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Pubmed/PMC as the First Line Resource in Biomedicine Field 2 1 579 2 Journal of Reproduction and Infertility (JRI) was indexed in Pubmed and Pubmed Central (PMC). This is good news for all authors, reviewers, physicians and researchers that are related to JRI. Launched in Febru-ary 2000, PMC is a free archive of biomedical and life sciences containing peer reviewed journals. It pro-vides free access to full papers of all contents for scientists, physicians, researchers, and students. Recently, about 3 million articles have been archived in PMC. PMC content is provided in part by 1290 full contribu-tion journals, 265 NIH supported journals and 2253 evaluated and selected worldwide journals. PMC acts as a digital counterpart to NLM hard copy journal collection; it is a repository for journal literature consisting of indexed journals (1). <br>According to criteria stated above, PubMed/PMC remains an important and the first line resource for clinicians and researchers. PubMed/PMC is a very handy, quick, easy to use and popular resource for data in biomedical field. In fact, indexing of journals in prestigious scholarly databases is a way for more visibility of the articles and consequently quality estimation of the indexed journals. Huge numbers of databases are actively collecting academic documents and papers worldwide, but most of them focus on a subspecialty with limited number of selected journals. The most important and popular databases in the fields of sciences and biomedicine are PubMed/PMC, Scopus, Web of Science (ISI) and Google Scholar. PubMed/PMC focuses mainly on medicine and biomedical sciences, whereas Scopus, Web of Science and Google Scholar cover most of the scientific fields. Web of Science covers old publications since its indexed and archived records go back to 1900. PubMed/PMC allows the larger number of keywords per search but is the only database among them that does not provide citation analysis. Scopus includes articles published from 1966 on, but results of citation analysis are available only for articles published after 1996. In contrast to Scopus or Web of Science, the major advantage of PubMed/PMC is that literature is readily updated online in an early version before print publication by various journals (2). <br>Authors’ reluctance to pay publication fees is a reason for their willingness to publish their works in open access journals. While open access has the potential to expand the authorship and readership of the scientific literature, it is considered that  open access publishing leads to an increase in the publication of poor quality research. Access to the journal is not usually an important problem for the authors. Several key factors including journal accessibility, reputation, quality (citation impact), frequency of publication (number of issues per year), and publication fees are crucial ones for authors to decide where to submit their manuscripts. Thus free access is not a significant factor in their decisions for selection of a journal (3). <br>However, many publishers of open access journals charge authors. Article processing charges (APC) pro-vide the ground for the acceptance of sub-standard articles since the journals’ income is related to the number of accepted manuscripts. There are few reports of some APC-funded open access publishers with extremely low quality standards. Therefore, in order to avoid compromising the quality of journals and reducing the economic pressure of editors in chief for publishing low quality articles, it is recommended that journal publishers consider the alternative sources of revenue for providing journals’ finance (4).<br>JRI is a peer reviewed, open access and free of charge journal and its articles are indexed in PubMed/PMC, Scopus, Google Scholar and several other scholarly databases. Recently, we applied for being indexed in Web of Science (ISI) in response to numerous requests of the authors who want to publish their articles in Journal of Reproduction and Infertility.<br><br> 095 96 Mohammad Reza MR Sadeghi محمدرضا صادقی Editor-in-chief Editor-in-chief Iran No Keyword 579.pdf US National Library of Medicine National Institutes of Health. PMC Overview [Internet]. Bethesda MD: National Center for Biotechnology Information, U.S. National Library of Medicine [updated 2011 Nov 14; cited 2013 Aug 20]. Available from: http://www.ncbi.nlm.nih.gov/pmc/##Falagas ME, Pitsouni EI, Malietzis GA, Pappas G. Comparison of PubMed, Scopus, Web of Science, and Google Scholar: strengths and weaknesses. FASEB J. 2008;22(2):338-42.##Davis PM, Walters WH. The impact of free access to the scientific literature: a review of recent research. J Med Libr Assoc. 2011;99(3):208-17.##Björk BC, Solomon D. Open access versus subscription journals: a comparison of scientific impact. BMC Med. 2012; 10:73.##

Assisted Reproductive Technology after the Birth of Louise Brown 2 1 535 2 Background: Public interest in Assisted Reproductive Technology (ART) has remained high since the birth of the world’s first in vitro fertilization baby, Louise Brown, in the United Kingdom. ART allows scientists to manipulate the fertilization process in order to bypass some pathological obstacles such as blocked fallopian tubes and non-functioning ovaries in the females, and blocked vas deferens and low sperm count in the males. The purpose was to provide a historical outline and identify the researches that most contributed to ART. Methods: A review of published experimental and clinical studies of assisted reproduction carried out at the University of Bristol library website (MetaLib®). A cross-search of seven different medical databases (AMED-Allied and Complementary Medicine Database, BIOSIS Previews on Web of Knowledge, Cochrane Library, Embase, and the Medline on Web of Knowledge, OvidSP and PubMed) was completed by using the key words to explore the major milestones and progress in the development and implementation of ART. Results: A speedy advancement in the development of different assisted reproductive techniques makes infertility problem more treatable than it ever had been. Conclusion: Although no other field in the medicine has integrated new knowledge into the daily practice more quickly than ART yet, there is a need for social research to counterbalance the dominance of biomedical one, in particular the people’s actual experiences and expectations of ART. 096 110 Remah Kamel RM Kamel Remah Kamel Department of Obstetrics and Gynaecology, Faculty of Medicine, Dammam University Department of Obstetrics and Gynaecology, Faculty of Medicine, Dammam University Saudi Arabia remahmoustafa@hotmail.com Assisted reproductive technologyHistoryInfertility managementLouise BrownMilestonesTimelines 535.pdf De Kretzer D, Dennis P, Hudson B, Leeton J, Lopata A, Outch K, et al. Transfer of a human zygote. Lancet. 1973;2(7831):728-9.##Steptoe PC, Edwards RG. Reimplantation of a human embryo with subsequent tubal pregnancy. Lancet.1976;1(7965):880-2.##Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet.1978;2(8085):366.##Edwards RG. An astonishing journey into reproductive genetics since the 1950's. Reprod Nutr Dev. 2005;45(3):299-306.