Are Scholarly Journals in Search for Top Quality Articles or Authors in Search for High Quality Journals? 2 1 704 2 The end of the industrial era began from the middle of the twentieth century and the world has entered a new era of information and communication. The rapid developments in science and technology were the driving force of this transformation. In the 21st century, the need for qualitative and quantitative changes in access to information and knowledge resources is quite evident. Without a doubt, one of the most important resources for quick and easy access to updated research and scientific contents for researchers and scientists is academic journals. These journals contribute to the quantitative and qualitative development and evolution of research and they are very important tools for solving underlying problems in the field of sciences and community and also the transfer of knowledge between scientists and the community. The development of universities, institutes and research centers led to increased scientific findings and subsequently the increase in the number and diversity of academic journals. Currently, scientific journals are highly specialized in various topics. In each topic, over tens to hundreds of specialty and subspecialty journals are published. Therefore, the need for ranking and separating high-quality journals from poor-quality journals is quite evident and necessary. Although the content of human scientific findings is growing with incredible speed, the issue of concern is accelerating the publication of academic journals on the scientific contents and findings of researchers. According to data published in Scientometrics journal (2010), growth rate of publication of scholarly journals is more than 5.6% per year; therefore, the number of journals was doubled in the period of 10-15 years. The growth was in such a way that the number of scholarly journals in the year 1950 was estimated about 60,000 and according to above growth rate, 50 years later in 2000, it reached to about 1,000,000 (1). Recently, the number is estimated to be 2,000,000 with reference to the double increase during the previous10-15 years. However, it seems that this estimation of growth rate and total numbers is not a correct calculation and far from reality. On the other hand, the STM report about the occasion on celebrating the 350th anniversary of scientific and scholarly journals has revealed that the number of active scholarly peer-reviewed journals was 28100 in English language and 6450 in other languages in 2014 (2). In addition, the research of Arif Jinha at Ottawa University declared that the number of scholarly articles passed 50 million in 2009 (3). It is estimated that 2.5 million articles will be added in this collection annually (2). If the last two above numbers (50 and 2.5 million articles) are taken into account, it seems that the number of about 35000 is more similar to reality for scholarly journals and two or even one million are too far from reality. Despite the crucial role of academic journals in the development and dissemination of science and knowledge, especially high quality journals, a lot of scholarly journals do not have minimum quality requirements. Unfortunately, as the number of publishing journals increases, the number of fake and low quality journals also rises. The growth rate of scholarly journals is estimated to be about 3.5% per year; however, this rate for published articles is less than 3% (2). This led to intense competition among the journals to get top quality articles; therefore, it is obvious that the journals with lower quality and discipline are inevitable losers in this competition. Moreover, although open access strategy of many scholarly journals is an excellent policy for free access of scientists, researchers and students to updated research and knowledge, but this makes the suppliers to receive the journal’s cost from students, research centers and universities and transfer it to the authors of articles. As a result, a lot of journals for meeting their expenses are forced to accept low quality papers. All of us as researchers, who have at least a few articles published in qualified journals, are witness of this struggle and competition between journals when we receive various and frequent e-mails to supply their expenses. Therefore, a systematic review on journals’ outline including their establishment, identity of owner, identity of publisher, financing, supplying, evaluation and publication of articles, and finally quality assessment and condition of journals should be performed by the scientific community and professional societies. Actually, the scientific community is a wanderer in a real forest of scholarly journals in which the absence of a roadmap and full attention will thus lead to deviation from the main road. 151 153 Mohammad Reza MR Sadeghi محمدرضا صادقی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran sadeghi@avicenna.ac.ir No Keyword 704.pdf Larsen PO, von Ins M. The rate of growth in scientific publication and the decline in coverage provided by Science Cita-tion Index. Scientometrics. 2010;84(3):575-603.##Ware M, Mabe M. The STM Report: An overview of scientific and scholarly journal publishing. 4th ed. Netherlands: In-ternational Association of Scientific, Technical and Medical Publishers; 2015. 180 p.##Jinha AE. Article 50 million: an estimate of the number of scholarly articles in existence. Learn Publ. 2010;23(3):258-63.##

Sociological Study on the Transformation of Fertility and Childbearing Concept in Iran 2 1 698 2 Fertility and childbearing, in addition to the biological aspects, has always been regarded as a social phenomenon and, therefore, to understand the incident, values and beliefs, norms, and in short, the culture of any society should be scrutinized. Since the concept, condition, and value of childbearing is associated with cultural, social, political and economic dimensions, it has undergone various transformations during passage of time from past to present. The sociological approach of the current study investigated the evolution of the concept and value of fertility and childbearing in light of historical, social, cultural and economic upheavals. This study shows that the methods of rationalizing and legitimizing decisions about fertility and childbearing are defined and specified in the context of society. The rational for selecting the decisions is intermingled with social, cultural, economic, and political evolutions of the society like modernization, urbanization and the level of development in human communities. Today, fertility, childbearing and the number of children are not only connected with the interpretations of the individuals about the conditions and micro and macro subjective and objective factors surrounding them, but they are also linked with factors such as family income, the amount of time parents allocate to their children, quality of child nurturing and other family variables. 153 162 Zohreh Z Behjati-Ardakani Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran Mehrdad M Navabakhsh Faculty of Humanistic and Social Sciences, Science and Research Branch, Islamic Azad University Faculty of Humanistic and Social Sciences, Science and Research Branch, Islamic Azad University Iran Seyed Hasan SH Hosseini Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran shhoseini@uti.ac.ir; hosseini_1332@yahoo. com ChildbearingCultural changeIndividualismSocial changeSocio economic transformation 698.pdf Abbasi-Shavazi MJ, Razeghi Nasrabad HB, Behjati Ardakani Z, Akhondi MM. [Attitudes of infertile women towards gamete donation: a case study in Tehran]. J Reprod Infertil. 2006;7(2):139-48. Persian.##Behjati Ardakani Z. [Sociological approach of lived experience of infertile couples seek ART treatment] [master’s thesis]. [Tehran]: Tehran University; 2014: 176 p. Persian.##Behjati-Ardakani Z, Akhondi MM, Mahmoodzadeh H, Hosseini SH. An evaluation of the historical importance of fertility and its reflection in ancient mythology. J Reprod Infertil. 2016;17(1):2-9.##Pazandeh F, Sharghi Somae N, Karami Nouri R, Alavi Majd H. [An investigation on the relationship between infertility and marriage satisfaction]. Pajoohandeh J. 2005;9(6):9-15. Persian.##Hosseini N. [The incompatibility of only children with society]. Shargh Daily. 2013 Octob 31:Sect. Iranian culture:12. Persian.