences Iran Mohammad Mehdi MM Akhondi محمدمهدی آخوندی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran akhondi@avicenna.ac.ir Nooshabeh N Pezhhan نوشابه پژهان Department of Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences Department of Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences Iran Mohammad Reza MR Sadeghi محمدرضا صادقی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Amir Hassan AH Zarnani امیرحسن زرنانی Nanobiotechnology Research Center, Avicenna Research Institute (ACECR) Nanobiotechnology Research Center, Avicenna Research Institute (ACECR) Iran Sheida Sh Salehkhou شیدا صالح‌خو Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran AzoospermiaBusulfanChemotherapyEstradiolFSHHaploid cellInfertilitySpermiogenesisTestosterone 343.pdf Walker WH, Cheng J. FSH and testosterone signaling in Sertoli cells. Reproduction. 2005; 130(1): 15-28. Re-view.##Fan QR, Hendrickson WA. Structure of human follicle-stimulating hormone in complex with its receptor. Nature. 2005; 433(7023): 269-77.##Hess RA. Estrogen in the adult male reproductive tract: a review. Reprod Biol Endocrinol. 2003; 1: 52.Review.##Akingbemi BT. Estrogen regulation of testicular func-tion. Reprod Biol Endocrinol. 2005; 3: 51. Review.##Anjamrooz SH, Movahedin M, Mowla SJ, Bairanvand SP. Assessment of morphological and functional changes in the mouse testis and epididymal sperms following busulfan treatment. Iran Biomed J. 2007; 11(1): 15-22.##Hemsworth BN, Jackson H. Effect of Busulphan on the developing gonad of the male rat. J Reprod Fertil. 1963; 5: 187-94.##Sierens JE, Sneddon SF, Collins F, Millar MR, Saunders PT. Estrogens in testis biology. Ann N Y Acad Sci. 2005; 1061: 65-76. Review.##Meistrich ML, Shetty G. Inhibition of spermatogonial differentiation by testosterone. J Androl. 2003; 24(2): 135-48. Review.##Kula K, Walczak-Jedrzejowska R, S?owikowska-Hilczer J, Oszukowska E. Estradiol enhances the stimulatory effect of FSH on testicular maturation and contributes to precocious initiation of spermatogenesis. Mol Cell Endocrinol. 2001; 178(1-2): 89-97.##Meistrich ML. Hormonal stimulation of the recovery of spermatogenesis following chemo- or radiotherapy. APMIS. 1998 ; 106(1): 37-45. Review.##Delbès G, Levacher C, Habert R. Estrogen effects on fetal and neonatal testicular development. Reproduc-tion. 2006; 132(4): 527-38. Review.##Eddy EM, Washburn TF, Bunch DO, Goulding EH, Gladen BC, Lubahn DB, et al. Targeted disruption of the estrogen receptor gene in male mice causes alter-ation of spermatogenesis and infertility. Endocrinology. 1996 ; 137(11): 4796-805.##Toyama Y, Hosoi I, Ichikawa S, Maruoka M, Yashiro E, Ito H, et al. beta-estradiol 3-benzoate affects sperm-atogenesis in the adult mouse. Mol Cell Endocrinol. 2001; 178(1-2): 161-8.##Lambard S, Carreau S. Aromatase and oestrogens in human male germ cells. Int J Androl. 2005; 28(5): 254-9. Review.##MacCalman CD, Getsios S, Farookhi R, Blaschuk OW. Estrogens potentiate the stimulatory effects of follicle-stimulating hormone on N-cadherin messenger ribonucleic acid levels in cultured mouse Sertoli cells. Endocrinology. 1997; 138(1): 41-8.##Dorrington JH, Bendell JJ, Khan SA. Interactions between FSH, estradiol-17 beta and transforming growth factor-beta regulate growth and differentiation in the rat gonad. J Steroid Biochem Mol Biol. 1993; 44(4-6): 441-7. Review.##Fujita K, Ohta H, Tsujimura A, Takao T, Miyagawa Y, Takada S, et al. Transplantation of spermatogonial stem cells isolated from leukemic mice restores fertility without inducing leukemia. J Clin Invest. 2005; 115(7): 1855-61.##Ogawa T. Spermatogonial transplantation: the prin-ciple and possible applications. J Mol Med. 2001; 79(7): 368-74. Review.##

لکوسيتواسپرمی و اثرات آن بر پارامترهای اسپرم در مردان مراجعه‌کننده براي درمان ناباروري Leukocytospermia and its Correlation with Sperm Parameters in Male Infertility 2 1 زمينه و هدف: لکوسيت‌هاي پراكسيداز مثبت، منبع اصلي توليد راديکال‌های آزاد اکسيژن (ROS) در مايع سمينال مي باشند. استرس اكسيداتيو در نتيجه افزايش ROS از دو منبع لكوسيت‌هاي مايع سمينال و اسپرمهاي معيوب، توليد مي‌شود كه منجر به پراكسيداسيون ليپيدها، اختلال در تحرك و كاهش توانايي باروري اسپرم مي‌شود. هدف از اين مطالعه، مقايسه پارامترهاي اسپرم (تعداد، تحرك و مورفولوژي اسپرم) در مردان نابارور مبتلا به لکوسيتواسپرمی و بدون لكوسيتواسپرمي و اندازه‌گيري ميزان ملان دي‌آلدئيد (MDA) و قدرت تام آنتي اكسيداني ايجاد شده در مايع سمينال مي‌باشد. روش بررسي: تعداد 110 مرد مراجعه‌كننده به مركز ناباروری كاشان، طي سال‌هاي 87-1386 بر اساس نتايج آناليز مايع سمينال در گروه‌هاي لكوسيتواسپرمی و بدون لكوسيتواسپرمی تقسيم شدند. 45 مرد با پارامترهاي نرمال (براساس معيارهای WHO) به عنوان گروه كنترل انتخاب شدند. پس از ارزيابي اسپرم، مايع سمينال براي اندازه‌گيري MDA و TAC در دماي °C80- ذخيره شد. ميزان ملان دي‌آلدئيد و ظرفيت تام آنتي‌اكسيدان در مايع سمينال، به روش اسپكتروفتومتري تعيين شد. با استفاده از آزمون‌هاي كروسكال واليس، 2 و فيشر نتايج دو گروه مقايسه شد. 05/0p< به عنوان سطح معني‌داري در نظر گرفته شد. نتايج: براساس نتايج اسپرموگرام30 نفر در گروه لكوسيتواسپرمی و 35 نفر عليرغم وجود لكوسيت در مايع سمينال (كمتر از 106×25/0 در ميلي‌ليتر)، در گروه غير لكوسيتواسپرمي قرار گرفتند. تحرک اسپرم (a+b) در گروه لكوسيتواسپرمي در مقايسه با گروه غيرلكوسيتواسپرمي و گروه افراد سالم، اختلاف معني‌داري را نشان داد (به ترتيب 05/0p< و 001/0(p<. ميزان MDA در گروه لكوسيتواسپرمي (mol/L48/18178) به مقدار زيادي بيشتر از گروه غير لكوسيتواسپرمي (mol/L73/17/2) و افراد سالم (mol/L14/04/0) بود (به ترتيب 001/0p< و 0001/0p<). همچنين ميزان TAC در گروه لكوسيتواسپرمي (mol/L 58/75636) در مقايسه با گروه غير لكوسيتواسپرمي (mol/L 56/105986) و كنترل (mol/L95/95989) به طور معني‌داري (0001/0p<) پايين‌تر بود.