##Lopata A, Johnston IW, Hoult IJ, Speirs AI. Pregnancy following intrauterine implantation of an embryo obtained by in vitro fertilization of a preovulatory egg. Fertil Steril. 1980;33(2):117-20.##Cohen J, Trounson A, Dawson K, Jones H, Hazekamp J, Nygren KG, Hamberger L. The early days of IVF outside the UK. Hum Reprod Update. 2005;11(5):439-59. Epub 2005 May 27.##Lopata A, Johnston IW, Hoult IJ, Speirs AI. Pregnancy following intrauterine implantation of an embryo obtained by in vitro fertilization of a preovu-latory egg. Fertil Steril. 1980;33(2):117-20.##Al-Nuaim L, Jenkins J. A brief historical overview of assisted reproduction. South Afr J Obstet Gynecol. 2007;13(2):38-41.##Trounson AO, Leeton JF, Wood C, Webb J, Wood J. Pregnancies in humans by fertilization in vitro and embryo transfer in the controlled ovulatory cycle. Science. 1981;212(4495):681-2.##Trounson AO, Mohr LR, Wood C, Leeton JF. Effect of delayed insemination on in-vitro fertilization, culture and transfer of human embryos. J Reprod Fertil. 1982;64(2):285-94.##Sathananthan AH, Trounson AO. Ultrastructural observations on cortical granules in human follicular oocytes cultured in vitro. Gamete Res. 1982;5:191-8.##Testart J, Frydman R, Feinstein MC, Thebault A, Roger M, Scholler R. Interpretation of plasma luteinizing hormone assay for the collection of mature oocytes from women: definition of a luteinizing hormone surge-initiating rise. Fertil Steril. 1981;36 (1):50-4.##Hamberger L, Wikland M, Nilsson L, Janson PO, Sjogren A, Hillensjo T. Methods for aspiration of human oocytes by various techniques. Acta Med Rom. 1982;20:370-8##Mohr LR, Trounson AO. The use of fluorescein diacetate to assess embryo viability in the mouse. J Reprod Fertil. 1980;58(1):189-96.##Fleming R, Adam AH, Barlow DH, Black WP, MacNaughton MC, Coutts JR. A new systematic treatment for infertile women with abnormal hormone profiles. Br J Obstet Gynaecol. 1982;89(1):80-3.##Lenz S, Lauritsen JG. Ultrasonically guided percutaneous aspiration of human follicles under local anesthesia: a new method of collecting oocytes for in vitro fertilization. Fertil Steril. 1982;38(6):673-7.##Trounson A, Leeton J, Besanko M, Wood C, Conti A. Pregnancy established in an infertile patient after transfer of a donated embryo fertilised in vitro. Br Med J (Clin Res Ed). 1983;286(6368):835-8.##Trounson A, Leeton J, Besanko M, Wood C, Conti A. Pregnancy established in an infertile patient after transfer of a donated embryo fertilised in vitro. Br Med J (Clin Res Ed). 1983;286(6368):835-8.##Trounson A, Mohr L. Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo. Nature. 1983;305(5936):707-9.##Veeck LL, Wortham JW Jr, Witmyer J, Sandow BA, Acosta AA, Garcia JE, et al. Maturation and fertilization of morphologically immature human oocytes in a program of in vitro fertilization. Fertil Steril. 1983;39(5):594-602.##Gleicher N, Friberg J, Fullan N, Giglia RV, Mayden K, Kesky T, et al. EGG retrieval for in vitro fertilisation by sonographically controlled vaginal culdocentesis. Lancet. 1983;2(8348):508-9.##Casper RF, Wilson E, Collins JA, Brown SF, Parker JA. Enhancement of human implantation by exogenous chorionic gonadotropin. Lancet. 1983;2(8360):1191.##Victoria Government. Infertility (Medical Procedures) Act 1984. Published by authority of Victoria Government Gazette. 1985;10163:47.##Asch RH, Ellsworth LR, Balmaceda JP, Wong PC. Pregnancy after translaparoscopic gamete intrafal-lopian transfer. Lancet. 1984;2(8410):1034-5.##Lutjen P, Trounson A, Leeton J, Findlay J, Wood C, Renou P. The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature. 1984;307(5947):174-5.##Schulman JD, Dorfmann AD, Jones SL, Pitt CC, Joyce B, Patton LA. Outpatient in vitro fertilization using transvaginal ultrasound-guided oocyte retrieval. Obstet Gynecol. 1987;69(4):665-8.##Zeilmaker GH, Alberda AT, van Gent I, Rijkmans CM, Drogendijk AC. Two pregnancies following transfer of intact frozen-thawed embryos. Fertil Steril. 1984;42(2):293-6.##Temple-Smith PD, Southwick GJ, Yates CA, Trounson AO, de Kretser DM. Human pregnancy by in vitro fertilization (IVF) using sperm aspirated from the epididymis. J In Vitro Fert Embryo Transf. 1985;2(3):119-22.##Cohen J, Simons RF, Fehilly CB, Fishel SB, Edwards RG, Hewitt J, et al. Birth after replacement of hatching blastocyst cryopreserved at expanded blastocyst stage. Lancet. 1985;1(8429):647.##Wikland M, Enk L, Hamberger L. Transvesical and transvaginal approaches for the aspiration of follicles by use of ultrasound. Ann N Y Acad Sci. 1985;442:182-94.##Strickler RC, Christianson C, Crane JP, Curato A, Knight AB, Yang V. Ultrasound guidance for hu man embryo transfer. Fertil Steril. 1985;43(1):54-61.##Szöllösi D, Mandelbaum J, Plachot M, Salat-Baroux J, Cohen J. Ultrastructure of the human preovulatory oocyte. J In Vitro Fert Embryo Transf. 1986;3(4):232-42.##Testart J, Lassalle B, Belaisch-Allart J, Hazout A, Forman R, Rainhorn JD, et al. High pregnancy rate after early human embryo freezing. Fertil Steril. 1986;46(2):268-72.##Quinn P, Kerin JF, Warnes GM. Improved pregnancy rate in human in vitro fertilization with the use of a medium based on the composition of human tubal fluid. Fertil Steril. 1985;44(4):493-8.##Feichtinger W, Kemeter P. Transvaginal sector scan sonography for needle guided transvaginal follicle aspiration and other applications in gynecologic routine and research. Fertil Steril. 1986;45(5): 722-5.##Rosenwaks Z, Veeck LL, Liu HC. Pregnancy following transfer of in vitro fertilized donated oocytes. Fertil Steril. 1986;45(3):417-20.##Navot D, Laufer N, Kopolovic J, Rabinowitz R, Birkenfeld A, Lewin A, et al. Artificially induced endometrial cycles and establishment of pregnancies in the absence of ovaries. N Engl J Med. 1986;314(13):806-11.##Devroey P, Braeckmans P, Smitz J, Van Waesberghe L, Wisanto A, Van Steirteghem A, et al. Pregnancy after translaparoscopic zygote intrafallopian transfer in a patient with sperm antibodies. Lancet. 1986;1(8493):1329.##Chen C. Pregnancy after human oocyte cryopreservation. Lancet. 1986;1(8486):884-6.##Laws-King A, Trounson A, Sathananthan H, Kola I. Fertilization of human oocytes by microinjection of a single spermatozoon under the zona pellucida. Fertil Steril. 1987;48(4):637-42.##Trounson A, Peura A, Kirby C. Ultrarapid freezing: a new low-cost and effective method of embryo cryopreservation. Fertil Steril. 1987;48(5):843-50.##Wilton LJ, Trounson AO. Biopsy of preimplantation mouse embryos: development of micromanipulated embryos and proliferation of single blastomeres in vitro. Biol Reprod. 1989;40(1):145-52.##Patrizio P, Silber S, Ord T, Balmaceda JP, Asch RH. Two births after microsurgical sperm aspiration in congenital absence of vas deferens. Lancet. 1988;2(8624):1364.##Ng SC, Bongso A, Ratnam SS, Sathananthan H, Chan CL, Wong PC, et al. Pregnancy after transfer of sperm under zona. Lancet. 1988;2(8614):790.##Cohen J, Malter H, Fehilly C, Wright G, Elsner C, Kort H, et al. Implantation of embryos after partial opening of oocyte zona pellucida to facilitate sperm penetration. Lancet. 1988;2(8603):162.##Handyside AH, Pattinson JK, Penketh RJ, Delhanty JD, Winston RM, Tuddenham EG. Biopsy of human preimplantation embryos and sexing by DNA amplification. Lancet. 1989;1(8634):347-9.