##Kalantari S, Abbaszadeh M, Amin-Mozafari F, Rakeei Bonab N. The sociological study of attitude to child bearing and it’s some related factors (Case study: married youth In Tabriz City). J Appl Sociol. 2010;21(1):83-104.##Nik Kholgh AA. [Rural sociology in Iran]. 1st ed. Tehran: Chapakhsh; 2015. 248 p. Persian.##Aghajanian A. Development gender and fertility in Iran. Sociology Department Working Papers; 1990. Paper 5.##Al-e-Ahmad J. [A Stone on a grave]. Tehran: Ravagh Publication;1981. 96 p. Persian.##Khadivzade T, Arghavani E. Religious beliefs and fertility preferences among engaged couples, referring to premarital counseling centers of Mashhad. J Midwifery Reprod Health. 2014;2(4):238-45.##Vedadhir AA, Hossein Nejad F, Hani Sadati SM, Taghavi S. [Childbearing as a socio-cultural problem: A realistic reflection on cesarean section]. Iran J Anthropol Res. 2012;1(2):111-35. Persian.##Michel A. Sociologie de la famille et du marriage. 1st ed. France: Presses universitaires de France; 1978. 263 p.##Durkheim E. The elementary forms of the religious life. New York: Oxford University Press; 1995. 344 p.##Kaveh Firouz Z. The evaluation of the policies in population control in previous three decades and their effect on fertility [master’s thesis]. [Tehran]: Tehran University. 1988.##Skidmore W. Theoretical thinking in Sociology. 2nd ed. London: Cambridge University Press; 1979. 265 p.##Moeeni M, Pourreza A, Torabi F, Heydari H, Mahmoudi M. Analysis of economic determinants of fertility in Iran: a multilevel approach. Int J Health Policy Manag. 2014;3(3):135-44.##Hosseini H, Bagi B. [Socioeconomic, cultural and demographic determinants of childbearing desires among married women attending health centers in Hamedan (2012)]. J Kermanshah Univ Med Sci. 2014;18(1):35-43. Persian.##Virtala A, Vilska S, Huttunen T, Kunttu K. Childbearing, the desire to have children, and awareness about the impact of age on female fertility among Finnish university students. Eur J Contracept Reprod Health Care. 2011;16(2):108-15.##Khadivzadeh T, Latifnejad Roudsari R, Bahrami M, Taghipour A, Abbasi Shavazi J. The influence of social network on couples’ intention to have the first child. Iran J Reprod Med. 2013;11(3):209-18.##Abbasi Shavazi MJ, Askari Nodoushan A. [Family changes and fertility decline in Iran: case study in Yazd province]. Nameh-ye Olum-e Ejtemai. 2005; 25:25-75. Persian.##Beigzadeh S. [Code of saba]. Tehran: Celck Saba Press; 2014. 1552 p. Persian.##Behboudi-Gandevani S, Ziaei S, Farahani FK, Jasper M. The perspectives of Iranian women on delayed childbearing: A qualitative study. J Nurs Res. 2015;23(4):313-21.##Khalajabadi Farahani F. [Reasons for low fertility in Iran]. Iran newspaper (Vige Name Jameite). 2011 Sept 21:37. Persian.##Hofstede G, Hofstede GJ, Minkov M. Cultures and organizations: software of the mind. 3rd ed. USA: McGraw-Hill books; 2010. 549 p.##Little D. Varieties of social explanation: An introduction to the philosophy of social science. 1st ed. Boulder, Colorado: Westview Press. 1991. 258 p.##Ghanadan M, Moti N. [Sociology: Key concepts]. 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Short Term Culture of Vitrified Human Ovarian Cortical Tissue to Assess the Cryopreservation Outcome: Molecular and Morphological Analysis 2 1 691 2 Background: The aim of the present study was to evaluate the effectiveness of human ovarian vitrification protocol followed with in vitro culture at the morphological and molecular levels. Methods: Ovarian tissues were obtained from 10 normal transsexual women and cut into small pieces and were divided into non-vitrified and vitrified groups and some of the tissues fragments in both groups were randomly cultured for two weeks. The morphological study using hematoxylin and eosin and Masson's trichrome staining was done. The analysis of mean follicular density, 17-β estradiol (E2) and anti mullerian hormone (AMH), and real-time RT-PCR was down for the evaluation of expression of genes related to folliculogenesis. Data were compared by paired-samples and independent-samples T test. Values of p<0.05 were considered statistically significant. Results: The proportion of normal follicles did not show significant difference between vitrified and non-vitrified groups before and after culture but these rates and the mean follicle density significantly decreased in both cultured tissues (p<0.05). The expression of genes was similar in vitrified and non-vitrified groups but in cultured tissues the expression of GDF9 and FSHR genes increased and the expression of FIGLA and KIT-L genes decreased (p<0.05). An increase in E2 and AMH concentration was observed after 14 days of culture in both groups. Conclusion: In conclusion, the present study indicated that the follicular development and gene expression in vitrified ovarian tissue was not altered before and after in vitro culture, thus this method could be useful for fertility preservation; however, additional studies are needed to improve the culture condition. 162 172 Mehdi M Ramezani Department of Anatomical Sciences, Medical Sciences Faculty, Tarbiat Modares University Department of Anatomical Sciences, Medical Sciences Faculty, Tarbiat Modares University Iran Mojdeh M Salehnia مژده صالح نیا Department of Anatomical Sciences, Medical Sciences Faculty, Tarbiat Modares University Department of Anatomical Sciences, Medical Sciences Faculty, Tarbiat Modares University Iran salehnim@modares.ac.ir, mogdeh@dr.com Mina M Jafarabadi مینا جعفرآبادی Reproductive Health Research Center, Tehran University of Medical Sciences Reproductive Health Research Center, Tehran University of Medical Sciences Iran 17 beta- EstradiolAnti- mullerian hormoneGene expressionVitrification 691.pdf Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(19):2500-10.##Skaznik-Wikiel ME, Gilbert SB, Meacham RB, Kondapalli LA. Fertility Preservation Options for Men and Women With Cancer. Rev Urol. 2015;17(4):211-9.##Andersen CY, Kristensen SG, Greve T, Schmidt KT. Cryopreservation of ovarian tissue for fertility preservation in young female oncological patients. Future Oncol. 2012;8(5):595-608.##Grynberg M, Poulain M, Sebag-Peyrelevade S, le Parco S, Fanchin R, Frydman N. Ovarian tissue and follicle transplan-tation as an option for fertility preservation. Fertil Steril. 2012;97(6):1260-8.##Jeong K, Aslan E, Ozkaya E, Sonmezer M, Oktay K. Ovarian cryopreservation. Minerva Med. 2012;103(1):37-46.##Hovatta O, Silye R, Krausz T, Abir R, Margara R, Trew G, et al. Cryopreservation of human ovarian tissue using dimethylsulphoxide and propanediol-sucrose as cryoprotectants. Hum Reprod. 1996;11(6):1268-72.##Gandolfi F, Paffoni A, Papasso Brambilla E, Bonetti S, Brevini TA, Ragni G. Efficiency of equilibrium cooling and vitrification procedures for the cryopreservation of ovarian tissue: comparative analysis between human and animal models. Fertil Steril. 2006;85 Suppl 1:1150-6.##Sheikhi M, Hultenby K, Niklasson B, Lundqvist M, Hovatta O. Clinical grade vitrification of human ovarian tissue: an ultrastructural analysis of follicles and stroma in vitrified tissue. Hum Reprod. 2011;26(3):594-603.##Amorim CA, David A, Van Langendonckt A, Dolmans MM, Donnez J. Vitrification of human ovarian tissue: effect of different solutions and procedures. Fertil Steril. 2011;95(3):1094-7.##Salehnia M, Sheikhi M, Pourbeiranvand S, Lundqvist M. Apoptosis of human ovarian tissue is not increased by either vitrification or rapid cooling. Reprod Biomed Online. 2012;25(5):492-9.##Bandeira FT, Carvalho AA, Castro SV, Lima LF, Viana DA, Evangelista JS, et al. Two methods of vitrification fol-lowed by in vitro culture of the ovine ovary: evaluation of the follicular development and ovarian extracellular matrix. Reprod Domest Anim. 2015;50(2):177-85.##Youm HW, Lee JR, Lee J, Jee BC, Suh CS, Kim SH. Optimal vitrification protocol for mouse ovarian tissue cryopres-ervation: effect of cryoprotective agents and in vitro culture on vitrified-warmed ovarian tissue survival. Hum Reprod. 2014;29(4):720-30.##Shams Mofarahe Z, Ghaffari Novin M, Jafarabadi M, Salehnia M, Noroozian M, Ghorbanmehr N. Effect of Human Ovarian Tissue Vitrification/Warming on the Expression of Genes Related to Folliculogenesis. Iran Biomed J. 2015;19(4):220-5.