نتيجه‌گيري: وجود مقادير بالاي لكوسيت منجر به افزايش توليد راديكال‌هاي آزاد (ROS) در مايع سمينال مي شود. راديكال‌هاي آزاد و محصولات پايدار ناشي از آن (MDA)، باعث كاهش ظرفيت آنتي‌اكسيداني (TAC) مايع سمينال مي‌گردد. كاهش TAC و افزايش ميزان MDA، باعث اختلال در عملكرد اسپرم به ويژه تحرك آن مي‌گردد. با توجه به تأثير مستقيم پارامترهاي اسپرم بر قدرت باروري اسپرم و لقاح، مي‌توان نتيجه گرفت كه احتمالاً لكوسيتواسپرمی منجر به اختلال در قدرت باروری مردان مي‌گردد. 2 Introduction: Reactive oxygen species (ROS) in the seminal fluid are derived from abnormal sperm, white blood cells or both. Oxidative stress will cause lipid peroxidation, decreased sperm motility and abnormalities in sperm fertilizing capacity. The aims of this study were to compare sperm parameters (Sperm count, motility and morphology) in infertile men with or without leukocytospermia and to measure both seminal total antioxidant capacity (TAC) and malon-dialdehyde (MDA) concentration.Materials and Methods: This case-control study included 110 male subjects referring to Kashan Infertility Center during 2007-2008. Regarding the World Health Organization criteria and following sperm analysis and seminal leukocyte counts, the cases were divided into two leukocytospermic and non-leukocytospermic groups and a third group composed of 45 men with normal test results were selected as the controls. Seminal plasma MDA and TAC levels were spectrophotometrically measured.Results: Upon semen analyses of 110 subjects, 45 individuals were classified as healthy, 30 as leukocytospermic and 35 as non-leukocytospermic; although there were <0.25106 leukocytes in the semen of the latter group. Sperm motility (a+b) had a significant difference in the leukocytospermic individuals compared to non-leukocytospermic or healthy subjects (p<0.05 and p<0.001, respectively). MDA levels in the leukocytospermic group (178±18.48μmol/L) were higher than those of the non-leukocytospermic (2.7±1.73μmol/L) and the control group (0.4±0.14μmol/L). Additionally, TAC levels in the leukocytospermic group (636±75.58μmol/L) were significantly lower than the non-leukocytospermic (986±105.56μmol/L) or the controls (989±95.95μmol/L), (p<0.0001).Conclusions: High counts of leukocytes in the seminal fluid results in the increased production of ROS and their stable byproducts (MDA) in semen with subsequent depletion of its antioxidant capacity. Decreased TAC and increased MDA levels influence sperm parameters, especially its motility. Regarding the direct effects of sperm parameters on sperm fertilizing capacity, it is concluded that leukocytospermia may deleteriously influence male fertility. 325 334 Hassan H Hassani Bafrani حسن حسنی بافرانی Department of Anatomy and Embryology, Faculty of Medicine, Kashan University of Medical Sciences Department of Anatomy and Embryology, Faculty of Medicine, Kashan University of Medical Sciences Iran hhassani@kaums.ac.ir Mohamad Esmaiil ME Shahaboddin محمداسماعیل شهاب الدین Department of Biochemistry, Faculty of Medicine, Kashan University of Medical Sciences Department of Biochemistry, Faculty of Medicine, Kashan University of Medical Sciences Iran LeukocytospermiaLipid peroxidationMale infertilityOxidative stressReactive oxygen speciesSemen analysisSperm Parameters 344.pdf Schmidt L, Münster K, Helm P. Infertility and the seeking of infertility treatment in a representative population. Br J Obstet Gynaecol. 1995; 102(12): 978-84.##Paul j, Turek MD, editors. Male infertility. 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Fertil Steril. 1987; 48(3): 510-1.##Yanushpolsky EH, Politch JA, Hill JA, Anderson DJ. Is leukocytospermia clinically relevant? Fertil Steril. 1996; 66(5): 822-5.##Thomas J, Fishel SB, Hall JA, Green S, Newton TA, Thornton SJ. Increased polymorphonuclear granulo-cytes in seminal plasma in relation to sperm morph-ology. Hum Reprod. 1997; 12(11): 2418-21.##Koksal IT, Usta M, Orhan I, Abbasoglu S, Kadioglu A. Potential role of reactive oxygen species on tes-ticular pathology associated with infertility. Asian J Androl. 2003; 5(2): 95-9.##Sharma RK, Pasqualotto FF, Nelson DR, Thomas AJ Jr, Agarwal A. The reactive oxygen species-total antioxidant capacity score is a new measure of oxida-tive stress to predict male infertility. Hum Reprod. 1999; 14(11): 2801-7.##Kiessling AA, Lamparelli N, Yin HZ, Seibel MM, Eyre RC. Semen leukocytes: friends or foes? Fertil Steril. 1995; 64(1): 196-8.##Tomlinson MJ, White A, Barratt CL, Bolton AE, Cooke ID. 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Lipid per-oxidation in human spermatozoa as related to midpiece abnormalities and motility. Gamete Res. 1989; 24(2): 127-34.##Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of "antioxidant power": the FRAP assay. Anal Biochem. 1996; 239(1): 70-6.##Huszar G, Sbracia M, Vigue L, Miller DJ, Shur BD. Sperm plasma membrane remodeling during spermio-genetic maturation in men: relationship among plasma membrane beta 1,4-galactosyltransferase, cytoplasmic creatine phosphokinase, and creatine phosphokinase isoform ratios. Biol Reprod. 1997; 56(4): 1020-4.##Saleh RA, Agarwal A, Kandirali E, Sharma RK, Anthony J, Thomas AJ, et al. Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa. Fertil steril. 2002; 78(6): 1215-24.##Sikka SC. Role of oxidative stress and antioxidants in andrology and assisted reproductive technology. J Androl. 2004; 25(1): 5-18. Review.##Alvarez JG, Storey BT. 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مقايسه‌ سطح سرمي هموسيستئين در افراد مبتلا به سندرم تخمدان پلي‌کيستيک و طبيعي Serum Homocysteine Levels in PCOS Patients versus Healthy Women 2 1 زمينه و هدف: خانم‌هاي مبتلا به سندرم تخمدان پلي‌كيستيك (PCOS) داراي عوامل خطر بيماري‌هاي قلبي‌ـ عروقي به خصوص افزايش ليپوپروتئينها، فشار خون و هيپرانسولينمي مي‌باشند. افزايش هموسيستئين نيز ممکن است زمينه‌ساز ايجاد بيماري قلبي‌ـ عروقي در اين افراد شود. اين مطالعه با هدف بررسي و مقايسه سطح سرمي هموسيستئين در زنان ايراني مبتلا و غير مبتلا به PCOS انجام شد.روش بررسي: در اين مطالعه موردـ شاهدي، 52 خانم 35-20 ساله مراجعه‌کننده به درمانگاه‌هاي ناباروري و زنان بيمارستان وليعصر (عج) با معيارهاي تشخيصي PCOS (معيار رتردام) به عنوان گروه مورد و 104 خانم 35-20 ساله غير مبتلا به PCOS، فاقد بيماري کليوي و ديابت، به عنوان گروه کنترل وارد مطالعه شدند. براي اندازه‌گيري سطح هموسيستئين و برخي پارامترهاي متابوليکي و آندوکريني، نمونه خون ناشتا در روز دوم تا پنجم سيكل قاعدگي دريافت شد و ميزان هموسيستئين، انسولين، اسيد فوليك، تري گليسريد، كلسترول و انواع ليپوپروتئينها در دو گروه اندازه‌گيري شد. روش‌ آماري Shapiro-Wilks براي بررسي نرمال بودن توزيع متغير اصلي (هموسيستئين) و آزمون t براي مقايسه متغيرهاي کمي در دو گروه به کار رفت. همبستگي ساده نيز به منظور بررسي ارتباط هموسيستئين و ديگر متغيرهاي بيوشيميايي در هر کدام از دو گروه استفاده شد و براي حذف اثر مخدوش‌کنندگي BMI و سن، از همبستگي جزئي استفاده گرديد. همچنين از رگرسيون چندگانه پس از حذف مخدوش‌کننده‌ها، براي بررسي رابطه متغير لگاريتم طبيعي هموسيستئين و فولات استفاده شد. 05/0p< به عنوان سطح معني‌داري در نظر گرفته شد.