##Tadir Y, Wright WH, Vafa O, Ord T, Asch RH, Berns MW. Micromanipulation of sperm by a laser generated optical trap. Fertil Steril. 1989;52(5):870-3.##Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril. 1989;52(3):446-50.##Gordts S, Roziers P, Campo R, Noto V. Survival and pregnancy outcome after ultrarapid freezing of human embryos. Fertil Steril. 1990;53(3):469-72.##Handyside AH, Kontogianni EH, Hardy K, Winston RM. Pregnancies from biopsied human preim-plantation embryos sexed by Y-specific DNA amplification. Nature. 1990;344(6268):768-70.##Cohen J, Elsner C, Kort H, Malter H, Massey J, Mayer MP, et al. Impairment of the hatching process following IVF in the human and improvement of implantation by assisting hatching using micromanipulation. Hum Reprod. 1990;5(1):7-13.##Verlinsky Y, Ginsberg N, Lifchez A, Valle J, Moise J, Strom CM. Analysis of the first polar body: preconception genetic diagnosis. Hum Reprod. 1990;5(7):826-9.##Gonen Y, Balakier H, Powell W, Casper RF. Use of gonadotropin-releasing hormone agonist to trigger follicular maturation for in vitro fertilization. J Clin Endocrinol Metab. 1990;71(4):918-22.##Gonen Y, Jacobson W, Casper RF. Gonadotropin suppression with oral contraceptives before in vitro fertilization. Fertil Steril. 1990;53(2):282-7.##Cha KY, Koo JJ, Ko JJ, Choi DH, Han SY, Yoon TK. Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril. 1991;55(1):109-13.##Palanker D, Ohad S, Lewis A, Simon A, Shenkar J, Penchas S, et al. Technique for cellular microsurgery using the 193-nm excimer laser. Lasers Surg Med. 1991;11(6):580-6.##Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet.##Devroey P, van Steirteghem A, Mannaerts B, Bennink HC. Successful in-vitro fertilisation and embryo transfer after treatment with recombinant human FSH. Lancet. 1992;339(8802):1170.##Patrizio P, Silber S, Ord T, Marello E, Balmaceda JP, Asch RH. Replacement of frozen embryos generated from epididymal spermatozoa: the first two pregnancies. Hum Reprod. 1992;7(5):652-3.##Anguiano A, Oates RD, Amos JA, Dean M, Gerrard B, Stewart C, et al. Congenital bilateral absence of the vas deferens. A primarily genital form of cystic fibrosis. JAMA. 1992;267(13):1794-7.##Emperaire JC, Ruffié A, Audebert AJ. [Ovulation induction by endogenous LH released by the administration of an LHRH agonist after follicular stimulation for in vitro fertilization]. J Gynecol Obstet Biol Reprod (Paris). 1992;21(5):489-94. French.##Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus M, et al. Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod. 1995;10(6):1457-60.##Patrizio P, Asch RH, Handelin B, Silber SJ. Aetiology of congenital absence of vas deferens: genetic study of three generations. Hum Reprod. 1993;8(2):215-20.##Devroey P, Mannaerts B, Smitz J, Coelingh Bennink H, Van Steirteghem A. First established pregnancy and birth after ovarian stimulation with recombinant human follicle stimulating hormone (Org 32489). Hum Reprod. 1993;8(6):863-5.##Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril. 1994;62(2):353-62.##Howles CM, Loumaye E, Giroud D, Luyet G. Multiple follicular development and ovarian steroid-genesis following subcutaneous administration of a highly purified urinary FSH preparation in pituitary desensitized women undergoing IVF: a multicentre European phase III study. Hum Reprod. 1994;9(3):424-30.##Hull M, Corrigan E, Piazzi A, Loumaye E. Recombinant human luteinising hormone: an effective new gonadotropin preparation. Lancet. 1994;344(8918):334-5.##Barnes FL, Crombie A, Gardner DK, Kausche A, Lacham-Kaplan O, Suikkari AM, et al. Blastocyst development and birth after in-vitro maturation of human primary oocytes, intracytoplasmic sperm injection and assisted hatching. Hum Reprod. 1995;10(12):3243-7.##Munné S, Sultan KM, Weier HU, Grifo JA, Cohen J, Rosenwaks Z. Assessment of numeric abnormalities of X, Y, 18, and 16 chromosomes in preim-plantation human embryos before transfer. Am J Obstet Gynecol. 1995;172(4 Pt 1):1191-9.##Fishel S, Green S, Bishop M, Thornton S, Hunter A, Fleming S, et al. Pregnancy after intracytoplasmic injection of spermatid. Lancet. 1995;345(8965):1641-2.##Dozortsev D, Rybouchkin A, De Sutter P, Qian C, Dhont M. Human oocyte activation following intracytoplasmic injection: the role of the sperm cell. Hum Reprod. 1995;10(2):403-7.##Gil-Salom M, Romero J, Minguez Y, Rubio C, De los Santos MJ, Remohí J, et al. Pregnancies after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa. Hum Reprod. 1996;11(6):1309-13.##Jurisicova A, Varmuza S, Casper RF. Programmed cell death and human embryo fragmentation. Mol Hum Reprod. 1996;2(2):93-8.##Casper RF, Meriano JS, Jarvi KA, Cowan L, Lucato ML. The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermia. Fertil Steril. 1996;65(5):972-6.##Kahraman S, Polat G, Samli M, Sözen E, Ozgün OD, Dirican K, et al. Multiple pregnancies obtained by testicular spermatid injection in combination with intracytoplasmic sperm injection. Hum Reprod. 1998;13(1):104-10.##Sun JG, Jurisicova A, Casper RF. Detection of deoxyribonucleic acid fragmentation in human sperm: correlation with fertilization in vitro. Biol Reprod. 1997;56(3):602-7.##Cohen J, Scott R, Schimmel T, Levron J, Willadsen S. Birth of infant after transfer of anucleate donor oocyte cytoplasm into recipient eggs. Lancet. 1997;350(9072):186-7.##Porcu E, Dal Prato L, Seracchioli R, Petracchi S, Fabbri R, Flamigni C. Births after transcervical gamete intrafallopian transfer with a falloposcopic delivery system. Fertil Steril. 1997;67(6):1175-7.##Itskovitz-Eldor J, Kol S, Mannaerts B, Coelingh Bennink H. First established pregnancy after controlled ovarian hyperstimulation with recombinant follicle stimulating hormone and the gonado-trophin releasing hormone antagonist ganirelix (Org 37462). Hum Reprod. 1998;13(2):294-5.##Gardner DK. Development of serum-free media for the culture and transfer of human blastocysts. Hum Reprod. 1998;13 Suppl 4:218-25.##Palermo GD, Schlegel PN, Sills ES, Veeck LL, Zaninovic N, Menendez S, et al. Births after intracytoplasmic injection of sperm obtained by testicular extraction from men with nonmosaic Kline-felter's syndrome. N Engl J Med. 1998;338(9):588-90.##Xu K, Shi ZM, Veeck LL, Hughes MR, Rosenwaks Z. First unaffected pregnancy using preimplantation genetic diagnosis for sickle cell anemia. JAMA. 1999;281(18):1701-6.##Kuleshova L, Gianaroli L, Magli C, Ferraretti A, Trounson A. Birth following vitrification of a small number of human oocytes: case report. Hum Reprod. 1999;14(12):3077-9.##Chian RC, Gülekli B, Buckett WM, Tan SL. Priming with human chorionic gonadotropin before retrieval of immature oocytes in women with infertility due to the polycystic ovary syndrome. N Engl J Med. 1999;341(21):1624, 1626.##Buckett WM, Fisch P, Dean NL, Biljan MM, Tan SL. In vitro fertilization and intracytoplasmic sperm injection pregnancies after successful transport of oocytes by airplane. Fertil Steril. 1999;71(4):753-5.##Nygren KG, Andersen AN. Assisted reproductive technology in Europe, 1999. Results generated from European registers by ESHRE. Hum Reprod. 2002;17(12):3260-74.##Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med. 2000;342(25):1919.