##Isachenko V, Lapidus I, Isachenko E, Krivokharchenko A, Kreienberg R, Woriedh M, et al. Human ovarian tissue vitri-fication versus conventional freezing: morphological, endocrinological, and molecular biological evaluation. Reproduc-tion. 2009;138(2):319-27.##Abdollahi M, Salehnia M, Salehpour S, Ghorbanmehr N. Human ovarian tissue vitrification/warming has minor effect on the expression of apoptosis-related genes. Iran Biomed J. 2013;17(4):179-86.##Wang X, Catt S, Pangestu M, Temple-Smith P. Successful in vitro culture of pre-antral follicles derived from vitrified murine ovarian tissue: oocyte maturation, fertilization, and live births. Reproduction. 2011;141(2):183-91.##Khosravi F, Reid RL, Moini A, Abolhassani F, Valojerdi MR, Kan FW. In vitro development of human primordial fol-licles to preantral stage after vitrification. J Assist Reprod Genet. 2013;30(11):1397-406.##Liu J, Van Der Elst J, Van Den Broecke R, Dumortier F, Dhont M. Maturation of mouse primordial follicles by combi-nation of grafting and in vitro culture. Biol Reprod. 2000;62(5):1218-23.##McGee EA, Hsueh AJ. Initial and cyclic recruitment of ovarian follicles. Endocr Rev. 2000;21(2):200-14.##Edson MA, Nagaraja AK, Matzuk MM. The mammalian ovary from genesis to revelation. Endocr Rev. 2009;30(6):624-712.##Adhikari D, Liu K. Molecular mechanisms underlying the activation of mammalian primordial follicles. Endocr Rev. 2009;30(5):438-64.##Johnson J, Canning J, Kaneko T, Pru JK, Tilly JL. Germline stem cells and follicular renewal in the postnatal mamma-lian ovary. Nature. 2004;428(6979):145-50.##Lin RS, Jimenez-Movilla M, Dean J. Figla-Cre transgenic mice expressing myristoylated EGFP in germ cells provide a model for investigating perinatal oocyte dynamics. PLoS One. 2014;9(1):e84477.##McNatty KP, Juengel JL, Reader KL, Lun S, Myllymaa S, Lawrence SB, et al. Bone morphogenetic protein 15 and growth differentiation factor 9 co-operate to regulate granulosa cell function. Reproduction. 2005;129(4):473-80.##Oron G, Fisch B, Ao A, Zhang XY, Farhi J, Ben-Haroush A, et al. Expression of growth-differentiating factor 9 and its type 1 receptor in human ovaries. Reprod Biomed Online. 2010;21(1):109-17.##Carlsson IB, Laitinen MP, Scott JE, Louhio H, Velentzis L, Tuuri T, et al. Kit ligand and c-Kit are expressed during early human ovarian follicular development and their interaction is required for the survival of follicles in long-term culture. Reproduction. 2006;131(4):641-9.##Tuck AR, Robker RL, Norman RJ, Tilley WD, Hickey TE. Expression and localisation of c-kit and KITL in the adult human ovary. J Ovarian Res. 2015;8:31.##Anjali G, Kaur S, Lakra R, Taneja J, Kalsey GS, Nagendra A, et al. FSH stimulates IRS-2 expression in human granulosa cells through cAMP/SP1, an inoperative FSH action in PCOS patients. Cell Signal. 2015;27(12):2452-66.##Oktay K, Briggs D, Gosden RG. Ontogeny of follicle-stimulating hormone receptor gene expression in isolated human ovarian follicles. J Clin Endocrinol Metab. 1997;82(11):3748-51.##Wang TR, Yan J, Lu CL, Xia X, Yin TL, Zhi X, et al. Human single follicle growth in vitro from cryopreserved ovarian tissue after slow freezing or vitrification. Hum Reprod. 2016;31(4):763-73.##Salehnia M, Abbasian Moghadam E, Rezazadeh Velojerdi M. Ultrastructure of follicles after vitrification of mouse ovarian tissue. Fertil Steril. 2002;78(3):644-5.##Drury RAB, Wallington EA. Carleton's histological technique. 5th ed. UK: Oxford University Press; 1980. p. 183-5.##Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev. 1996;17(2):121-55.##Pfaffl MW. A new mathematical model for relative quantification in real-time RT-PCR. Nucleic Acids Res. 2001;29(9):e45.##Sheikhi M, Hultenby K, Niklasson B, Lundqvist M, Hovatta O. Preservation of human ovarian follicles within tissue frozen by vitrification in a xeno-free closed system using only ethylene glycol as a permeating cryoprotectant. Fertil Steril. 2013;100(1):170-7.##Zeng YC, Tang HR, Zeng LP, Chen Y, Wang GP, Wu RF. Assessment of the effect of different vitrification solutions on human ovarian tissue after short-term xenotransplantation onto the chick embryo chorioallantoic membrane. Mol Reprod Dev. 2016;83(4):359-69.##Sanfilippo S, Canis M, Smitz J, Sion B, Darcha C, Janny L, et al. Vitrification of human ovarian tissue: a practical and relevant alternative to slow freezing. Reprod Biol Endocrinol. 2015;13:67.##Tian T, Zhao G, Han D, Zhu K, Chen D, Zhang Z, et al. Effects of vitrification cryopreservation on follicular morphol-ogy and stress relaxation behaviors of human ovarian tissues: sucrose versus trehalose as the non-permeable protective agent. Hum Reprod. 2015;30(4):877-83.##Fabbri R, Vicenti R, Macciocca M, Pasquinelli G, Paradisi R, Battaglia C, et al. Good preservation of stromal cells and no apoptosis in human ovarian tissue after vitrification. Biomed Res Int. 2014;2014:673537.##Orisaka M, Tajima K, Tsang BK, Kotsuji F. Oocyte-granulosa-theca cell interactions during preantral follicular devel-opment. J Ovarian Res. 2009;2(1):9.##Isachenko V, Montag M, Isachenko E, van der Ven K, Dorn C, Roesing B, et al. Effective method for in-vitro culture of cryopreserved human ovarian tissue. Reprod Biomed Online. 2006;13(2):228-34.##Telfer EE, McLaughlin M, Ding C, Thong KJ. A two-step serum-free culture system supports development of human oocytes from primordial follicles in the presence of activin. Hum Reprod. 2008;23(5):1151-8.##Hovatta O, Wright C, Krausz T, Hardy K, Winston RM. Human primordial, primary and secondary ovarian follicles in long-term culture: effect of partial isolation. Hum Reprod. 1999;14(10):2519-24.##Hovatta O. Cryopreservation and culture of human primordial and primary ovarian follicles. Mol Cell Endocrinol. 2000;169(1-2):95-7.##McLaughlin M, Kinnell HL, Anderson RA, Telfer EE. Inhibition of phosphatase and tensin homologue (PTEN) in hu-man ovary in vitro results in increased activation of primordial follicles but compromises development of growing folli-cles. Mol Hum Reprod. 2014;20(8):736-44.##Morohaku K, Hoshino Y, Sasada H, Sato E. Incorporation of phosphatase inhibitor in culture prompts growth initiation of isolated non-growing oocytes. PLoS One. 2013;8(11):e77533.##Smitz JE, Cortvrindt RG. The earliest stages of folliculogenesis in vitro. Reproduction. 2002;123(2):185-202.##Li J, Kawamura K, Cheng Y, Liu S, Klein C, Liu S, et al. Activation of dormant ovarian follicles to generate mature eggs. Proc Natl Acad Sci USA. 2010;107(22):10280-4.##Schmidt KL, Byskov AG, Nyboe Andersen A, Müller J, Yding Andersen C. Density and distribution of primordial fol-licles in single pieces of cortex from 21 patients and in individual pieces of cortex from three entire human ovaries. 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Leptin Improves Sperm Cryopreservation via Antioxidant Defense 2 1 692 2 Background: Leptin and its receptor are present in spermatozoa; however, the role of leptin in sperm function is still controversial. Our present study aimed at demonstrating the effect of cryopreservation on sperm DNA fragmentation (DNAf) and investigating the possible effects of sperm capacitation techniques and leptin in vitro incubation on frozen-thawed sperm DNAf and oxidative stress. Methods: Samples of 45 normospermic men attending for infertility investigation at Vida Centro de Fertilidade, Rio de Janeiro, Brazil, were frozen and thawed with or without capacitation and leptin incubation prior to freezing. Sperm DNA fragmentation was evaluated by Sperm Chromatin Dispersion Assay before and after cryopreservation and oxidative stress parameters were measured by spectrophotometry with and without leptin incubation. Statistical analysis was performed using paired t test to compare DNAf between groups before and after freeze-thaw cycle, to compare groups before and after capacitation and leptin incubation and oxidative measurements before and after leptin incubation. Statistical significance was considered when p≤0.05. Results: Our results revealed a significant post-thaw rise in sperm DNAf compared with fresh samples (p=0.0003). Sperm DNAf was significantly reduced when sperm capacitation was performed before freezing, when compared to those frozen with no previous capacitation (p=0.01). The addition of leptin to capacitated sperm before freezing reduced DNAf (p<0.0001) and enhanced superoxide dismutase (p=0.001) and glutathione peroxidase (p=0.02) antioxidant enzymes activity. Conclusion: The addition of leptin to capacitated sperm can improve sperm DNA quality following cryopreservation, possibly by inducing the activity of certain antioxidant enzymes. 