نتايج: سطح سرمي انسولين و فولات در گروه PCOS (به ترتيب IU/ml45/762/16 و ng/ml37/448/7) به‌طور معني‌داري بالاتر از زنان گروه کنترل (به ترتيب IU/ml23/404/12 و ng/ml15/343/5) بود (001/0p<). سطح سرمي تري‌گليسيريد در گروه PCOS (mg/dl02/7362/116) به‌طور معني‌داري بالاتر از زنان سالم (mg/dl29/5000/88) بود (01/0p=). ميانگين هموسيستئين در گروه PCOS، mol/L553/4±21/12و در گروه زنان سالم mol/L307/4±68/13 به‌دست آمد كه اختلاف مذكور از نظر آماري معني‌داري نبود (057/0p=). در بررسي رگرسيون چندگانه، تغييرات لگاريتم نپرين هموسيستئين بيشتر تحت تأثير تغييرات فولات و FBS بود.نتيجه‌گيري: هموسيستئين در بيمارانPCOS با ميزان اسيد فوليک ارتباط مستقيم دارد؛ لذا با تجويز مناسب اسيد فوليک، مي‌توان در کاهش سطح هموسيستيئن و کنترل عوارض قلبي‌ـ عروقي منسوب به آن اقدام نمود. 2 Introduction: Patients with PCOS have risk factors for cardiovascular diseases, especially elevated lipoproteins, high blood pressure or hyperinsulinaemia. Clinical evidence shows that hyperhomocysteinaemia may contribute to the development of cardiovascular diseases in PCOS patients. In this study we compared serum homocysteine levels in PCOS patients with healthy Iranian women.Materials and Methods: This case-control study was performed on 52 individuals with PCOS (Rotterdam 2003 criteria). The cases were compared to 104 healthy non-PCOS, 20 to 35-year-old female subjects with no history of diabetes or renal diseases. The cases had referred to the Gynecology and Infertility Clinic of Vali-e-Asr Hospital in Tehran. Blood samples were taken on the 2nd to the 5th day of menstrual cycle for the evaluation of homocysteine levels, folic acid, triglyceride, insulin and some other metabolic and endocrine parameters.Results: Serum levels of insulin and folate were significantly higher in PCOS patients (16.62±7.45IU/ml and 7.48±4.37ng/ml) compared to the controls (12.04±4.23IU/ml and 5.43±3.15ng/ml), (p<0.001). Serum triglyceride concentrations were significantly higher in PCOS patients (116.62±73.02mg/dl) compared to the healthy subjects (88.00±50.29mg/dl), (p=0.01). The mean value for homocysteine (±SD) was 12.21 (±4.55) and 13.68 (±4.37)mol/L in PCOS and healthy women, respectively but no significant statistical differences were observed (p=0.057). Regression analyses depicted that homocysteine level was mostly under the influence of folate and FBS concentrations.Conclusion: There is an inverse correlation between homocysteine and serum folic acid levels in PCOS patients. Therefore, it seems that proper administration of folic acid can reduce homocysteine levels in patients with PCOS and help prevent the attributed cardiovascular risk factors associated with the disease. 334 342 Farnaz F Sohrabvand فرناز سهراب‌وند Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran fsohrabvand@yahoo.com Mahnaz M Lankarani مهناز لنکرانی Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences Iran Banafsheh B Golestan بنفشه گلستان Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Fedyeh F Haghollahi فدیه حق‌اللهی Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Leila L Asgarpoor لیلا عسگرپور Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Zohreh Z Badamchi زهره بادامچی زاده Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences Iran Masoomeh M Masoomi معصومه معصومی Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Ebrahim E Djavadi ابراهیم جوادی Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences Iran Female infertilityFolic acidHomocysteinePolycystic ovary syndrome 345.pdf Cattrall FR, Healy DL. Long-term metabolic, cardio-vascular and neoplastic risks with polycystic ovary syndrome Best Pract Res Clin Obstet Gynaecol. 2004; 18(5): 803-12.##Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syn-drome (PCOS). Hum Reprod. 2004; 19(1): 41-7.##Polson DW, Adams J, Wads Worth J, Franks S. Poly cystic ovaries-a common finding in normal woman. Lancet. 1988; 870-2.##Atamer A, Demir B, Bayhan G, Atamer Y, Ilhan N, Akku? Z. Serum levels of leptin and homocysteine in women with polycystic ovary syndrome and its rela-tionship to endocrine, clinical and metabolic param-eters. J Int Med Res. 2008; 36(1): 96-105.##Herrmann W. The importance of hyperhomocysteinemia as a risk factor for diseases: overview. Clin Chem Lab Med. 2001; 39(8): 666-74.##Hoque MM, Bulbul T, Mahal M, Islam NA, Ferdausi M. Serum homocysteine in pre-eclampsia and eclamp-sia. Bangladesh Med Res Counc Bull. 2008; 34(1): 16-20.##Vollset SE, Refsum H, Irgens LM, Emblem BM, Tverdal A, Gjessing HK, et al. Plasma total homo-cysteine, pregnancy complications, and adverse preg-nancy outcomes: the Hordaland Homocysteine study. Am J Clin Nutr. 2000; 71(4): 962-8.##Gillum R. Distribution of serum total homocysteine and its association with diabetes and cardiovascular risk factors of the insulin resistance syndrome in Mexican American men: the Third National Health and Nutri-tion Examination Survey. Nutr J. 2003; 5: 2(1): 6.##Wijeyaratne CN, Nirantharakumar K, Balen AH, Barth JH, Sheriff R, Belchetz PE. Plasma homocysteine in polycystic ovary syndrome: does it correlate with insu-lin resistance and ethnicity? Clin Endocrinol. 2004; 60(5): 560-7.##Refsum H. Folate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcome. Br J Nutr. 2001; 85 Suppl 2: 109-13.##Budde MP, De Lange TE, Dekker GA, Chan A, Nguyen AM. Risk factors for placental abruption in a socio-economically disadvantaged region. J Matern Fetal Neonatal Med. 2007; 20(9): 687-93.##Yilmaz N, Pektas M, Tonguc E, Kilic S, Gulerman C, Gungor T. The correlation of plasma homocysteine with insulin resistance in polycystic ovary syndrome. J Obstet Gynaecol Res. 2008; 34(3): 384-91.##Vrb?kov? J, Tallov? J, Bicikov? M, Dvor?kov? K, Hill M, St?rka L. Plasma thiols and androgen levels in Poly Cystic ovary syndrome. Clin Chem Lab Med. 2003; 41(2): 216-21.##Oktem M, Ebru Ozcimen E, Uckuyu A, Esinler I, Pamuk B, Bayraktar N, et al. Polycystic ovary syn-drome is associated with elevated plasma soluble CD40 ligand, a marker of coronary artery disease. Fertil Steril. 2008; [Epub ahead of print].##Kazerooni T, Asadi N, Dehbashi S, Zolghadri J. Effect of folic acid in women with and without insulin resist-ance who have hyperhomocysteinemic polycystic ovary syndrome. Int J Gynaecol Obstet. 2008; 101(2): 156-60.