##Kojima K, Nomiyama M, Kumamoto T, Matsumoto Y, Iwasaka T. Transvaginal ultrasound-guided embryo transfer improves pregnancy and implantation rates after IVF. Hum Reprod. 2001;16(12):2578-82.##Chian RC, Gülekli B, Buckett WM, Tan SL. Pregnancy and delivery after cryopreservation of zygotes produced by in-vitro matured oocytes retrieved from a woman with polycystic ovarian syndrome. Hum Reprod. 2001;16(8):1700-2.##Abdul-Jalil AK, Child TJ, Phillips S, Dean N, Carrier S, Tan SL. Ongoing twin pregnancy after ICSI of PESA-retrieved spermatozoa into in-vitro matured oocytes: case report. Hum Reprod. 2001;16(7):1424-6.##Belker AM, Swanson ML, Cook CL, Carrillo AJ, Yoffe SC. Live birth after sperm retrieval from a moribund man. Fertil Steril. 2001;76(4):841-3.##De Boer K, McArthur S, Murray C, Jansen R. First live birth following blastocyst biopsy and PGD analysis. Reprod Biomed Online. 2002;4:35.##Wells D, Escudero T, Levy B, Hirschhorn K, Delhanty JD, Munné S. First clinical application of comparative genomic hybridization and polar body testing for preimplantation genetic diagnosis of aneuploidy. Fertil Steril. 2002;78(3):543-9.##Yoon TK, Kim TJ, Park SE, Hong SW, Ko JJ, Chung HM, et al. Live births after vitrification of oocytes in a stimulated in vitro fertilization-embryo transfer program. Fertil Steril. 2003;79(6):1323-6.##Beckers NG, Macklon NS, Devroey P, Platteau P, Boerrigter PJ, Fauser BC. First live birth after ovarian stimulation using a chimeric long-acting human recombinant follicle-stimulating hormone (FSH) agonist (recFSH-CTP) for in vitro fertilization. Fertil Steril. 2003;79(3):621-3.##Barash A, Dekel N, Fieldust S, Segal I, Schechtman E, Granot I. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril. 2003;79(6):1317-22.##Donnez J, Dolmans MM, Demylle D, Jadoul P, Pirard C, Squifflet J, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet. 2004;364(9443):1405-10.##Rao GD, Chian RC, Son WS, Gilbert L, Tan SL. Fertility preservation in women undergoing cancer treatment. Lancet. 2004;363(9423):1829-30.##Chian RC, Buckett WM, Abdul Jalil AK, Son WY, Sylvestre C, Rao D, et al. Natural-cycle in vitro fertilization combined with in vitro maturation of immature oocytes is a potential approach in infertility treatment. Fertil Steril. 2004;82(6):1675-8.##Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: a prospective randomized trial. Fertil Steril. 2004;81(3):551-5.##Verlinsky Y, Rechitsky S, Sharapova T, Morris R, Taranissi M, Kuliev A. Preimplantation HLA testing. JAMA. 2004;291(17):2079-85.##Xu K, Rosenwaks Z, Beaverson K, Cholst I, Veeck L, Abramson DH. Preimplantation genetic diagnosis for retinoblastoma: the first reported liveborn. Am J Ophthalmol. 2004;137(1):18-23.##Meirow D, Levron J, Eldar-Geva T, Hardan I, Fridman E, Zalel Y, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005;353(3):318-21.##Kokkali G, Vrettou C, Traeger-Synodinos J, Jones GM, Cram DS, Stavrou D, et al. Birth of a healthy infant following trophectoderm biopsy from blastocysts for PGD of beta-thalassaemia major. Hum Reprod. 2005;20(7):1855-9.##Bedaiwy MA, Hussein MR, Biscotti C, Falcone T. Cryopreservation of intact human ovary with its vascular pedicle. Hum Reprod. 2006;21(12):3258-69.##Ao A, Jin S, Rao D, Son WY, Chian RC, Tan SL. First successful pregnancy outcome after preimplantation genetic diagnosis for aneuploidy screening in embryos generated from naturalcycle in vitro fertilization combined with an in vitro maturation procedure. Fertil Steril. 2006; 85(5):1510.##Son WY, Lee SY, Yoon SH, Lim JH. Pregnancies and deliveries after transfer of human blastocysts derived from in vitro matured oocytes in in vitro maturation cycles. Fertil Steril. 2007;87(6):1491-3.##Heijnen EM, Eijkemans MJ, De Klerk C, Polinder S, Beckers NG, Klinkert ER, et al. A mild treatment strategy for in-vitro fertilisation: a randomised non-inferiority trial. Lancet. 2007;369(9563):743-9.##Patrizio P, Gavish Z, Martel M, Azodi M, Silber S, Arav A. Whole human ovaries cryopreservation using a novel multi-gradient freezing device. Fertil Steril. 2007;88(1):S355.##Son WY, Chung JT, Chian RC, Herrero B, Demirtas E, Elizur S, et al. A 38 h interval between hCG priming and oocyte retrieval increases in vivo and in vitro oocyte maturation rate in programmed IVM cycles. Hum Reprod. 2008;23(9):2010-6.##Jones GM, Cram DS, Song B, Kokkali G, Pantos K, Trounson AO. Novel strategy with potential to identify developmentally competent IVF blastocysts. Hum Reprod. 2008;23(8):1748-59.##Porcu E, Venturoli S, Damiano G, Ciotti PM, Notarangelo L, Paradisi R, et al. Healthy twins delivered after oocyte cryopreservation and bilateral ovariectomy for ovarian cancer. Reprod Biomed Online. 2008;17(2):265-7.##Fishel S, Gordon A, Lynch C, Dowell K, Ndukwe G, Kelada E, et al. Live birth after polar body array comparative genomic hybridization prediction of embryo ploidy-the future of IVF? Fertil Steril. 2010;93(3):1006.##Campbell A, Fishel S, Bowman N, Duffy S, Sedler M, Thornton S. Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS. Reprod Biomed Online. [Epub ahead of print].##

Assessment of Questionnaires Measuring Quality of Life in Infertile Couples: A Systematic Review 2 1 2 <p>Background: Infertility has potentially inappropriate effects on quality of life in infertile couples. Various general and specific questionnaires have been structured for assessing different aspects of quality of life in infertile men, women, or couples. The present systematic review was designed to assess these questionnaires and also identify different factors affecting infertile couples based on the aforesaid questionnaires. Methods: The research strategy involved general and specific terms in relation to couples’s infertility and their quality of life. A review was done for studies published from 1982 to 2012 that were indexed in Medline, ISI Web of Science and Scopus as well as abstract books on this subject. We also corresponded with the authors of the references in related studies for introducing more resources and references. Results: In all reviewed studies, different aspects of the quality of life in couples were evaluated including sexual, psychological, social, communicational, environmental, occupational, medical, as well as economical ones. In total, after initial screening of all studies, 10 general and 2 specific questionnaires were retrieved. Although no meta-analysis was found in the review, infertility had a negative effect on quality of life in couples. Conclusion: This study revealed that some general questionnaires such as SF-36 and WHO-QOL were mostly used for assessing quality of life in infertile couples and some specific questionnaires such as FERTI-QoL and Fertility Problem Inventory were rarely used. Thus, it seems that the evaluation of quality of life in infertile couples needs valid instruments for measurement.