172 179 Paula P Fontoura University Hospital Pedro Ernesto, State University of Rio de Janeiro University Hospital Pedro Ernesto, State University of Rio de Janeiro Brazil Mariana M Mello Vida Centro de Fertilildade da Rede D’Or Clinic Vida Centro de Fertilildade da Rede D’Or Clinic Brazil Paulo P Gallo-Sá Vida Centro de Fertilildade da Rede D’Or Clinic Vida Centro de Fertilildade da Rede D’Or Clinic Brazil Maria Cecília MC Erthal-Martins Vida Centro de Fertilildade da Rede D’Or Clinic Vida Centro de Fertilildade da Rede D’Or Clinic Brazil Maria Cecília MC Cardoso Vida Centro de Fertilildade da Rede D’Or Clinic Vida Centro de Fertilildade da Rede D’Or Clinic Brazil Cristiane C Ramos University Hospital Pedro Ernesto, State University of Rio de Janeiro University Hospital Pedro Ernesto, State University of Rio de Janeiro Brazil DNA fragmentationFreeze-thaw cycleLeptinOxidative stressSperm 692.pdf Petyim S, Neungton C, Thanaboonyawat I, Laokirkkiat P, Choavaratana R. Sperm preparation before freezing improves sperm motility and reduces apoptosis in post-freezing-thawing sperm compared with post-thawing sperm preparation. J Assist Reprod Genet. 2014;31(12):1673-80.##Sieme H, Oldenhof H, Wolkers WF. Sperm membrane behaviour during cooling and cryopreservation. Reprod Domest Anim. 2015;50 Suppl 3:20-6.##Yeste M, Estrada E, Rocha LG, Marin H, Rodriguez-Gil JE, Miro J. Cryotolerance of stallion spermatozoa is related to ROS production and mitochondrial membrane potential rather than to the integrity of sperm nucleus. Andrology. 2015;3(2):395-407.##Di Santo M, Tarozzi N, Nadalini M, Borini A. Human Sperm Cryopreservation: Update on Techniques, Effect on DNA Integrity, and Implications for ART. Adv Urol. 2012;2012:854837.##Aitken RJ, Baker MA, De Iuliis GN, Nixon B. New insights into sperm physiology and pathology. Handb Exp Pharmacol. 2010;(198):99-115.##Helfenstein F, Losdat S, Moller AP, Blount JD, Richner H. Sperm of colourful males are better protected against oxidative stress. Ecol Lett. 2010;13(2):213-22.##Cocuzza M, Sikka SC, Athayde KS, Agarwal A. Clinical relevance of oxidative stress and sperm chromatin damage in male infertility: an evidence based analysis. Int Braz J Urol. 2007;33(5):603-21.##Sakkas D, Alvarez JG. Sperm DNA fragmentation: mechanisms of origin, impact on reproductive outcome, and analysis. Fertil Steril. 2010;93(4):1027-36.##Zhao J, Zhang Q, Wang Y, Li Y. Whether sperm deoxyribonucleic acid fragmentation has an effect on pregnancy and miscarriage after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis. Fertil Steril. 2014;102(4):998-1005.##Zhang W, Li F, Cao H, Li C, Du C, Yao L, et al. Protective effects of l-carnitine on astheno- and normozoospermic human semen samples during cryopreservation. Zygote. 2016;24(2):293-300.##Mata-Campuzano M, Alvarez-Rodriguez M, Alvarez M, Tamayo-Canul J, Anel L, de Paz P, et al. Post-thawing quality and incubation resilience of cryopreserved ram spermatozoa are affected by antioxidant supplementation and choice of extender. Theriogenology. 2015;83(4):520-8.##Garcia-Galiano D, Allen SJ, Elias CF. Role of the adipocyte-derived hormone leptin in reproductive control. Horm Mol Biol Clin Investig. 2014;19(3):141-9.##Li HW, Chiu PC, Cheung MP, Yeung WS, O WS. Effect of leptin on motility, capacitation and acrosome reaction of human spermatozoa. Int J Androl. 2009;32(6):687-94.##Jope T, Lammert A, Kratzsch J, Paasch U, Glander HJ. Leptin and leptin receptor in human seminal plasma and in human spermatozoa. Int J Androl. 2003;26(6):335-41.##Aquila S, Giordano F, Guido C, Rago V, Carpino A. Nitric oxide involvement in the acrosome reaction triggered by leptin in pig sperm. Reprod Biol Endocrinol. 2011;9:133.##Lampiao F, du Plessis SS. Insulin and leptin enhance human sperm motility, acrosome reaction and nitric oxide production. Asian J Androl. 2008;10(5):799-807.##Haron MN, D'Souza UJ, Jaafar H, Zakaria R, Singh HJ. Exogenous leptin administration decreases sperm count and increases the fraction of abnormal sperm in adult rats. Fertil Steril. 2010;93(1):322-4.##Solinas G. Leptin signalling coordinates lipid oxidation with thermogenesis and defence against oxidative stress. Clin Exp Pharmacol Physiol. 2010;37(10):953-4.##Zheng J, Fang J, Yin YJ, Wang XC, Ren AJ, Bai J, et al. Leptin protects cardiomyocytes from serum-deprivation-induced apoptosis by increasing anti-oxidant defence. Clin Exp Pharmacol Physiol. 2010;37(10):955-62.##Yamagishi SI, Edelstein D, Du XL, Kaneda Y, Guzman M, Brownlee M. Leptin induces mitochondrial superoxide production and monocyte chemoattractant protein-1 expression in aortic endothelial cells by increasing fatty acid oxidation via protein kinase A. J Biol Chem. 2001;276(27):25096-100.##Feijo CM, Esteves SC. Diagnostic accuracy of sperm chromatin dispersion test to evaluate sperm deoxyribonucleic acid damage in men with unexplained infertility. Fertil Steril. 2014;101(1):58-63.##Draper HH, Hadley M. Malondialdehyde determination as index of lipid peroxidation. Methods Enzymol. 1990;186:421-31.##Ellman GL. Tissue sulfhydryl groups. Arch Biochem Biophys. 1959;82(1):70-7.##Bannister JV, Calabrese L. Assays for superoxide dismutase. Methods Biochem Anal. 1987;32:279-312.##Aebi H. Catalase in vitro. Methods Enzymol. 1984;105:121-6.##Flohe L, Gunzler WA. Assays of glutathione peroxidase. Methods Enzymol. 1984;105:114-21.##Paoli D, Lombardo F, Lenzi A, Gandini L. Sperm cryopreservation: effects on chromatin structure. Adv Exp Med Biol. 2014;791:137-50.##Sharma R, Kattoor AJ, Ghulmiyyah J, Agarwal A. Effect of sperm storage and selection techniques on sperm parameters. Syst Biol Reprod Med. 2015;61(1):1-12.##Meamar M, Zribi N, Cambi M, Tamburrino L, Marchiani S, Filimberti E, et al. Sperm DNA fragmentation induced by cryopreservation: new insights and effect of a natural extract from Opuntia ficus-indica. Fertil Steril. 2012;98(2):326-33.##Tataru DA, Markova EV, Osadchuk LV, Sheina EV, Svetlakov AV. [The optimal conditions of storage of spermatozoa for analysis of DNA fragmentation]. Klin Lab Diagn. 2015;60(4):52-6. Russian.##Vutyavanich T, Piromlertamorn W, Nunta S. Rapid freezing versus slow programmable freezing of human spermatozoa. Fertil Steril. 2010;93(6):1921-8.##Ozkavukcu S, Erdemli E, Isik A, Oztuna D, Karahuseyinoglu S. Effects of cryopreservation on sperm parameters and ultrastructural morphology of human spermatozoa. J Assist Reprod Genet. 2008;25(8):403-11.##Basu S, Pant M, Rachana R. Protective effect of Salacia oblonga against tobacco smoke-induced DNA damage and cellular changes in pancreatic β-cells. Pharm Biol. 2016;54(3):458-64.##Olaciregui M, Luno V, Gonzalez N, De Blas I, Gil L. Freeze-dried dog sperm: Dynamics of DNA integrity. Cryobiology. 2015;71(2):286-90.##Khodayari Naeini Z, Hassani Bafrani H, Nikzad H. Evaluation of ebselen supplementation on cryopreservation medium in human semen. Iran J Reprod Med. 2014;12(4):249-56.##Ghorbani M, Amiri I, Khodadadi I, Fattahi A, Atabakhsh M, Tavilani H. Influence of BHT inclusion on post-thaw attributes of human semen. Syst Biol Reprod Med. 2015;61(1):57-61.##Kalthur G, Adiga SK, Upadhya D, Rao S, Kumar P. Effect of cryopreservation on sperm DNA integrity in patients with teratospermia. Fertil Steril. 2008;89(6):1723-7.##Saritha KR, Bongso A. Comparative evaluation of fresh and washed human sperm cryopreserved in vapor and liquid phases of liquid nitrogen. J Androl. 2001;22(5):857-62.##Martínez-Soto JC, Landeras J, Gadea J. Spermatozoa and seminal plasma fatty acids as predictors of cryopreservation success. Andrology. 2013;1(3):365-75.##Thomson LK, Fleming SD, Aitken RJ, De Iuliis GN, Zieschang JA, Clark AM. 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Relationship of Number of Embryos Transferred with Perinatal Outcome of Singleton Pregnancy 2 1 697 2 Background: Singleton pregnancy with a live birth beyond 37 weeks of gestation is the ultimate goal of any assisted reproductive technology. However, singletons conceived after ART are found to have a poor perinatal outcome in comparison to naturally conceived singletons. It was hypothesized that the outcome of singleton conceived after transfer of two or more embryos may be dependent on the sharing of uterine space with other embryos. Methods: Patients who had single gestational sac visualized at 6 weeks after transfer of 4, 3 or 2 embryos were considered for the study. 