##De la Calle M, Gallardo T, Diestro MD, Hernanz A, Pérez E, Fern?ndez-Miranda C. [Increased homocysteine levels in polycystic ovary syndrome. Med Clin] (Barc). 2007; 129(8): 292-4. Spanish.##Guzelmeric K, Alkan N, Pirimoglu M, Unal O, Turan C. Chronic inflammation and elevated homocysteine levels are associated with increased body mass index in women with Polycystic ovary syndrome. Gynecol Endocrinol. 200; 23(9): 505-10.##Yilmaz M, Biri A, Bukan N, Karakoç A, Sancak B, T?rüner F, Pa?ao?lu H. Levels of lipoprotein and homocysteine in non-obese and obese patients with polycystic ovary syndrome. Gynecol Endocrinol. 2005; 20(5): 258-63.##Loverro G, Lorusso F, Mei L, Depalo R, Cormio G, Selvaggi L. The plasma homocysteine levels are in-creased in polycystic ovary syndrome. Gynecol Obstet Invest. 2002; 53(3): 157-162.##Badawy A, State O, El Gawad SSh, El Aziz OA. Plasma homocysteine and polycystic ovary syndrome: the missed link. Eur J Obstet Gynecol Reprod Biol. 2007; 131(1): 68-72.##Morgante G, La Marca A, Setacci F, Setacci C, Petraglia F, De Leo V. The cardiovascular risk factor homocysteine is not elevated in young women with hyperandrogenism or hypoestrogenism. Gynecol Obstet Invest. 2002; 53(4): 200.##Mancini F, Cianciosi A, Reggiani GM, Facchinetti F, Battaglia C, de Aloysio D. Endothelial function and its relationship to leptin, homocysteine, and insulin resist-ance in lean and overweight eumenorrheic women and PCOS patients: a pilot study. Fertil Steril. 2008; 5. Epub ahead of print.##

بررسي عادت استعمال دخانيات در زوج‌هاي نابارور در تهران Prevalence of Tobacco Smoking among Infertile Couples in Tehran 2 1 زمينه و هدف: سيگار يكي از مهمترين عوامل آسيب‌رسان به سلامت عمومي است كه با مكانيسم‌هاي متعددي سبب انواع بيماريها از جمله اختلال در توليدمثل و كاهش باروري مي‌گردد؛ لذا به منظور بررسي اثر دخانيات در باروري و روش‌هاي درمان ناباروري، اولين اقدام بررسي وضعيت استعمال دخانيات در جامعه مورد نظر است. مطالعه حاضر با هدف بررسي چگونگي وضعيت استعمال دخانيات در افراد نابارور مراجعه‌كننده به مركز فوق تخصصي درمان ناباروري و سقط مكرر ابن‌سينا انجام شد.روش بررسي: اين مطالعه به‌صورت مقطعي روي 342 زوج با شكايت ناباروري، مراجعه‌كننده به مركز فوق تخصصي درمان ناباروري و سقط مكرر ابن‌سينا تهران، انجام شد. توسط پرسشنامه اقتباس شده از پرسشنامه WHO با عنوان IUATLD، مشتمل بر سئوالاتي در مورد اطلاعات دموگرافيك، وضعيت استعمال دخانيات و ميزان وابستگي به نيكوتين (بر حسب تست فاگرشتروم با نمره بندي 1 تا 10) بررسي انجام شد. اطلاعات حاصل با آزمونt و 2 مورد ارزيابي قرار گرفت. 05/0p< به عنوان سطح معني‌داري در نظر گرفته شد.نتايج: از 342 زوج مورد بررسي، 264 نفر (6/38%) تجربه مصرف دخانيات داشتند (6/12% خانمها و 4/59% آقايان). متوسط سن شروع مصرف در اين افراد 8/5±1/20 سالگي بود. ميزان شيوع مصرف مردان بيش از زنان بود (01/0p<). از كل نمونه‌هاي مورد بررسي 141 نفر (6/20%) سيگاري بودند كه به ترتيب 12 نفر خانم (5/3%) و 129 نفر آقا (7/37%) را شامل مي‌شد كه شيوع سيگاري بودن در مردان بيشتر از زنان بود (01/0p<). از اين افراد، 70 نفر (2/10%) بطور روزانه و 29 نفر (2/4%) گهگاه سيگار مي‌كشيدند و 42 نفر (1/6%) سيگار خود را ترك كرده بودند. در اين مطالعه نمره ميزان وابستگي به نيكوتين براساس تست فاگرشتروم در گروه سيگاري 8/2±9/2 به‌دست آمد و مشخص شد كه در بين افرادي كه هنوز سيگار خود را ترك نكرده‌اند، 1/16% داراي وابستگي زياد، 3/18% داراي وابستگي متوسط و 6/65% داراي وابستگي كم بودند.نتيجه‌گيري: با وجود شيوع 5/12% مصرف دخانيات در جامعه ايراني، تفاوت معني‌داري در شيوع مصرف دخانيات در جامعه مورد مطالعه نسبت به جامعه عادي مشاهده نشد. البته اين امر قابل توجه بود كه علي‌رغم خطرات بالقوه مصرف دخانيات بر باروري، هنوز 4/14% از نمونه‌هاي مورد بررسي به مصرف دخانيات ادامه مي‌دادند. از آنجاييكه سيگار مي‌تواند به عنوان يك عامل خطر ايجادكننده ناباروري و كاهش دهنده احتمال موفقيت درمان ناباروري مطرح باشد بررسي‌هاي تكميلي بيشتري مورد نياز است. 2 Introduction: Cigarette smoking is a major public health hazard which may cause different diseases such as fertility disorders through numerous mechanisms. Smoking decreases sperm quality and its fertilizing capacity; it prevents growth of ovarian follicles and decreases female fertility. The objective of this study was to determine the prevalence of smoking in infertile couples referring to Avicenna Infertility Clinic.Materials and Methods: This cross-sectional study included 342 infertile couples referring to Avicenna Infertility Clinic during 2000-2008. The data were collected via interviews using WHO Fagerström test for nicotine dependence and questionnaires by the International Union against Tuberculosis and Lung Disease (IUATLD).Results: Out of 684 cases, 246 (36%) had cigarette smoking experiences, with more prevalence among men than women (59.4% of men vs. 12.6% of women), (p<0.01). The mean age for smoking initiation was 20.1±5.8 years. Totally, 141 subjects (20.6%) were cigarette smokers, with a significant prevalence among male subjects (37.7% of men vs. 3.5% of women), (p<0.01). The mean value for nicotine dependency (Fagerström test) among the smokers was 2.9±2.8; with high, average and low nicotine dependencies, 16.1%, 18.3% and 65.6% respectively.Conclusion: The prevalence of cigarette smoking among infertile couples in Tehran was about 14.4%; quite similar to that of the prevalence among the Iranian general population (12.5%). 342 350 Mahshid M Aryanpur مهشید آریانپور Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Iran Gholamreza Gh Heydari غلامرضا حیدری Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Iran Madjid M Tarahomi مجید ترحمی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran tarahomi@avicenna.ac.ir Mohammad Mehdi MM Akhondi محمدمهدی آخوندی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Hojjat H Zeraati حجت زراعتی Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Mohammad Reza MR Masjedi محمدرضا مسجدی Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Iran Cigarette smokingCurrent smokerInfertilityNicotine dependenceOccasional smokerQuit smokingTobacco 346.pdf Heydari GhR, Masjedi MR. [Smoke cessation guide-line, you con do it]. 1th rev. ed. Tehran: NRITLD; 2007. 12 p. Persian.##Berthiller J, Sasco AJ. [Smoking (active or passive) in relation to fertility, medically assisted procreation and pregnancy]. J Gynecol Obstet Biol Reprod. 2005; 34 Spec No 1: 3S47-54. Review. French.##Peate I. The effects of smoking on the reproductive health of men. Br J Nurs. 2005; 14(7): 362-6. Review.