</p> 110 120 Seyyed Abbas SA Mousavi Seyyed Abbas Mousavi Golestan Research Center of Psychiatry, Golestan University of Medical Sciences Golestan Research Center of Psychiatry, Golestan University of Medical Sciences Iran Seyyedeh Zahra SZ Masoumi Seyyedeh Zahra Masoumi Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences Iran Afsaneh A Keramat افسانه کرامت Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences Iran keramat1@yahoo.com Jalal J Pooralajal Jalal Pooralajal Research Center for Modeling of No Communicable Diseases, School of Public Health, Hamadan University of Medical Sciences Research Center for Modeling of No Communicable Diseases, School of Public Health, Hamadan University of Medical Sciences Iran Fatemeh F Shobeiri Fatemeh Shobeiri Mother and Child Care Research Center, Hamadan University of Medical Sciences Mother and Child Care Research Center, Hamadan University of Medical Sciences Iran AssessmentCouplesInfertilityQuality of lifeQuestionnaire 534.pdf Benyamini Y, Gozlan M, Kokia E. 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Use of Fluorescent Dyes in Readily Recognizing Sperm Damage 2 1 533 2 Sperm is produced by the testis and mature in the epididymis. For having a successful conception, the fertilizing sperm should have functional competent membranes, intact acrosome, functional mitochondria and an intact haploid genome. The effects of genetic and environmental factors result in sperm vulnerability to damage in the process of spermatogenesis and maturation. In recent years, the feasibility of detecting sperm damage is enhanced through the advances in technologies like fluoscerent staining techniques assisted with fluorescence microscope, flow cytometry and computer analysis systems. Fluoscerent staining techniques involve the use of fluorescent dyes, either directly or indirectly for binding them with some ingredients of sperm and evaluating the damage of the structure or function of the sperm, i.e. membrane, acrosome, mitochondria, chromosome or DNA. 120 126 Omar Ibrahim OI Farah Omar Ibrahim Farah Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology China Li L Cuiling Li Cuiling Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology China Wang W Jiaojiao Wang Jiaojiao Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology China Zhang Z Huiping Zhang Huiping Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology China zhpmed@yahoo.com.cn AcrosomeChromatinDNAFluorescent stainingMotichondrialMotilitySperm function assay 533.pdf University of Wisconsin. 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Reversible Germ Cell Toxicity of Sulphasalazine and Ampicillin Combination in Male Rats 2 1 536 2 Background: The antifertility effect of ampicillin (AMP, 40 mg/kg) and sulphasalazine or salicylazosulfapyridine (SASP, 300,450 and 600 mg/kg) in male rats has been reported earlier. The combination of AMP and SASP is generally used in certain pathological conditions, but the combined effect of these two drugs on the fertility is not clear. So, the aim of this study was to investigate the antifertility effect of ampicillin and sulphasalazine combination in male rats. Methods: In the present study, forty rats were randomly divided into five groups (n=8). Group I served as the control, while Group II and III received AMP and SASP at the doses of 20 mg/kg and 200 mg/kg respectively. Moreover, group IV and V received the combination of SASP (100 mg/kg) and AMP (10 mg/kg). However, for evaluating the reversible effect of the combination, a washout period of 30 days was given in group V. After 45 days of drug treatment, each rat was sacrificed. The testes, seminal vesicles and epididymis were dissected & weighed. Furthermore, fertility tests, sperm characteristic analysis, histopathological studies, testosterone assay and tissue biochemistry were performed. The data were analyzed using ANOVA and in case ANOVA shows statistical differences, post hoc analysis was performed. Results: A decrease in parameters related to fertility of males such as sperm count, sperm motility, fertility ratio, serum testosterone level, glycogen and protein content in sexual organs was observed. Although AMP and SASP significantly (p<0.001) reduced the reproductive activity separately, but their combination was found to be impairing the reproductive activity at a considerably lower dose. However, on withdrawing the treatment, all these parameters were restored which was confirmed by the histopathological analysis of the testis. Conclusion: The combination produces synergistic antifertility effect in male rats and the effect was reversible. The dose and efficacy of results could be extrapolated in future clinical trials. 126 133 Himanshu H Gupta Himanshu Gupta Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology India himanshu.bpharm@gmail.com Kamal K Maheshwari Kamal Kishore Maheshwari Department of Pharmacy, Mahatma Jyotiba Phule Rohilkhand University Department of Pharmacy, Mahatma Jyotiba Phule Rohilkhand University India Nitin N Kumar Nitin Kumar Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology India AmpicillinFertilitySerum testosterone assaySperm countSulphasalazine 536.pdf Kamal R, Gupta RS, Lohiya NK. Plants for male fertility regulation. Phytother Res. 2003;17(6):579-90.##Ziarati P. Determination of contaminants in some Iranian popular herbal medicines. J Env Anal Toxicol. 2012;2:120.##Ma WK, Ramaswamy SB. Histological changes during ovarian maturation in the tarnished plant bug, Lygus lineolaris (Hemiptera: Miridae). J Insect Morphol Embryo1. 1974;16:304-32.##Olayemi FO. A review on some causes of male infertility. Afr J Biotech. 2010;9:2834-42.##Egozcue S, Blanco J, Vendrell JM, García F, Veiga A, Aran B, et al. Human male infertility: chromosome anomalies, meiotic disorders, abnormal spermatozoa and recurrent abortion. Hum Reprod Update. 2000;6(1):93-105.##Marmor D. The effects of sulphasalazine on male infertility. Reprod Tox. 1995;9:219-23.##Drife JO. Drugs and sperm. Br Med J (Clin Res Ed). 1982;284(6319):844-5.##Shivabasavaiah KRH, Pavana T, Ramyashree M, Ramya MC, Manjunath R. Antifertility effects of madhuca indica leaves in male swiss albino rats. J Pharm Res. 2011;4:323-6.##Pholpramool C, Srikhao A. Suppression of fertility by sulfasalazine and its metabolite in the male rats. J Androl. 1985;6:50.##Timmermans L. Influence of antibiotics on spermatogenesis. J Urol. 1974;112(3):348-9.##Kushniruk YI. Influence of certain antibacterial preparations on the nucleic acid content in cells of the spermatogenic epithelium. Tsitol Genet. 1976;10:342-7.##Raji Y, Awobajo FO, Alabi TK, Gbadegsin MA, Bolarinwa AF. In vivo and in vitro reproductive toxicity assesment of ampicillin and cloxacillin in mammalian models. Int J Pharmacol. 2006;2:9-14.##Pholpramool C, Srikhaoa A. Antifertility effect of sulfasalazine in the male rat. Contraception. 1983;28(3):273-9.##Tripathi KD. Essential of Medical Pharmacology. 5th ed. India: Jaypee Brothers Medical Publishers; 2004. 754p.##Peirce EJ, Breed WG. A comparative study of sperm production in two species of Australian arid zone rodents (Pseudomys australis, Notomys alex is) with marked differences in testis size. 