195 singleton pregnancies were selected for final evaluation such that as per implantation rates of 25%, 33%, and 50%, they were divided into 3 groups of 50, 82 and 63 cases, respectively. The basic characteristics of pregnancy (gestational age, birth weight) were compared using analysis of variance (continuous variables), and categorical variables were evaluated with chi-squared test. The p<0.05 was considered statistically significant. Results: Among the various variables including maternal age, conception, type of infertility, type of abortion, total live birth, gestational age in live birth, birth weight, kind of embryo transfer and gestational age, there was not significant statistical differences between groups except gestational age that it was higher in group with 50% (p<0.04) implantation rate. Therefore, higher number of initial embryos may affect the perinatal outcome of singleton conceived subsequently. Conclusion: There is higher chance of missed abortion in patients with singleton pregnancies conceived after multiple embryo transfer. Gestational age at delivery and birth weight were correlated with number of embryo transfered. 179 185 Shilpa Sh Bhandari Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute India drshilpa.b@gmail.com Ishita I Ganguly Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute India Pallavi P Agarwal Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute India Niharika N Munaganuru Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute India Nitika N Gupta Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute India Aparna A Singh Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute Department of Reproductive Medicine and Surgery, Sri Aurobindo Medical College and Post Graduate Institute India Assisted Reproductive TechniquesEmbryo transferImplantation ratePerinatal outcomeSingleton pregnancy 697.pdf Practice Committee of the American Society for Reproductive Medicine; Practice Committee of the Society for Assisted Reproductive Technology. Criteria for number of embryos to transfer: a committee opinion. Fertil Steril. 2013;99(1):44-6.##Pinborg A, Wennerholm UB, Romundstad LB, Loft A, Aittomaki K, Soderstrom-Anttila V, et al. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis. Hum Reprod Update. 2013;19(2):87-104.##Oron G, Son WY, Buckett W, Tulandi T, Holzer H. The association between embryo quality and perinatal outcome of singletons born after single embryo transfers: a pilot study. Hum Reprod. 2014:29(7):1444-51.##Poikkeus P, Unkila-Kallio L, Vilska S, Repokari L, Punamaki RL, Aitokallio-Tallberg A, et al. Impact of infertility characteristics and treatment modalities on singleton pregnancies after assisted reproduction. Reprod Biomed Online. 2006;13(1):135-44.##Hunault CC, Eijkemans MJ, Pieters MH, te Velde ER, Habbema JD, Fauser BC, et al. A prediction model for selecting patients undergoing in vitro fertilization for elective single embryo transfer. Fertil Steril. 2002;77(4):725-32.##Hillier SG. The Parkes lecture: controlled ovarian stimulation in women. J Reprod Fertil. 2010;120(2):201-10.##Casper RF, Yanushpolsky EH. Optimal endometrial preparation for frozen embryo transfer cycles: window of implantation and progesterone support. Fertil Steril. 2016;105(4):867-72.##Practice Committee of the American Society for Reproductive Medicine in collaboration with Society for Reproductive Endocrinology and Infertility. Progesterone supplementation during the luteal phase and in early pregnancy in the treatment of infertility: an educational bulletin. Fertil Steril. 2008;90(5 Suppl):S150-3.##Zhang S, Lin H, Kong S, Wang S, Wang H, Wang H, et al. Physiological and molecular determinants of embryo implantation. Mol Aspects Med. 2013;34(5):939-80.##Chen Q, Zhang Y, Peng H, Lei L, Kuang H, Zhang L, et al. Transient {beta}2-adrenoceptor activation confers pregnancy loss by disrupting embryo spacing at implantation. J Biol Chem. 2011;286(6):4349-56.##Terriou P, Sapin C, Giorgetti C, Hans E, Spach JL, Roulier R. Embryo score is a better predictor of pregnancy than the number of transferred embryos or female age. Fertil steril. 2001;75(3):525-31.##Pinborg A, Lidegaard O, la Cour Freiesleben N, Andersen AN. Consequences of vanishing twins in IVF/ICSI pregnancies. Hum Reprod. 2005;20(10):2821-9.##Balassiano E, Malik S, Vaid P, Knochenhauer ES, Traub ML. The presence of multiple gestational sacs confers a higher live birth rate in women with infertility who achieve a positive pregnancy test after fresh and frozen embryo transfer: a retrospective local cohort. Reprod Biol Endocrinol. 2014;12:104.##Garrido N, Bellver J, Remohi J, Alama P, Pellicer A. Cumulative newborn rates increase with the total number of transferred embryos according to an analysis of 15,792 ovum donation cycles. Fertil Steril. 2012;98(2):341-6.##Pelkonen S, Koivunen R, Gissler M, Nuojua-Huttunen S, Suikkari AM, Hyden-Granskog C, et al. Perinatal outcome of children born after frozen and fresh embryo transfer: the Finnish cohort study 1995-2006. Hum Reprod. 2010;25(4):914-23.##Hsu MI, Mayer J, Aronshon M, Lanzendorf S, Muasher S, Kolm P, et al. Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection: impact of cleavage status, morphology grade, and number of embryos transferred. Fertil Steril. 1999;72(4):679-85.##

BMP15 and GDF9 Gene Mutations in Premature Ovarian Failure 2 1 693 2 Background: Premature ovarian failure (POF) is an ovarian defect characterized by the premature depletion of ovarian follicles before the age of 40, representing one major cause of female infertility. Mutations in bone morphogenetic protein 15 (BMP15) and growth differentiation factor 9 (GDF9) have been shown to be associated with POF. Methods: Genomic DNA was isolated from 52 idiopathic premature ovarian failure patients and 100 normal control individuals. Exons of BMP15 and GDF9 gene were amplified using PCR method and subjected to directed sequencing. Variants were identified by comparing the sequences obtained with normal sequences from NCBI database. Results: Four BMP15 gene variants were identified in 6 patients in heterozygous condition. Out of these 4 variants, 3 variants namely, c.165A>T (p.Glu55Asp), c.538 G>T (p.Aln180 Ser) and c. 510_512 delT were novel variants. In silico analysis using SIFT, Provean and Polyphen 2 score predicted the non-deleterious effect of c.165A>T and c.538 G>T variant. 788insTCT variant was identified in 3 patients. No variant was identified in GDF9 gene in any patients and controls. Conclusion: Although the variant has been identified in BMP15 gene but it may not be associated with the premature ovarian failure. 185 190 Ravindra R Kumar Central Research Laboratory, Sri Aurobindo Medical College and PG Institute Central Research Laboratory, Sri Aurobindo Medical College and PG Institute India ravindrachhabra@gmail.com Madhuri M Alwani Department of Obstetrics & Gynaecology, Sri Aurobindo Medical College and PG Institute Department of Obstetrics & Gynaecology, Sri Aurobindo Medical College and PG Institute India Susmit S Kosta Central Research Laboratory, Sri Aurobindo Medical College and PG Institute Central Research Laboratory, Sri Aurobindo Medical College and PG Institute India Ravjyot R Kaur Department of Obstetrics & Gynaecology, Sri Aurobindo Medical College and PG Institute Department of Obstetrics & Gynaecology, Sri Aurobindo Medical College and PG Institute India Sarita S Agarwal Gene targeting Lab, John Curtin School of Medical Research, The Australian National University Gene targeting Lab, John Curtin School of Medical Research, The Australian National University India Bone morphogenetic protein 15Female infertilityGene mutationGrowth differentiation factor 9Premature ovarian failure 693.pdf Coulam CB. Premature gonadal failure. Fertil Steril. 1982;38(6):645-55.##Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986;67(4):604-6.##Dixit H, Rao L, Padmalatha V, Raseswari T, Kapu AK, Panda B, et al. Genes governing premature ovarian failure. Reprod Biomed Online. 2010;20(6):724-40.##Chand AL, Ponnampalam AP, Harris SE, Winship IM, Shelling AN. Mutational analysis of BMP15 and GDF9 as candidate genes for premature ovarian failure. Fertil Steril. 2006;86(4):1009-12.