##Bordel R, Laschke MW, Menger MD, Vollmar B. Nicotine does not affect vascularization but inhibits growth of freely transplanted ovarian follicles by inducing granulosa cell apoptosis. Hum Reprod. 2006; 21(3): 610-7.##Talbot P, Riveles K. Smoking and reproduction: the oviduct as a target of cigarette smoke. Reprod Biol Endocrinol. 2005; 3: 52. Review.##Sajdak S, Witczak K, Sroka L, Samulak D. [Smoking and female reproductive health]. Przegl Lek. 2005; 62(10): 1154-8. Review. Polish.##Azimi Gh, Baseri M, Faghih Zadeh S. A comparetive study of the sexual life of COPD patient to healthy individuals and investigation of associated and partici-pating factors in patients impotency. Daneshvar Medi-cine. 2006; 14(66): 53-8.##Mohammad K, Zali MR, Masjedi MR, MAajd zadeh SR. [Cigarette smoking in Iran; based on national health survey]. J Med Council I.C.T. 1989; 16(1): 33-7. Persian.##Nori M, Adili F, Pour Ebrahim R, Heshmat R, Fakhade H. [Evolution of smoking pattern and its association with cardiovascular diseases]. Iran J Diabet Lipid Disord. 2003; 3(1): 91-7. Persian.##Aghamolaei T, Zare S. [Cigarette and hookah using pattern in over 15th population of Bandar abass, a popu-lation based study]. Hormozgan Med J. 2006; 11(4): 241-6. Persian.##Emami H, Habibian S, Salehi P, Azizi F. [Pattern and smoking habit in an urban area in Tehran]. J Faculty of Medicine, Shaheed Beheshti University of Medical Sciences and Health Services. 2001; 27(1): 47-52. Persian.##Wong WY, Thomas CM, Merkus HM, Zielhuis GA, Doesburg WH, Steegers-Theunissen RP. Cigarette smoking and the risk of male factor subfertility: minor association between cotinine in seminal plasma and semen morphology. Fertil Steril. 2000; 74(5): 930-5.##Saleh RA, Agarwal A, Sharma RK, Nelson DR, Thomas AJ. Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study. Fertil Steril. 2002; 78(3): 491-9.##Zavos PM. Cigarette Smoking: male and female infertility. Fertil Contracept Sex. 1989; 17(2): 133-8.##Wright KP, Trimarchi JR, Allsworth J, Keefe D. The effect of female tobacco smoking on IVF outcomes. Hum Reprod. 2006; 21(11): 2930-4.##Sills ES, Qublan HS, Blumenfeld Z, Dizaj AV, Revel A, Coskun S, et al. Regional clinical practice patterns in reproductive endocrinology: A collaborative trans-national pilot survey of in vitro fertilization programs in the Middle East. J Exp Clin Assist Reprod. 2007;4:3.##

شيوع اختلالات روانپزشکي و تيپ‌هاي شخصيتي در زنان بارور و نابارور Prevalence of Psychiatric Disorders and Types of Personality in Fertile and Infertile Women 2 1 زمينه و هدف: ناباروري يکي از مهمترين بحران‌هاي دوران زندگي است که منجر به مشکلات رواني و تجربيات استرس‌زاي هيجاني مي‌شود. تشخيص ارتباط اين پديده و عوامل فوق، تأثيري عميق در بهبود کيفيت زندگي و سلامت روان خواهد داشت؛ لذا هدف از اين پژوهش، بررسي فراواني اختلالات روانپزشکي و تیپ‌های شخصيتي در زنان نابارور و بارور مراجعه كننده به مرکز تحقيقات بهداشت باروري وليعصر (عج) بود. روش بررسي: 150 زن نابارور در درمانگاه ناباروري مرکز تحقيقات بهداشت باروري وليعصر (عج) و150 زن بارور در درمانگاه زنان بيمارستان امام خميني (ره) با روش نمونه‌گيري ساده (در دسترس)، انتخاب و اطلاعات لازم بوسيله پرسش‌نامه‌هاي SCL-90-R و آيزنک (EPQ) از نظر وضعيت ابتلا به اختلالات روانپزشکي و تيپ‌هاي شخصيتي و همچنين پرسشنامه محقق ساخته به منظور تعيين عوامل زمينه‌ساز اين اختلالات، گردآوري گرديد. در اين پژوهش از آزمون‌هاي من‌ويتني، 2 و رگرسيون لجستيک به‌منظور تجزيه و تحليل داده‌ها استفاده و 05/0p< به عنوان سطح معني‌داري در نظر گرفته شد. نتايج: براساس نتايج اين بررسي 44% زنان نابارور و 7/28% زنان بارور، مبتلا به اختلالات رواني بودند. بالاترين ميانگين نمرات زنان نابارور در آزمون SCL-90-Rدر مقياس‌هاي افکار پارانوئيدي، افسردگي، حساسيت در روابط بين فردي و کمترين آنها در مقياس‌هاي روان‌پريشي و ترس مرضي بود. زنان نابارور در مقياس‌هاي حساسيت در روابط بين فردي، افسردگي، ترس مرضي، افکار پارانوئيدي و روان‌پريشي با زنان بارور تفاوت معني‌داري داشتند (05/0p<). همچنين نتايج نشان داد که زنان نابارور از لحاظ شخصيتي بر اساس آزمون آيزنک، نااستوارتر از زنان بارور هستند و اين اختلافات از لحاظ آماري معني‌دار بود (001/0p<). نتيجه‌گيري: با توجه به شيوع اختلالات رواني در زنان نابارور، نياز به توجه جدي متخصصين در زمينه درمان‌هاي رواني اين گروه از بيماران مي‌باشد و استفاده از درمان‌هاي روانشناسي خصوصاً روان‌درماني حمايتي بايد در چارچوب درمان‌هاي ناباروري مورد توجه قرار گيرد. 2 Introduction: It is estimated that about 22% of couples suffer from infertility worldwide, which is believed to be one of the most important life crises resulting in psychological problems and emotional stresses. This study examines the prevalence of psychiatric disorders and types of personality in fertile and infertile women referring to Vali-e-Asr Reproductive Health Research Center.Materials and Methods: In this cross-sectional study, 150 infertile women from Vali-e-Asr Infertility Clinic and 150 fertile women from Imam Khomeini Hospitals Gynecologic Clinic were selected. Research tools included Symptom Checklist-90-Revised (SCL-90-R), Eysenck Personality Questionnaire (EPQ) and a structured researcher-devised questionnaire.Results: Noticeably, 44% of the infertile and 28.7% of fertile women were suffering from psychiatric disorders. The highest scores among infertile women upon SCL-90-R assessment were for paranoid ideation and depression, interpersonal sensitivity and the lowest scores were for psychoticism and phobic anxiety. Interpersonal sensitivity, depression, phobic anxiety, paranoid ideation and psychoticism scales were significantly more prevalent in infertile than fertile women (p<0.05). Additionally, emotionally unstable personality disorder was more prevalent among infertile than fertile women, based on Eysenck Personality Questionnaire (p<0.001).Conclusion: The higher prevalence of psychiatric disorders in infertile women demands serious psychological support and attention by the medical team. Developing a rapid and reliable screening instrument for identifying patients at greater need for psychological support and the inclusion of counseling and supportive psychotherapy in the general therapeutic framework of infertility are of great importance. 