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Reproductive Outcome Following Thawed Embryo Transfer in Management of Ovarian Hyperstimulation Syndrome 2 1 537 2 Background: The purpose of the study was to compare clinical pregnancy and delivery rates with fresh and frozen embryo transfer in patients admitted to Shiraz- Human Assisted Reproductive Center with ovarian hyperstimulation syndrome (OHSS). Methods: OHSS patients randomly divided in two groups, group A (n=50) with fresh embryo transfer and group B (n=50) with frozen embryo transfer. We used vitrification method for freezing the embryos. Patient age, combination of female and male factors, total number of retrieved oocytes, number of cryopreserved embryo, number of transferred embryos, clinical pregnancy and delivery rates were recorded for all patients. All statistical calculations were done using SPSS software. Generalized linear model was used to adjust the confounding factors to compare the clinical pregnancy and delivery rates between two groups. The p<0.05 was considered statistically significant. Results: Mean (±SD) ages of these patients were 26.78±3.5 and 28.42±4.2 yrs in fresh (A) and frozen (B) embryo transfer groups respectively. Combinations of male and female factors were 28.3% and 32.1% respectively. Average numbers of oocytes retrieved in two groups were 22.14±4.3 and 21.02±4.9, and after fertilization, embryos cryopreserved per patient yielded averages of 13.82±3.5 and 12.5±4.3. Thaw and ET were performed and the means for transferred embryos were 3.22±0.6 and 4.1±0.7. We didn’t find any significant differences in implicit parameters between the two groups. The pregnancy and delivery rates in OHSS patients were significantly higher in frozen embryo transfer, 63.1% and 45.6%, compared with fresh embryo transfer, 55.1% and 35.4%, respectively. Conclusion: The pregnancy and delivery rates in OHSS cases, both fresh and subsequently with frozen embryo transfer, were exceptionally high. There was statistically significant difference of pregnancy and delivery rates between fresh and frozen embryo transfer. As a result, an elective embryo freezing policy to moderate the severity and duration of OHSS has compromising outcomes for women at risk of OHSS. 133 138 Forouzan F Absalan Forouzan Absalan Department of anatomy, Medical faculty, Ahvaz Jundishapur University of Medical Sciences Department of anatomy, Medical faculty, Ahvaz Jundishapur University of Medical Sciences Iran forouzan_absalan@yahoo.com Alireza A Ghannadi Alireza Ghannadi Shiraz- Human Assisted Reproductive Center Shiraz- Human Assisted Reproductive Center Iran Marjaneh M Kazerooni مرجانه کازرونی Shiraz- Human Assisted Reproductive Center Shiraz- Human Assisted Reproductive Center Iran CryopreservationEmbryo transferOvarian hyperstimulation syndrome 537.pdf D'Angelo A, Amso NN. Embryo freezing for preventing ovarian hyperstimulation syndrome: a Cochrane review. Hum Reprod. 2002;17(11):2787-94.##Tiitinen A, Husa LM, Tulppala M, Simberg N, Seppälä M. The effect of cryopreservation in prevention of ovarian hyperstimulation syndrome. Br J Obstet Gynaecol. 1995;102(4):326-9.##Davis M, Kennedy R. Ovarian hyperstimulation syndrome: aetiology, prevention and management. Rev Gynaecol Perinat Pract. 2006:6(2):26-32.##Tomazevic T, Meden-Vrtovec H. Early timed follicular aspiration prevents severe ovarian hyperstimu-lation syndrome. J Assist Reprod Genet. 1996;13(4):282-6.##Amso NN, Ahuja KK, Morris N, Shaw RW. The management of predicted ovarian hyperstimulation involving gonadotropin-releasing hormone analog with elective cryopreservation of all pre-embryos. Fertil Steril. 1990;53(6):1087-90.##Awonuga AO, Pittrof RJ, Zaidi J, Dean N, Jacobs HS, Tan SL. Elective cryopreservation of all embryos in women at risk of developing ovarian hyper-stimulation syndrome may not prevent the condition but reduces the live birth rate. J Assist Reprod Genet. 1996;13(5):401-6.##Queenan JT Jr, Veeck LL, Toner JP, Oehninger S, Muasher SJ. Cryopreservation of all prezygotes in patients at risk of severe hyperstimulation does not eliminate the syndrome, but the chances of pregnancy are excellent with subsequent frozen-thaw transfers. Hum Reprod. 1997;12(7):1573-6.##Asch RH, Li HP, Balmaceda JP, Weckstein LN, Stone SC. Severe ovarian hyperstimulation syndrome in assisted reproductive technology: definition of high risk groups. Hum Reprod. 1991;6(10):1395-9.##Binder H, Dittrich R, Einhaus F, Krieg J, Müller A, Strauss R, et al. Update on ovarian hyperstimulation syndrome: Part 1--Incidence and pathogenesis. Int J Fertil Womens Med. 2007;52(1):11-26.##Pattinson HA, Hignett M, Dunphy BC, Fleetham JA. Outcome of thaw embryo transfer after cryopreservation of all embryos in patients at risk of ovarian hyperstimulation syndrome. Fertil Steril. 1994;62(6):1192-6.##Mocanu E, Redmond ML, Hennelly B, Collins C, Harrison R. Odds of ovarian hyperstimulation syndrome (OHSS)-time for reassessment. Hum Fertil (Camb). 2007;10(3):175-81.##Awonuga AO, Pittrof RJ, Zaidi J, Dean N, Jacobs HS, Tan SL. Elective cryopreservation of all embryos in women at risk of developing ovarian hyperstimulation syndrome may not prevent the condition but reduces the live birth rate. J Assist Reprod Genet. 1996;13(5):401-6.##Shaker AG, Zosmer A, Dean N, Bekir JS, Jacobs HS, Tan SL. Comparison of intravenous albumin and transfer of fresh embryos with cryopreservation of all embryos for subsequent transfer in prevention of ovarian hyperstimulation syndrome. Fertil Steril. 1996;65(5):992-6.##Ferraretti AP, Gianaroli L, Magli C, Fortini D, Selman HA, Feliciani E. Elective cryopreservation of all pronucleate embryos in women at risk of ovarian hyperstimulation syndrome: efficiency and safety. Hum Reprod. 1999;14(6):1457-60.##Fitzmaurice GJ, Boylan C, McClure N. Are pregnancy rates compromised following embryo freezing to prevent OHSS? Ulster Med J. 2008;77(3):164-7.##Wada I, Matson PL, Troup SA, Hughes S, Buck P, Lieberman BA. Outcome of treatment subsequent to the elective cryopreservation of all embryos from women at risk of the ovarian hyperstimulation syndrome. Hum Reprod. 1992;7(7):962-6.##Wada I, Matson PL, Troup SA, Morroll DR, Hunt L, Lieberman BA. Does elective cryopreservation of all embryos from women at risk of ovarian hyperstimulation syndrome reduce the incidence of the condition? Br J Obstet Gynaecol. 1993;100(3):265-9.##Kuć P, Kuczyńska A, Stankiewicz B, Sieczyński P, Matysiak J, Kuczyński W. Vitrification vs. slow cooling protocol using embryos cryopreserved in the 5th or 6th day after oocyte retrieval and IVF outcomes. Folia Histochem Cytobiol. 2010;48(1):84-8.##Chang EM, Han JE, Kim YS, Lyu SW, Lee WS, Yoon TK. Use of the natural cycle and vitrification thawed blastocyst transfer results in better in-vitro fertilization outcomes: cycle regimens of vitrification thawed blastocyst transfer. J Assist Reprod Genet. 2011;28(4):369-74.##Fatemi HM, Kyrou D, Bourgain C, Van den Abbeel E, Griesinger G, Devroey P. Cryopreservedthawed human embryo transfer: spontaneous natural cycle is superior to human chorionic gonadotropin-induced natural cycle. Fertil Steril. 2010;94(6):2054-8.##Aflatoonian A, Oskouian H, Ahmadi S, Oskouian L. Can fresh embryo transfers be replaced by cryopreserved-thawed embryo transfers in assisted reproductive cycles? A randomized controlled trial. J Assist Reprod Genet. 2010;27(7):357-63.##Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responders. Fertil Steril. 2011;96(2):344-8.##European Society of Human Reproduction and Embryology. Freezing all embryos in IVF with transfer in a later non-stimulated cycle may improve outcome. Science Daily, 4 Jul. 2012. Web 15 May 2013.##