##Richards JS, Russell DL, Ochsner S, Hsieh M, Doyle KH, Falender AE, et al. Novel signaling pathways that control ovarian follicular development, ovulation, and luteinization. Recent Prog Horm Res. 2002;57:195-220.##Di Pasquale E, Beck-Peccoz P, Persani L. Hypergonadotropic ovarian failure associated with an inherited mutation of human bone morphogenetic protein-15 (BMP15) gene. Am J Hum Genet. 2004;75(1):106-11.##Chang H, Brown CW, Matzuk MM. Genetic analysis of the mammalian transforming growth factor-beta superfamily. Endocr Rev. 2002;23(6):787-823.##Otsuka F, Yao Z, Lee T, Yamamoto S, Erickson GF, Shimasaki S. Bone morphogenetic protein-15. Identification of target cells and biological functions. J Biol Chem. 2000;275(50):39523-8.##Shimasaki S, Moore RK, Otsuka F, Erickson GF. The bone morphogenetic protein system in mammalian reproduction. Endocr Rev. 2004;25(1):72-101.##Di Pasquale E, Rossetti R, Marozzi A, Bodega B, Borgato S, Cavell L, et al. Identification of new variants of human BMP15 gene in a large cohort of women with premature ovarian failure. J Clin Endocrinol Metab. 2006;91(5):1976-9.##Laissue P, Christin-Maitre S, Touraine P, Kuttenn F, Ritvos O, Aittomaki K, et al. Mutations and sequence variants in GDF9 and BMP15 in patients with premature ovarian failure. Eur J Endocrinol. 2006;154(5):739-44.##Rossetti R, Di Pasquale E, Marozzi A, Bione S, Toniolo D, Grammatico P, et al. BMP15 mutations associated with primary ovarian insufficiency cause a defective production of bioactive protein. Hum Mutat. 2009;30(5):804-10.##Zhang P, Shi YH, Wang LC, Chen ZJ. Sequence variants in exons of the BMP-15 gene in Chinese patients with premature ovarian failure. Acta Obstet Gynecol Scand. 2007;86(5):585-9.##Ledig S, Röpke A, Haeusler G, Hinney B, Wieacker P. BMP15 mutations in XX gonadal dysgenesis and premature ovarian failure. Am J Obstet Gynecol. 2008;198(1):84.e1-5.##Yan C, Wang P, DeMayo J, DeMayo FJ, Elvin JA, Carino C, et al. Synergistic roles of bone morphogenetic protein 15 and growth differentiation factor 9 in ovarian function. Mol Endocrinol. 2001;15(6):854-66.##Takebayashi K, Takakura K, Wang H, Kimura F, Kasahara K, Noda Y. Mutation analysis of the growth differentiation factor-9 and -9B genes in patients with premature ovarian failure and polycystic ovary syndrome. Fertil Steril. 2000;74(5):976-9.##Dixit H, Rao LK, Padmalatha V, Kanakavalli M, Deenadayal M, Gupta N, et al. Mutational screening of the coding region of growth differentiation factor 9 gene in Indian women with ovarian failure. Menopause. 2005;12(6):749-54.##Zhao H, Qin Y, Kovanci E, Simpson JL, Chen ZJ, Rajkovic A. Analyses of GDF9 mutation in 100 Chinese women with premature ovarian failure. Fertil Steril. 2007;88(5):1474-6.##Choi Y, Sims GE, Murphy S, Miller JR, Chan AP. Predicting the functional effect of amino acid substitutions and indels. PLoS One. 2012;7(10):e46688.##Ng PC, Henikoff S. SIFT: Predicting amino acid changes that affect protein function. Nucleic Acids Res. 2003;31(13):3812-4.##Adzhubei I, Jordan DM, Sunyaev SR. Predicting functional effect of human missense mutations using PolyPhen-2. Curr Protoc Hum Genet. 2013;Chapter 7:Unit7.20.##Zhao ZZ, Painter JN, Palmer JS, Webb PM, Hayward NK, Whiteman DC, et al. Variation in bone morphogenetic protein 15 is not associated with spontaneous human dizygotic twinning. Hum Reprod. 2008;23(10):2372-9.##Hogan BL. Bone morphogenetic proteins: multifunctional regulators of vertebrate development. Genes Dev. 1996;10(13):1580-94.##Hashimoto O, Moore RK, Shimasaki S. Posttranslational processing of mouse and human BMP-15: potential implication in the determination of ovulation quota. Proc Natl Acad Sci USA. 2005;102(15):5426-31.##Tiotiu D, Alvaro Mercadal B, Imbert R, Verbist J, Demeestere I, De Leener A, et al. Variants of the BMP15 gene in a cohort of patients with premature ovarian failure. Hum Reprod. 2010;25(6):1581-7.##Dixit H, Rao LK, Padmalatha VV, Kanakavalli M, Deenadayal M, Gupta N, et al. Missense mutations in the BMP15 gene are associated with ovarian failure. Hum Genet. 2006;119(4):408-15.##Wang B, Wen Q, Ni F, Zhou S, Wang J, Cao Y, et al. Analyses of growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) mutation in Chinese women with premature ovarian failure. Clin Endocrinol (Oxf). 2010;72(1):135-6.##

Certain Less Invasive Infertility Treatments Associated with Different Levels of Pregnancy-Related Anxiety in Pregnancies Conceived via In Vitro Fertilization 2 1 687 2 Background: Research supports that in vitro fertilization causes anxiety and that anxiety can continue into the resulting pregnancy. Most women who have IVF will have a less invasive treatment for infertility prior to IVF; however, it is unclear if specific less invasive treatment cycles impact anxiety that is experienced in the pregnancy resulting from IVF. Methods: A prospective study was conducted for women who became pregnant via IVF, and data was collected about reported previous non-IVF treatment cycles as well as Pregnancy Related Anxiety Measure. Latent Class Analysis was conducted A p-value of ≤0.05 was considered significant. Results: 144 subjects participated and were highly educated, affluent, married, and primarily white. The LCA process yielded two groups that on average had similar levels on most items except for use of intra uterine insemination and/or ovarian stimulation. This information was used to generate four exhaustive and mutually exclusive groups: Stimulation Only (stim-only), Stimulation and Intra uterine Insemination (stim-IUI), Intra uterine Insemination only (IUI only), or No Treatment (No Tx). ANOVA found that those in the Stim Only group had statistically significantly higher PRAM scores than the Stim IUI (p=0.0036), the IUI only group (p=0.05), and the No Tx group (p=0.0013). Conclusion: Women who become pregnant via IVF and had a history of non-in vitro fertilization cycles that only involved ovarian stimulation experienced more pregnancy-specific anxiety in the pregnancy that results from in vitro fertilization. 190 197 Eleanor EL Stevenson Division of Health for Women, Children and Families, School of Nursing, Duke University Division of Health for Women, Children and Families, School of Nursing, Duke University USA eleanor.stevenson@duke. edu Richard R Sloane School of Medicine, Duke University School of Medicine, Duke University USA InfertilityIntra uterine inseminationIn Vitro fertilizationPregnancy anxietyStress 687.pdf Stephen EH, Chandra A, King RB. Supply of and demand for assisted reproductive technologies in the United States: clinic- and population-based data, 1995-2010. Fertil Steril. 2016;105(2):451-8.##Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Barfield WD. Assisted reproductive technology surveillance-United States, 2011. MMWR Surveill Summ. 2014;63(10):1-28.##Sazonova A, Källen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Obstetric outcome after in vitro fertilization with single or double embryo transfer. Hum Reprod. 2011;26(2):442-50.##Wisborg K, Ingerslev HJ, Henriksen TB. In vitro fertilization and preterm delivery, low birth weight, and admission to the neonatal intensive care unit: a prospective follow-up study. Fertil Steril. 2010;94(6):2102-6.##Greil AL, Slauson-Blevins K, McQuillan J. The experience of infertility: a review of recent literature. Sociol Health Illn. 2010;32(1):140-62.##Gana K, Jakubowska S. Relationship between infertility-related stress and emotional distress and marital satisfaction. J Health Psychol. 2016;21(6):1043-54.##Olshansky EF. Psychosocial implications of pregnancy after infertility. NAACOGS Clin Issu Perinat Womens Health Nurs. 1990;1(3):342-7.##Sandelowski M, Harris BG, Black BP. Relinquishing infertility: the work of pregnancy for infertile couples. Qual Health Res. 1992;2(3):282-301.##Gourounti K. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women Health. 2016;56(1):98-118.##Wu AK, Elliott P, Katz PP, Smith JF. Time costs of fertility care: the hidden hardship of building a family. Fertil Steril. 2013;99(7):2025-30.##Berg BJ, Wilson JF. Psychological functioning across stages of treatment for infertility. J Behav Med. 1991;14(1):11-26.##Mahajan NN, Turnbull DA, Davies MJ, Jindal UN, Briggs NE, Taplin JE. Changes in affect and state anxiety across an in vitro fertilization/intracytoplasmic sperm injection cycle. Fertil Steril. 2010;93(2):517-26.##Wadhwa PD, Sandman CA, Porto M, Dunkel-Schetter C, Garite TJ. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol. 1993;169(4):858-65.##Check JH. A practical approach to diagnosing and treating infertility by the generalist in obstetrics and gynecology. Clin Exp Obstet Gynecol. 2015;42(4):405-10.##Pandian Z, Gibreel A, Bhattacharya S. In vitro fertilisation for unexplained subfertility. Cochrane Database Syst Rev. 2015;11:CD003357.##Davies CD, Craske MG. Psychophysiological responses to unpredictable threat: effects of cue and temporal unpredictability. Emotion. 2015;15(2):195-200.##Stevenson EL, Hershberger PE, Bergh PA. Evidence-Based Care for Couples With Infertility. J Obstet Gynecol Neonatal Nurs. 2016;45(1):100-10.##Hjelmstedt A, Widstrom AM, Collins A. Psychological correlates of prenatal attachment in women who conceived after in vitro fertilization and women who conceived naturally. Birth. 2006;33(4):303-10.##Dhaliwal LK, Gupta KR, Gopalan S, Kulhara P. Psychological aspects of infertility due to various causes--prospective study. 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Loop Mediated Isothermal Amplification (LAMP) for Embryo Sex Determination in Pregnant Women at Eight Weeks of Pregnancy 2 1 699 2 Background: In human, SRY (sex-determining region of the Y chromosome) is the major gene for the testis-determining factor which is found in normal XY males and in the rare XX males, and it is absent in normal XX females and many XY females. There are several methods which can indicate a male genotype by the presence of the amplified product of SRY gene. The aim of this study was to identify the SRY gene for embryo sex determination in human during pregnancy using loop mediated isothermal amplification (LAMP) method. Methods: A total of 15 blood samples from pregnant women at eight weeks of pregnancy were collected, and Plasma DNA was extracted. LAMP assay was performed using DNA obtained for detection of SRY gene. Furthermore, colorimetric LAMP assay for rapid and easy detection of SRY gene was developed. Results: LAMP results revealed that the positive reaction was highly specific only with samples containing XY chromosomes, while no amplification was found in samples containing XX chromosomes. A total of 15 blood samples from pregnant women were seven male embryos (46.6%) and eight female embryos (53.4%). All used visual components in the colorimetric assay could successfully make a clear distinction between positive and negative ones. Conclusion: The LAMP assay developed in this study is a valuable tool capable of monitoring the purity and detection of SRY gene for sex determination. 197 205 Mohammad Amin MA Almasi Young Researchers and Elites Club, North Tehran Branch, Islamic Azad University Young Researchers and Elites Club, North Tehran Branch, Islamic Azad University Iran aminalmasi63@gmail.com Galavizh G Almasi Young Researchers and Elites Club, North Tehran Branch, Islamic Azad University Young Researchers and Elites Club, North Tehran Branch, Islamic Azad University Iran Detection dyesEmbryo sexingLAMP assayPregnancySex determination analysisSRY gene 699.pdf Murakami H, Yamamoto Y, Yoshitome K, Ono T, Okamoto O, Shigeta Y, et al. Forensic study of sex determination using PCR on teeth samples. Acta Med Okayama. 2000;54(1):21-32.##Assumpção JG, Benedetti CE, Maciel-Guerra AT, Guerra G Jr, Baptista MT, Scolfaro MR, et al. Novel mutations af-fecting SRY DNA-binding activity: the HMG box N65H associated with 46, XY pure gonadal digenesis and the familial non-HMG box R30I associated with variable phenotypes. J Mol Med (Berl). 2002;80(12):782-90.##Gimelli G, Gimelli S, Dimasi N, Bocciardi R, Di Battista E, Pramparo T, et al. Identification and molecular modelling of a novel familial mutation in the SRY gene implicated in the pure gonadal dysgen-esis. Eur J Hum Genet. 2007;15(1):76-80.##Kellermayer R, Halvax L, Czakó M, Shahid M, Dhi-llon VS, Husain SA, et al. A novel frame shift mutation in the HMG box of the SRY gene in a patient with complete 46, XY pure gonadal dysgenesis. Di-agn Mol Pathol. 2005;14(3):159-63.##King TF, Conway GS. Swyer syndrome. Curr Opin Endocrinol Diabetes Obes. 2014;21(6):504-10.##Phillips NB, Jancso-Radek A, Ittah V, Singh R, Chan G, Haas E, et al. SRY and human sex determination: the basic tail of the HMG box functions as a kinetic clamp to augment DNA bending. J Mol Biol. 2006;358(1):172-92.##Racca JD, Chen YS, Maloy JD, Wickramasinghe N, Phillips NB, Weiss MA. Structure-function relationships in human testis-determining factor SRY: an aromatic buttress underlies the specific DNA-bend-ing surface of a high mobility group (HMG) box. J Biol Chem. 2014;289(47):32410-29.##Rizvi AA. 46, XX man with SRY gene translocation: cytogenetic characteristics, clinical features and management. Am J Med Sci. 2006;335(4):307-9.##Shahid M, Dhillion VS, Jain N, Hedau S, Diwakar S, Sachdeva P, et al. Two new novel point mutations localized up-stream and downstream of the HMG box region of the SRY gene in three Indian 46,XY females with sex reversal and gonadal tumour formation. Mol Hum Reprod. 2004;10(7):521-6.##Waters PD, Wallis MC, Marshall Graves JA. Mam-malian sex--Origin and evolution of the Y chromosome and SRY. Semin Cell Dev Biol. 2007;18(3):389-400.##Santos FR, Pandya A, Tyler-Smith C. Reliability of DNA-based sex tests. Nat Genet. 1998;18(2):103.##Thangaraj K, Reddy AG, Singh L. Is the ameloge-nin gene reliable for gender identification in forensic casework and prenatal diagnosis? Int J Legal Med. 2002;116(2):121-3.##Notomi T, Okayama H, Masubuchi H, Yonekawa T, Watanabe K, Amino N, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res. 2000;28(12):E63.##Hirayama H, Katagiri S, Kageyama S, Minamiha-shi A, Moriyasu S, Sawai K, et al. Rapid sex chro-mosomal chimerism analysis in heterosexual twin female calves by Loop-mediated Isothermal Amp-lification. Anim Reprod Sci. 2007;101(1-2):38-44.##Zhang ZP, Zhang Y, Liu JP, Zhang JT, An ZX, Quan FS, et al. Codeposition of dNTPs detection for rapid LAMP-based sexing of bovine embryos. Reprod Domest Anim. 2009;44(1):116-21.##Chan KW, Liu PC, Yang WC, Kuo J, Chang CL, Wang CY. A novel loop-mediated isothermal amp-lification approach for sex identification of Colum-bidae birds. Theriogenology. 2012;78(6):1329-38.##Kanchanaphum P, Sarataphan T, Thirasan W, Ana-tasomboon G. Development of Loop mediated isothermal amplification (LAMP) of SRY gene in human blood samples for sex determination. Ran-gsit J Arts Sci. 2013;3(2):129-35.##Iwamoto T, Sonobe T, Hayashi K. Loop-mediated isothermal amplification for direct detection of Mycobacterium tuberculosis complex, M. avium, and M. intracellulare in sputum samples. J Clin Microbiol. 2003;41(6):2616-22.##Mori Y, Notomi T. Loop-mediated isothermal amplification (LAMP): a rapid, accurate, and cost-effective diagnostic method for infectious diseases. J Infect Chemother. 2009;15(2):62-9.##Hadersdorfer J, Neumuller M, Treutter D, Fischer T. Fast and reliable detection of Plum pox virus in woody host plants using the Blue LAMP protocol. Ann Appl Biol. 2011;159(3):456-66.##Cardoso TC, Ferrari HF, Bregano LC, Silva-Frade C, Rosa AC, Andrade AL. Visual detection of turkey coronavirus RNA in tissues and feces by reverse-transcription loop-mediated isothermal amplification (RT-LAMP) with hydroxynaphthol blue dye. Mol Cell Probes. 2010;24(6):415-7.##Goto M, Honda E, Ogura A, Nomoto A, Hanaki K. Colorimetric detection of loopmediated isothermal amplification reaction by using hydroxyl naphthol blue. Biotechniques. 2009;46(3):167-72.##Fu S, Qu G, Guo S, Ma L, Zhang N, Zhang S, et al. Applications of loop-mediated isothermal DNA amplification. Appl Biochem Biotechnol. 2011;163 (7):845-50.##Almasi MA, Jafary H, Moradi A, Zand N, Ojagh-kandi MA, Aghaei S. Detection of coat protein gene of the Potato Leafroll Virus by reverse transcription loop-mediated isothermal amplification. J Plant Pathol Microbiol. 2013;4(1):156.##Moradi A, Nasiri J, Abdollahi H, Almasi MA. Development and evaluation of a loopmediated isothermal amplification assay for detection of Erwi-nia amylovora based on chromosomal DNA. Eur J Plant Pathol. 2012;133(3):609-20.##Parida M, Shukla J, Sharma S, Ranghia Santhosh S, Ravi V, Mani R, et al. Development and evaluation of reverse transcription loop-mediated isothermal amplification assay for rapid and real-time detection of the swine-origin in-fluenza A H1N1 virus. J Mol Diagn. 2011;13(1):100-7.