350 361 Ahmad-Ali AA Noorbala احمدعلی نوربالا Psychiatric and Psychology Research Centers, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences Psychiatric and Psychology Research Centers, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences Iran Fatemeh F Ramezanzadeh فاطمه رمضان زاده Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Nasrin N Abedi-Nia نسرین عابدی نیا Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran abedinia_nasrin@yahoo.com Mohammad Mehdi MM Naghizadeh محمدمهدی نقی زاده Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Fedyeh F Haghollahi فدیه حق‌اللهی Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Demographic CharacteristicsEysenck Personality QuestionnaireFertilityInfertilityPersonality typesPsychiatric disordersSCL-90-RStress 347.pdf Freeman EW, Rickels K, Tausig J, Boxer A, Mast-roianni L Jr, Tureck RW. Emotional and psychosocial factors in follow-up of women after IVF-ET treatment. A pilot investigation. Acta Obstet Gynecol Scand. 1987; 66(6): 517-21.##Mahlstedt PP, Macduff S, Bernstein J. Emotional fac-tors and the in vitro fertilization and embryo transfer process. J In Vitro Fert Embryo Transf. 1987; 4(4): 232-6.##Menning BF. The infertile couple: a plea for advocacy. Child Welfare. 1975; 54(4): 454-60.##Pfeffer N, Woollett A. The experience of infertility. 2nd rev. ed. London: Vixago press; 1983. 127 p.##Keye WR. Psychosexual responses to infertility. Clin Obstet Gynecol. 1984; 27(4): 760-6.##Golombok S. Pyschological functioning in infertility patients. Hum Reprod. 1992; 7(3): 208-12.##Merari D, Feldberg D, Elizur A, Goldman J, Modan B. Psychological and hormonal changes in the course of in vitro fertilization. J Assist Reprod Genet. 1992; 9(2): 161-9.##Domar AD, Broome A, Zuttermeister PC, Seibel M, Friedman R. 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بررسی ابعاد مشاوره برای مادر جانشين قبل از اقدام به اهدای رحم جايگزين The Need for Counseling Surrogate Mothers before Practicing Surrogacy 2 1 زمينه و هدف: استفاده از رحم جايگزين، که در آن يک زن (مادر جانشين) برای يک زوج، جنينی را حمل می‌کند و به مجرد تولد، نوزاد را به زوج می‌دهد، يکی از درمان‌های کمکی در ناباروری است. اين روش در سال‌های اخير در ايران در بين زوجين نابارور رايج شده است. اين زنان در صورتی که بدون آگاهی‌های لازم اقدام به اين کار نمايند، ممکن است در طول بارداری و پس از زايمان و يا به هنگام تحويل جنين به زوج درخواست‌کننده، دچار مشکلات رفتاری‌ـ روانی شوند كه تأثيرات نامطلوبی بر زندگی آنان و زوج صاحب فرزند بگذارد. هدف از اين مطالعه، شناسايي خطرات احتمالی و مواردی است که ممکن است برای مادران جانشين مشکل‌ساز شده و يا ايجاد نگراني كنند تا قبل از اقدام به اهدای رحم جايگزين، اين نکات طی جلسات مشاوره برای آنها توضيح داده شود.روش بررسی: اين مقاله براساس مروری بر مطالعات صورت گرفته طی سال‌های 1987 تا 2008 نگاشته شده و در زمينه‌های فرهنگی و حقوقی، به منابع و مطالعات داخل کشور نيز توجه شده است. در اين نوشتار ابتدا مطالعات انجام شده روی مادران جانشين، مرور می‌شود و سپس نکات حائز اهميت در مشاوره با اين زنان بيان می‌گردد.نتايج: براساس نتايج اين مطالعه در مراکز درمان ناباروری، پزشک يا مشاور بايد در اولين مشاوره، به مسائل اخلاقی و قانونی استفاده از رحم جايگزين، همچنين به خطرات پزشکی و مزايای همه جانبه اين عمل، اشاره داشته باشد. ارجاع برای مشاوره بهداشت روانی بايد امکان‌پذير باشد و قبل از اقدام به بارداری صورت گيرد؛ بدين ترتيب به مادر جانشين امکان داده مي‌شود دامنه نتايج و اثرات طولانی مدت اين عمل را بررسی نمايد و نيز خطرات روانشناختی و آسيب‌پذيری خودش و همچنين اثرات احتمالی بارداری بر روابط اجتماعی‌اش را بررسی کند. مادر جانشين بالقوه بايد اهميت داشتن توافقنامه کتبی مشتمل بر شرايط، پيش شرطها و حوادث احتمالی را درک کند. آگاهی مادر جانشين از روند درمان و پيامدهای آن، از نکات مهمی است که بايد در مشاوره به آن توجه شود.نتيجه‌گيری: مطالعات انجام شده نشان می‌دهد که انجام مشاوره دقيق و آگاه ساختن زنان داوطلب رحم جايگزين از مسيری که پيش‌رو دارند، می‌تواند به آنها کمک کند تا اين دوران را به صورت يک تجربه مثبت و همراه با حس کمک و نوع دوستی نسبت به زوج درخواست کننده پشت سر بگذارند؛ لذا بايد در مراکز باروری و ناباروری، يک تيم مشاور متشكل از متخصصان مختلف تشکيل شود که بتوانند تمامی ابعاد مشاوره برای رحم جايگزين اعم از پزشکی، روان‌شناختی، فقهی، حقوقی و اجتماعی را برای زوج درخواست کننده و همچنين مادران جانشين به تفکيک ارائه دهند. 2 Introduction: Practicing surrogacy without proper consultations with the two concerned parties, may poses surrogate mothers to psychological and behavioral problems during pregnancy, delivery, and postpartum. This study aims to underline possible risks and problems faced by surrogate mothers and it tries to take care of them by persuading to hold decent preliminary consultations.Materials and Methods: This paper reviews the published literatures during 1987 - 2008, and it covers domestic resources as well as foreign ones and focuses mainly on legal and cultural issues surrounding surrogacy and surrogate motherhood. Results: The reviews showed that the physicians or the counselors should explain the ethical and legal issues and medical risks related to surrogacy, as well as disclose benefits from this act to both parties during counseling sessions. Possible referral of both parties for mental health consultation must be available before surrogacy process is started. The potential surrogate mothers should understand the importance of a written agreement consisting of terms, preconditions and possible future incidents.Conclusion: It seems that consultation and clarification of probable contingencies faced during the surrogacy process greatly help surrogate mothers experience the period with an altruistic feeling to help the intended couples. Organizing a consulting team composed of clinicians and health experts with various expertise is recommended to cover all dimensions of surrogacy including its medical, psychological, religious, legal, and social aspects. 361 373 Monir M Pashmi منیر پشمی Department of Social Sciences, Faculty of Literature and Humanities, Isfahan University Department of Social Sciences, Faculty of Literature and Humanities, Isfahan University Iran monirpashmi@Gmail.com Seyed Ahmad SA Ahmadi سید احمد احمدی Department of Counseling, Faculty of Psychology, Isfahan University Department of Counseling, Faculty of Psychology, Isfahan University Iran Seyed Mohammad Sadegh SM Tabatabaie سید محمدصادق طباطبایی Department of Law, Faculty of Administrative Science and Economics, Isfahan University Department of Law, Faculty of Administrative Science and Economics, Isfahan University Iran Conventional surrogacyGestational surrogacyInfertile coupleLegal counselingMedical counselingMental counselingSurrogacySurrogate Mother 348.pdf Brinsden PR, editor. Gestational surrogacy. Taylor & Francis; 2004. 