Comparison of Letrozole and Clomiphene Citrate Efficacy along with Gonadotrophins in Controlled Ovarian Hyperstimulation for Intrauterine Insemination Cycles 2 1 538 2 <p>Background: We performed this study to investigate and compare the effects of Letrozole and gonadotrophins versus Clomiphene Citrate and gonadotrophins in women undergoing superovulation for Intrauterine Insemination (IUI). Methods: We performed this prospective cohort study at Australian Concept and Fertility centre, Karachi Pakistan. Women younger than 40 years of age with patent fallopian tubes and infertility of more than 2 years in duration who were undergoing IUI and gonadotrophins therapy were divided into two groups, one received Letrozole for 5 days and another received Clomiphene Citrate for 5 days. Results: All 500 IUI treatment cycles conducted from March 2008 to March 2010 were included. Patients co-treated with Letrozole required fewer gonadotrophins administrations (median difference, 300 IU (95% confidence interval (CI), 225-375 IU), developed more follicles larger than 14 mm (median difference, 1 follicle, 95% CI, 1-2 follicles), and had a thicker endometrium (median difference, 1 mm, 95% CI, 0.4–1.6 mm). The pregnancy rate was not significantly different between two groups (11% vs. 12.6%). Conclusion: The addition of Letrozole to gonadotrophins decreases gonadotrophins requirements and improves endometrial thickness, without a significant effect on pregnancy rates. An improved pregnancy rate has been observed in older age group, >35 years with Letrozole.</p> 138 143 Fauzia F HaqNawaz Fauzia HaqNawaz MRCOG (UK), FCPS (Pak); LMCC (Canada) Aga Khan University Hospital MRCOG (UK), FCPS (Pak); LMCC (Canada) Aga Khan University Hospital Pakistan fauzia.nawaz@gmail.com Saadia S Virk Saadia Virk FRCOG Australian Concept Fertility Centre FRCOG Australian Concept Fertility Centre Pakistan Tasleem T Qadir Tasleem Qadir FCPS Australian Concept Fertility Centre FCPS Australian Concept Fertility Centre Pakistan Saadia S Imam Saadia Imam FCPS Australian Concept Fertility Centre FCPS Australian Concept Fertility Centre Pakistan Javed J Rizvi Javed Rizvi FRCOG Australian Concept Fertility Centre FRCOG Australian Concept Fertility Centre Pakistan GonadotrophinInfertilityIntrauterin inseminationLetrozolePregnancy 538.pdf Glazener CM, Coulson C, Lambert PA, Watt EM, Hinton RA, Kelly NG, et al. Clomiphene treatment for women with unexplained infertility: placebo-controlled study of hormonal responses and conception rates. Gynecol Endocrinol. 1990;4(2):75-83.##Brodie A, Lu Q, Long B. Aromatase and its inhibitors. J Steroid Biochem Mol Biol. 1999;69(1-6):205-10.##Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril. 2001;75(2):305-9.##World Health Organization. WHO laboratory manual for the examination of human semen and sperm cervical mucus interaction. 4th ed. Cambridge: Cambridge University Press; 1999.##Sioufi A, Gauducheau N, Pineau V, Marfil F, Jaouen A, Cardot JM, et al. Absolute bioavailability of letrozole in healthy postmenopausal women. Biopharm Drug Dispos. 1997;18(9):779-89.##Healey S, Tan SL, Tulandi T, Biljan MM. Effects of letrozole on superovulation with gonadotropins in women undergoing intrauterine insemination. Fertil Steril. 2003;80(6):1325-9.##Cortínez A, De Carvalho I, Vantman D, Gabler F, Iñiguez G, Vega M. Hormonal profile and endometrial morphology in letrozole-controlled ovarian hy-perstimulation in ovulatory infertile patients. Fertil Steril. 2005;83(1):110-5.##Al-Fozan H, Al-Khadouri M, Tan SL, Tulandi T. A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation. Fertil Steril. 2004;82(6):1561-3.##Mitwally MF, Casper RF. Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders. Fertil Steril. 2002;77(4):776-80.##Fisher SA, Reid RL, Van Vugt DA, Casper RF. A randomized double-blind comparison of the effects of clomiphene citrate and the aromatase inhibitor letrozole on ovulatory function in normal women. Fertil Steril. 2002;78(2):280-5.##

The Role of Psychological Adjustment in the Decision-making Process for Voluntary Termination of Pregnancy 2 1 532 2 Background: This study’s objective was to evaluate the role of psychological adjustment in the decision-making process to have an abortion and explore individual variables that might influence this decision. Methods: In this cross-sectional study, we sequentially enrolled 150 women who made the decision to voluntarily terminate a pregnancy in Maternity Dr. Alfredo da Costa, in Lisbon, Portugal, between September 2008 and June 2009. The instruments were the Depression, Anxiety and Stress Scale (DASS), Satisfaction with Social Support Scale (SSSS), Emotional Assessment Scale (EAS), Decision Conflict Scale (DCS), and Beliefs and Values Questionnaire (BVQ). We analyzed the data using Student’s t-tests, MANOVA, ANOVA, Tukey’s post-hoc tests and CATPCA. Statistically significant effects were accepted for p<0.05. Results: The participants found the decision difficult and emotionally demanding, although they also identified it as a low conflict decision. The prevailing emotions were sadness, fear and stress; but despite these feelings, the participants remained psychologically adjusted in the moment they decided to have an abortion. The resolution to terminate the pregnancy was essentially shared with supportive people and it was mostly motivated by socio-economic issues. The different beliefs and values found in this sample, and their possible associations are discussed. Conclusion: Despite high levels of stress, the women were psychologically adjusted at the time of making the decision to terminate the pregnancy. However, opposing what has been previously reported, the women presented high levels of sadness and fear, showing that this decision was hard to make, triggering disruptive emotions. 143 152 Sara S Sereno Sara Sereno Maternidade Dr. Alfredo da Costa Maternidade Dr. Alfredo da Costa Portugal Isabel I Leal Isabel Leal Psychology and Health Research Unit, Instituto Superior de Psicologia Aplicada Psychology and Health Research Unit, Instituto Superior de Psicologia Aplicada Portugal ileal@ispa.pt João J Maroco João Maroco Psychology and Health Research Unit, Instituto Superior de Psicologia Aplicada Psychology and Health Research Unit, Instituto Superior de Psicologia Aplicada Portugal AbortionDecision makingEmotionsPsychological adjustmentStress 532.pdf Associação para o Planeamento da Família. [The situation of abortion in Portugal: Practices, contexts and problems]. Lisboa: Associação para o Planeamento; 2007.Portuguese.##Barden-O'Fallon JL, Speizer IS, White JS. Association between contraceptive discontinuation and pregnancy intentions in Guatemala. Rev Panam Salud Publica. 2008;23(6):410-7.##Read C, Bateson D, Weisberg E, Estoesta J. Contraception and pregnancy then and now: examining the experiences of a cohort of mid-age Australian women. Aust N Z J Obstet Gynaecol. 2009;49(4):429-33.##Leal I. [Psychology of Pregnancy and Parenthood]. Lisboa: Fim de Século; 2005. Portuguese.##Tachibana M, Santos LP, Duarte CAM. [The conflict between the conscious and unconscious in unplanned pregnancy]. Psychê. 2006;10(19):149-67. Portuguese.##Kero A, Högberg U, Jacobsson L, Lalos A. Legal abortion: a painful necessity. Soc Sci Med. 2001;53(11):1481-90.##Leal I. [Opening note]. Análise Psicológica. 