##Tomita N, Mori Y, Kanda H, Notomi T. Loop-me-diated isothermal amplification (LAMP) of gene sequences and sim-ple visual detection of products. Nat Protoc. 2008;3(5):877-82.##Tsai SM, Chan KW, Hsu WL, Chang TJ, Wong ML, Wang CY. Development of a loop-mediated isothermal amplifica-tion for rapid detection of orf virus. J Virol Methods. 2009;157(2):200-4.##Ahmadi S, Almasi MA, Fatehi F, Struik PC, Mo-radi A. Visual detection of potato leafroll virus by one-step reverse transcription loop-mediated isothermal amplification of DNA with hydroxynaph-thol blue dye. J phytopathol. 2012;161(2):120-4.##Dukes JP, King DP, Alexandersen S. Novels reverse transcription loop-mediated isothermal amplification for rapid detection of foot-and-mouth disease virus. Arch Virol. 2006;151(6):1093-106.##Almasi MA, Hosseyni-Dehabadi SM, Aghapour- Ojaghkandi M. Comparison and evaluation of three diagnostic meth-ods for detection of Beet Curly Top Virus in sugar beet using different visualizing systems. Appl Biochem Biotechnol. 2014;173(7):1836-48.##Almasi MA, Moradi A, Nasiri J, Karami S, Nasiri M. Assessment of performance ability of three diagnostic methods for detection of Potato Leafroll Virus (PLRV) using different visualizing systems. Appl Biochem Biotechnol. 2012;168(4):770-84.##Almasi MA, Dehabadi SH, Eftekhari Z. Immuno-capture loop mediated isothermal amplification for rapid detection of Tomato Yellow Leaf curl Virus (TYLCV) without DNA extraction. J Plant Pathol Microbiol. 2013;4(7):185.##Almasi MA, Hosseini SMD, Moradi A, Eftekhari Z, Ojaghkandi MA, Aghaei S. Development and application of loop-mediatred Isothermal amplification assay for rapid detection of fusarium oxy-sporum f. sp. Lycopersici. J Plant Pathol Micro-biol. 2013;4(5):177.##Moradi A, Almasi MA, Jafary H, Mercado-Blanco J. A novel and rapid loop-mediated isothermal amplification assay for the specific detection of Verticillium dahlia. J Appl Microbiol. 2014;116(4):942-54.##Fukuta S, Iida T, Mizukami Y, Ishida A, Ueda J, Kanbe M, et al. Detection of Japanese yam mosaic virus by RT-LAMP. Arch Virol. 2003;148(9):1713-20.##Almasi MA, Erfan manesh M, Jafary H, Dehabadi SM. Visual detection of Potato Leafroll virus by one-step reverse transcription loop-mediated isothermal amplification of DNA with the genefind-erTM dye. J Virol Methods. 2013;192(1-2):51-4.##Almasi MA, Ojaghkandi MA, Hemmatabadi A, Ha-midi F, Aghaei S. Development of colorimetric loop- mediated iso-thermal amplification assay for rapid detection of the Tomato Yellow Leaf Curl Virus. J Plant Pathol Microbiol. 2013;4(1):153.##Almasi MA, Aghapour-ojaghkandi M, Bagheri K, Ghazvini M, Hosseyni-dehabadi SM. Comparison and evaluation of two diagnostic methods for detection of npt II and GUS genes in Nicotiana ta-bacum. Appl Biochem Biotechnol. 2015;175(8):3599-616.##Almasi M. Establishment and application of a reverse transcription loop-mediated isothermal amplification assay for detection of grapevine Fanleaf Virus. Mol Biol. 2016;5(1):149.##

Unusual Presentation of Invasive Mole: A Case Report 2 1 690 2 Background: Invasive mole is responsible for most cases of localized gestational trophoblastic neoplasia. Gestational trophoblastic disease describes a number of gynecologic tumors that originate in trophoblastic layer including hydatidiform mole (complete or partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor. Invasive mole may arise from any pregnancy event although in most cases is diagnosed after molar pregnancy. Overall cure rate in low risk patients is nearly 100% and in high-risk patient 90%. In rare cases, molar tissue traverses thickness of myometrium and leads to perforation and acute abdomen and invasive mole infrequently metastasis. The best treatment option is chemotherapy (according to stage and score with single or multiple agent) and in patients that fertility is not the matter, hysterectomy can be done. Case Presentation: A 41 years old G3P2ab1 woman referred to Firouzgar hospital 2 months after curettage of molar pregnancy with vaginal bleeding and acute abdomen. In workup, HCG 224000 mIU/ml and evidence of metastasis was detected. Chemotherapy due to stage 3 and score 9 and surgery due to acute abdomen was done. This case was reported for its rarity. Discussion: This case reported about ovarian metastasis and uterine rupture with acute abdomen and involvement of omentum in metastatic invasive mole. Lack of surveillance led to extensive morbidity. Management of this patient was successful. In follow up, she was free of disease without sequel of any kind for five years now. 205 210 Soheila S Aminimoghaddam Department of Obstetrics and Gynecology, Firouzgar Hospital, Iran University of Medical Sciences Department of Obstetrics and Gynecology, Firouzgar Hospital, Iran University of Medical Sciences Iran Dr_aminimoghaddam@ yahoo.com Andisheh A Maghsoudnia Tarbiat Modares University Tarbiat Modares University Iran Complete moleGestational trophoblastic neoplasiaHaemoperitoneumInvasive moleTrophoblast 690.pdf Tse KY, Chan KK, Tam KF, Ngan HY. An update on gestational trophoblastic disease. Obstet Gynaecol Reprod Med. 2012;22(1):7-15.##Seckl MJ, Fisher RA, Salerno G, Rees H, Paradinas FJ, Foskett M, et al. Choriocarcinoma and partial hydatidiform moles. Lancet. 2000;356(9223):36-9.##Uberti EM, Fajardo Mdo C, da Cunha AG, Rosa MW, Ayub AC, Graudenz Mda S, et al. Prevention of postmolar gestational trophoblastic neoplasia using prophylactic single bolus dose of actinomycin D in high-risk hydatidiform mole: a simple, effective, secure and low-cost approach without adverse effects on compliance to general follow-up or subsequent treatment. Gynecol Oncol. 2009;114(2):299-305.##Darby S, Jolley I, Pennington S, Hancock BW. Does chest CT matter in the staging of GTN? Gynecol Oncol. 2009;112(1):155-60.##Yamamoto E. Solid tumor section. Atlas Genet Cytogenet Oncol Haematol. 2009;13(9):683-5.##Doll KM, Soper JT. The role of surgery in the management of gestational trophoblastic neoplasia. Obstet Gynecol Surv. 2013;68(7):533-42.##El-Helw LM, Coleman RE, Everard JE, Tidy JA, Horsman JM, Elkhenini HF, et al. Impact of the revised FIGO/WHO system on the management of patients with gestational trophoblastic neoplasia. Gynecol Oncol. 2009;113(3):306-11.##Wells M. The pathology of gestational trophoblastic disease: recent advances. Pathology. 2007;39(1):88-96.##Green CL, Angtuaco TL, Shah HR, Parmley TH. Gestational trophoblastic disease: a spectrum of radiologic diagnosis. Radiographics. 1996;16(6):1371-84.##El-Helw LM, Hancock BW. Treatment of metastatic gestational trophoblastic neoplasia. Lancet Oncol. 2007;8(8):715-24.##Tidy J, Hancock BW. The Management of Gestational Trophoblastic Disease. UK: Royal College of Obstetricians and Gynaecologists; 2010 Feb. 11 p. RCOG Green-top Guideline No.: 38.##Balagopal P, Pandey M, Chandramohan K, Somanathan T, Kumar A. Unusual presentation of choriocarcinoma. World J Surg Oncol. 2003;1(1):4.##Kumar S, Vimala N, Mittal S. Invasive Mole Presenting as Acute Haemoperitoneum. JK Sci. 2004;6(3):159-60.##Atala C, Riedemann R, Biotti M, Ramírez F, Paublo M. [Invasive mole with uterine rupture]. Rev Chil Obstet Ginecol. 1992;57(5):356-8. Spanish.##Bruner DI, Pritchard AM, Clarke J. Uterine rupture due to invasive metastatic gestational trophoblastic neoplasm. West J Emerg Med. 2013;14(5):444-7.##Okumura M, Fushida K, Pulcineli Vieira Francisco R, Schultz R, Zugaib M. Sonographic appearance of an advanced invasive mole and associated metastatic thrombus in the inferior vena cava. J Clin Ultrasound. 2013;41(2):113-5.##Ngan HY, Kohorn EI, Cole LA, Kurman RJ, Kim SJ, Lurain JR, et al. Trophoblastic disease. Int J Gynecol Obstet. 2012;119 Suppl 2:S130-6.##Berkowitz RS, Goldstein DP. Current advances in the management of gestational trophoblastic disease. Gynecol Oncol. 2013;128(1):3-5.##Lybol C, Sweep FC, Harvey R, Mitchell H, Short D, Thomas CM, et al. Relapse rates after two versus three consolidation courses of methotrexate in the treatment of low-risk gestational trophoblastic neoplasia. Gynecol Oncol. 2012;125(3):576-9.##Fang J, Wang S, Han X, An R, Wang W, Xue Y. Role of adjuvant hysterectomy in management of high-risk gestational trophoblastic neoplasia. Int J Gynecol Cancer. 2012;22(3):509-14.##Zhang HY, Wu W, Zhu J. Unilateral hydronephrosis caused by invasive mole: a case report. Int J Clin Exp Med. 2013;6(10):1010-4.##