703 p. (Gardner DK, Weissman A, Howles CM, Shoham Z, editors. Textbook of Assisted Reproductive Techniques; vol. 59).##Sullivan L. Surrogacy: the case for a conventional approach. Med Law. 1991; 10(4): 401-15.##Golombok S, Murray C, Jadva V, Lycett E, MacCallum F, Rust J. Non-genetic and non-gestational parenthood: consequences for parent-child relationships and the psychological well-being of mothers, fathers and child-ren at age 3. Hum Reprod. 2006; 21(7): 1918-24.##Raziel A, Schachter M, Strassburger D, Komarovsky D, Ron-El R, Friedler S. Eight years experience with an IVF surrogate gestational pregnancy programme. Reprod Biomed Online. 2005; 11(2): 254-8.##Carp HJ, Dirnfeld M, Dor J, Grudzinskas JG. ART in recurrent miscarriage: preimplantation genetic diagno-sis/screening or surrogacy? Hum Reprod. 2004; 19(7): 1502-5.##Brinsden PR. Gestational surrogacy. Hum Reprod Update. 2003; 9(5): 483-91.##British Medical Association. Changing Conceptions of Motherhood: The Practice of Surrogacy in Britain. London: British Medical Association; 1996. 75 p.##Committee on Ethics. ACOG committee opinion num-ber 397, February 2008: surrogate motherhood. Obstet Gynecol. 2008; 111(2 Pt 1): 465-70.##van den Akker OB. Psychosocial aspects of surrogate motherhood. Hum Reprod Update. 2007; 13(1): 53-62.##Garmaroudy Sh. [Gestational Surrogacy in Iran]. J Reprod Infertil. 2008; 9(1): 50-64.persian.##Blyth E. Not a primrose path: commissioning parents experiences of surrogacy arrangements in Britain. J Reprod Infant Psycho. 1995; 13(3/4): 185-96.##Council on Ethical and Judicial Affairs, American Medical Association. Guidelines for the appropriate use of do-not-resuscitate orders. JAMA. 1991; 265(14): 1868-71.##MacPhee D, Forest K. Surrogacy: programme com-parisons and policy implications. Int J Law Fam. 1990; 4(3): 308-17.##Jadva V, Murray C, Lycett E, MacCallum F, Golombok S. Surrogacy: the experiences of surrogate mothers. Hum Reprod. 2003; 18(10): 2196-204.##Rezania Moallem MR. [Forensic pregbubcies in ac-cord with law and Islamic jurisprudence]. 1st ed. Qom: Islamic Development Organization. 2005: 321p. Persian.##Brazier M, Golombok S, Campbell A. Surrogacy: re-view for the UK Health Ministers of current arrange-ments for payments and regulation. Hum Reprod Update. 1997; 3(6): 623-8.##MacCallum F, Lycett E, Murray C, Jadva V, Golombok S. Surrogacy: the experience of commis-sioning couples. Hum Reprod. 2003; 18(6): 1334-42.##Ragone H. Surrogate Motherhood: Conception in the heart. 1st ed. Oxford: Westview press; 1994. 215 p.##Seif S, Kadivar P, Koromi Nouri R, Lotfabadi H. [Developmental psychology]. 11th ed. Tehran: Samt; 2002. 206 p. Persian.##Moody-Adams MM. On surrogacy: morality, markets, and motherhood. Public Aff Q. 1991; 5(2): 175-90.##Blyth E. I wanted to be interesting. I wanted to be able to say i ve done something interesting with my life: Interviews with surrogate mothers in britain. J Reprod Infant Psychol. 1994; 12(3): 189-98.##Reilly DR. Surrogate pregnancy: a guide for Canadian prenatal health care providers. CMAJ. 2007; 176(4): 483-5. Review.##Harrison M. Financial incentives for surrogacy. Womens Health Issues. 1991; 1(3): 145-7.##Van den Akker OB. Genetic and gestational surrogate mothers, experience of surrogacy. J Repord Infant Psychol. 2003; 21(2): 145-61.##Hanafin H. Surrogate parenting: reassessing human bonding. American sychological Association Conven-tion. NewYork; 1987.##Baslington H. Anxiety overflow : Implications of the IVF surrogacy case and the ethical and moral limits of reproductive technologies in Britain. Womens Stud Int Forum. 1996; 19(6): 675-84.##van den Akker OB. Psychosocial, moral and ethical issues involved in donor, surrogacy and adoption triads: A graded evaluation. London: Human fertil-ization and Embryology Association; 2002.##van den Akker OB. Psychological trait and state char-acteristics, social support and attitudes to the surrogate pregnancy and baby. Hum Reprod. 2007; 22(8): 2287-95.##Shenfield F, Pennings G, Cohen J, Devroey P, de Wert G, Tarlatzis B. ESHRE Task Force on Ethics and Law 10: surrogacy. Hum Reprod. 2005; 20(10): 2705-7.##

گزارش يک مورد نادر هيسترکتومي به‌دليل جفت اينکرتا در سه ماهه اول بارداري Hysterectomy due to Placenta Increta in the First Trimester of Pregnancy; A Case Report 2 1 زمينه و هدف: جفت اينکرتا عارضه‌اي ناشايع و تهديدکننده حيات مادر در دوران بارداري است. اين عارضه معمولاً به‌صورت خونريزي واژينال به دنبال خارج کردن مشکل جفت در سه ماهه سوم تظاهر مي‌يابد. با وجود اين، جفت اينکرتا ممکن است باعث ايجاد عوارضي مانند سقط‌هاي سه ماهه اول و دوم گردد که تشخيص آن مشکل مي‌باشد. هدف از ارائه اين گزارش، معرفي يک مورد نادر هيسترکتومي به‌دليل جفت اينکرتا در سه ماهه اول بارداري مي‌باشد.معرفي مورد: بيمار خانمي 34 ساله بود که 18 روز پس از کورتاژ به‌دليل سقط ناقص، با خونريزي شديد واژينال در بارداري چهارم به بيمارستان مراجعه کرد. نامبرده سابقه 2 مورد سزارين قبلي داشت. به علت خونريزي شديد با تشخيص احتمالي تخليه ناکامل رحم، مجدداً تحت عمل کورتاژ قرارگرفت که به علت خونريزي غيرقابل کنترل حين عمل براي وي هيسترکتومي انجام شد. در بررسي آسيب‌شناسي، جفت اينكرتا در سگمنت تحتاني رحم گزارش گرديد.نتيجه‌گيري: در زنان با سابقه سزارين قبلي، احتمال جايگزيني غيرطبيعي جفت وجود دارد که حتي در سه ماهه اول بارداري نيز ممکن است دچار خونريزي غير قابل كنترل گردد كه بدليل ماهيت غير طبيعي جفت، ممكن است حتي نياز به هيستركتومي اورژانس ايجاد شود. 2 Introduction: Placenta increta is an uncommon and life-threatening pregnancy complication. This disorder usually is presented with vaginal bleeding during difficult placental removal in the third trimester of pregnancy. However, the disorder may cause some other complications such as abortion at the first or second trimesters of pregnancy too, which make its diagnosis more difficult. This report discusses a case of hysterectomy due to placenta increta at the first trimester of pregnancy. Case Presentation: A 34-years old woman was admitted to Imam Reza Hospital in Mashad, with a history of severe vaginal bleeding. Evacuation curettage had been done due to incomplete abortion at her first admission in another hospital 18 days ago. She had a history of two previous cesarean sections too. Curettage was done to control the severe hemorrhage with a probable diagnosis of incomplete uterine evacuation. Since hemorrhage was not controllable, the patient was consulted for hysterectomy. Afterwards, the pathology report confined the diagnosis, reading “Lower uterine segment with placenta increta”.Conclusion: Women with a history of previous caesarean sections are at risk for abnormal placentation. The condition is prone to complications such as uncontrollable vaginal bleeding in the first trimester which might necessitate immediate hysterectomy because of the complications due to abnormal nature of placenta increta. 