1998;3(16):363-4. Portuguese.##Roynet D. [Making waves: adolescence and sex]. Sexualidade & Planeamento Familiar. 2008;50/51:29-33. Portuguese.##Berer M. Making abortion a woman's right world-wide. Making abortion a woman's right worldwide. Reprod Health Matters. 2002;10(19):1-8.##Broen AN, Moum T, Bödtker AS, Ekeberg O. Reasons for induced abortion and their relation to women's emotional distress: a prospective, two-year follow-up study. Gen Hosp Psychiatry. 2005;27(1):36-43.##Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception. 2006;74(4):334-44.##Kirkman M, Rowe H, Hardiman A, Mallett S, Rosenthal D. Reasons women give for abortion: a review of the literature. Arch Womens Ment Health. 2009;12(6):365-78.##Santelli JS, Speizer IS, Avery A, Kendall C. An exploration of the dimensions of pregnancy intentions among women choosing to terminate pregnancy or to initiate prenatal care in New Orleans, Louisiana. Am J Public Health. 2006;96(11):2009-15.##Sihvo S, Bajos N, Ducot B, Kaminski M. Women's life cycle and abortion decision in unintended pregnancies. J Epidemiol Community Health. 2003;57(8):601-5.##Stotland NL. Induced abortion in the United States. In: Scotland NL, Stewart DE, editors. Psychological aspects of women and health care: The interface between psychiatry and obstetrics and gynecology. Washington DC: American Psychiatric Press; 2000. p. 219-39.##National Statistics, Department of Health. Abortion Statistics, England and Wales: 2006. Statistical Bulletin [Internet]. 2007 Jun [cited 2012 Dec]; Available from: http://www.mariestopes.org.uk/ documents/UK Abortion Statistics 200 6.pdf##Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH. Induced abortion: estimated rates and trends world-wide. Lancet. 2007;370(9595):1338-45.##Beja V, Leal I. Abortion counselling according to healthcare providers: a qualitative study in the Lisbon metropolitan area, Portugal. Eur J Contracept Reprod Health Care. 2010;15(5):326-35.##Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. Psychological factors in abortion. A review. Am Psychol. 1992;47(10):1194-204.##Bradshaw Z, Slade P. The effects of induced abortion on emotional experiences and relationships: a critical review of the literature. Clin Psychol Rev. 2003;23(7):929-58.##Coleman PK. Resolution of unwanted pregnancy during adolescence through abortion versus childbirth: Individual and family predictors and psychological consequences. J Youth Adolescence. 2006;35:903-11.##Lauzon P, Roger-Achim D, Achim A, Boyer R. Emotional distress among couples involved in first-trimester induced abortions. Can Fam Physician. 2000;46:2033-40.##Broen AN, Moum T, Bödtker AS, Ekeberg O. Predictors of anxiety and depression following pregnancy termination: a longitudinal five-year follow-up study. Acta Obstet Gynecol Scand. 2006;85(3):317-23.##Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.##Pais-Ribeiro J, Honrado A, Leal I. [Contribution to the study of the Portuguese adaptation of the scale of depression and anxiety by Lovibond and Lovibond]. Psycologica. 2004;36:235-46. Portuguese.##Pais-Ribeiro J. [Satisfaction with Social Support Scale (SSSS)]. Análise Psicológica. 1999;17(3):547-58. Portuguese.##Carlson CR, Collins FL, Stewart JF, Porzellius J, Nitz JA, Lind CO. The assessment of emotional reactivity: A scale development and validation study. J Psychopathol Behav Assess. 1989;11(4):313-25.##Moura-Ramos MC. Adaptação materna e paterna ao nascimento de um filho: Percursos e contextos da infância: Universidade de Coimbra; 2006.##O'Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25-30.##Roha JC. Factores Psicológicos da Mulher Face à Interrupção Médica da Gravidez: Universidade do Porto; 2005.##Sereno S, Leal I, Maroco J. [Development and validation of a questionnaire of values and beliefs about sexuality, motherhood and abortion]. Psicologia, Saúde & Doenças. 2009;10(2):193-204. Portuguese.##Rizzardo R, Magni G, Desideri A, Consentino M, Salmaso P. Personality and psychological distress before and after legal abortion: a prospective study. J Psychosom Obstet Gynaecol.1992;13(2):75-91.##Chełstowska A. Stigmatisation and commercialisation of abortion services in Poland: turning sin into gold. Reprod Health Matters. 2011;19(37):98-106.##

Successful Prognosis of Brain Abscess during Pregnancy 2 1 539 2 Introduction: Brain abscess in pregnancy is very rare, which mostly progresses to neurological abnormalities. Case Presentation: The patient is a 24-year-old pregnant woman. She was referred to Saitama hospital due to severe headache and nausea on October 2008. Brain MRI detected a 1.5 cm abscess mass with extensive edema in the right frontal lobe. We performed intensive therapy using some antibiotics that included cefotaxime and meropenem and depressants for intracranial pressure for six weeks. There was a good prognosis for the woman and her fetus without any sign of neurological abnormalities. Conclusion: Early medical intervention is required before it is too late for brain abscess in pregnancy. 152 156 Masashi M Yoshida Masashi Yoshida Department of Obstetrics and Gynecology, National Defense Medical College Department of Obstetrics and Gynecology, National Defense Medical College Japan dr22023@ndmc.ac.jp Hideo H Matsuda Hideo Matsuda Division of Perinatology, Matsuda Perinatal Clinic Division of Perinatology, Matsuda Perinatal Clinic Japan Kenichi K Furuya Kenichi Furuya Department of Obstetrics and Gynecology, National Defense Medical College Department of Obstetrics and Gynecology, National Defense Medical College Japan No Keyword 539.pdf Braun TI, Kerson LA, Eisenberg FP. Nocardial brain abscesses in a pregnant woman. Rev Infect Dis. 1991;13(4):630-2.##Baxi LV, Mayer SA, Mansukhani M. Cerebral abscess and thrombophilia in pregnancy. A case report. J Reprod Med. 2001;46(6):606-8.##Wax JR, Blackstone J, Mancall A, Cartin A, Pinette MG. Sinogenic brain abscess complicating pregnancy. Am J Obstet Gynecol. 2004;191(5):1711-2.##Kim HC, Kang SG, Huh PW, Yoo do S, Cho KS, Kim DS. Pituitary abscess in a pregnant woman. J Clin Neurosci. 2007;14(11):1135-9.##Jacob CE, Kurien M, Varghese AM, Aleyamma TK, Jasper P, Prabu K, et al. Treatment of otogenic brain abscess in pregnancy. Otol Neurotol. 2009;30(5):602-3.##Hobson DT, Imudia AN, Soto E, Awonuga AO. Pregnancy complicated by recurrent brain abscess after extraction of an infected tooth. Obstet Gynecol. 2011;118(2 Pt 2):467-70.##Pallasch TJ, Slots J. Antibiotic prophylaxis and the medically compromised patient. Periodontol 2000. 1996;10:107-38.##Lanciers S, Despinasse B, Mehta DI, Blecker U. Increased susceptibility to Helicobacter pylori infection in pregnancy. Infect Dis Obstet Gynecol. 1999;7(4):195-8.##Yang SY. Brain abscess: a review of 400 cases. J Neurosurg. 1981;55(5):794-9.##Wax JR, Pinette MG, Blackstone J, Cartin A. Brain abscess complicating pregnancy. Obstet Gynecol Surv. 2004;59(3):207-13.##Duncan KR. The development of magnetic resonance imaging in obstetrics. Br J Hosp Med. 1996; 55(4):178-81.##Nicklas AH, Baker ME. Imaging strategies in the pregnant cancer patient. Semin Oncol. 2000;27(6):623-32.##Lu CH, Chang WN, Lui CC. Strategies for the management of bacterial brain abscess. J Clin Neurosci. 2006;13(10):979-85.##