373 378 Sedigheh Ayaty صدیقه آیتی Department of Obs. &amp; Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services Department of Obs. & Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services Iran Sara S Mirzaeean سارا میرزائیان Department of Obs. &amp; Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services Department of Obs. & Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services Iran Fatemeh F Vahidrodsari فاطمه وحید رودسری Department of Obs. &amp; Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services Department of Obs. & Gyn., Ghaem Hospital, Faculty of Medicine, Mashad University of Medical Sciences and Health Services Iran Nayereh N Ghomian نیره قمیان Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashad University of Medical Sciences Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashad University of Medical Sciences Iran Nozzhat N Mousavifar نزهت موسوی فر Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashad University of Medical Sciences Department of Obstetrics and Gynecology, Imam Reza Hospital, Faculty of Medicine, Mashad University of Medical Sciences Iran Cesarean deliveryCurettageHysterectomyIncomplete abortionPlacenta incretaPregnancyUterine hemorrhage 349.pdf Berchuck A, Sokol RJ. Previous cesarean section, pla-centa increta, and uterine rupture in second trimester abortion. Am J Obstet Gynecol. 1983; 145(6): 766-7.##Ju W, Kim SC. Placenta increta after first-trimester dilatation and curettage manifesting as an unusual uterine mass: magnetic resonance findings. Acta Radiol. 2007; 48(8): 938-40.##Lapresta Moros M, Conte Mart?n P, Pérez Pérez P, Az?a Romeo J, Oro Fraile J, Lapresta Ferr?ndez C. Post abortal haemorrhage and disseminated intravascu-lar coagulation due to placenta accrete. Arch Gynecol Obstet. 2003; 268(4): 329-30.##Hung TH, Shau WY, Hsieh CC, Chiu TH, Hsu JJ, Hsieh TT. Risk factors for placenta accreta. Obstet Gynecol. 1999; 93(4): 545-50.##Lam G, Kuller J, McMahon M. Use of magnetic reson-ance imaging and ultrasound in the antenatal diagnosis of placenta accreta. J Soc Gynecol Investig. 2002; 9(1): 37-40.##Twickler DM, Lucas MJ, Balis AB, Santos-Ramos R, Martin L, Malone S, et al. 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بررسی فراوانی نایسریا گنوره در زنان نابارور و بارور تهراني Prevalence of Neisseria gonorrhea in Fertile and Infertile Women in Tehran 2 1 زمینه و هدف: عفونت نایسریا گنوره یکی از شایع‌ترین عفونت‌های باکتریایی در کشورهای در حال توسعه می‌باشد و اطلاعات محدودی در مورد فراوانی عفونت گنوره در زنان بارور و نابارور ایران، بالاخص وجود دارد؛ لذا مطالعه‌ای با هدف تعیین فراوانی عفونت‌ گنوره در زنان نابارور و بارور تهراني انجام شد.روش بررسی: در اين مطالعه مقطعي، 209 زن نابارور به عنوان گروه مورد و 170 زن باردار در سه ماهه سوم بارداري به‌عنوان گروه كنترل انتخاب شدند که توسط پرسشگران آموزش دیده، فرم جمع‌آوري اطلاعات طي مصاحبه‌ با اين افراد كامل و بخش اول نمونه ادرار (ml15) ايشان براي تشخيص وجود باكتري نايسريا گنوره به روش PCR جمع‌آوري شد. اطلاعات پرسشنامه همراه با نتایج حاصل از آزمون در دو گروه به روش PCR مورد تحليل آماري قرار گرفت.نتایج: در ارزيابي نتايج مولكولي تشخيص باكتري در هر دو گروه، موردی از عفونت به گنوره مشاهده نشد و به دلیل عدم وجود موارد مثبت در دو گروه مورد مطالعه، آزمون‌های تکمیلی و تحلیلی روابط مقدور نبود.نتیجه‌گیری: براساس نتایج این تحقیق، عدم يافتن هیچ مورد مثبتي از عفونت گنوره در جمعيت زنان بارور و نابارور، ممكن است بیانگر موفقیت احتمالي برنامه‌های پیشگیری و درمانی در ایران از نظر این عفونت باشد. 2 Introduction: Gonococcal infection is one of the most common bacterial infections, especially in developing countries, but limited information is available about its prevalence in fertile and infertile women in Iran. Therefore, this study was set up to determine the prevalence of the disease in the aforementioned populations in Tehran.Materials and Methods: In this cross-sectional study, 209 infertile women as the cases, and 170 pregnant women in the third trimester of pregnancy as the controls, were evaluated for signs and symptoms of gonococcal infection through interviews. A first-catch urine sample (15ml) was collected from each subject for the detection of Neisseria gonorrhea by PCR method. The data from questionnaires and molecular evaluation were statistically analyzed.Results: PCR testing on urine specimens of fertile and infertile women showed no Neisseria gonorrhea infections.Conclusion: Absence of Neisseria gonorrhea infection in infertile and pregnant women in Tehran could signify the success of health initiatives and preventive measures taken in Iran. 379 384 Batool B Hossein Rashidi بتول حسین رشیدی Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran bhrashidi@sina.tums.ac.ir Leili L Chamani Tabriz لیلی چمنی تبریز Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Fedyeh F Haghollahi فدیه حق‌اللهی Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Mahmood M Jeddi-Tehrani محمود جدی‌تهرانی Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR) Iran Fatemeh F Ramezanzadeh فاطمه رمضان زاده Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Vali-e- Asar Reproductive Health Research Center,Tehran Medical Sciences University Iran Abbas A Rahimi Foroushani عباس رحیمی فروشانی Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Mamak M Shariat مامک شریعت Maternal-Fetal-Neonatal Health Research Center, Tehran University of Medical Sciences Maternal-Fetal-Neonatal Health Research Center, Tehran University of Medical Sciences Iran Mohammad Mehdi MM Akhondi محمدمهدی آخوندی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Faezeh F Daneshjoo فائزه دانشجو Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran InfertilityNeisseria gonorrheaPolymerase chain reactionPregnancy 351.pdf Centers for Disease Control and Prevention (CDC), Workowski KA, Berman SM. 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