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Iranian Journal of Reproductive Medicine Vol. 6, No. s1, pp. 1-32 Abstracts of 14th Congress of Iranian Society for Reproductive Medicine- Oral Presentations Code Number: rm08035 1- Infertility, Gynecology O-1 Robotic assisted minimally invasive surgery Nanbakhsh F. Obstetrics and Gynecological Department, Urmia Medical Sciences University, Urmia, Iran. Robotic surgery represents the state of art approach, which by using 3D resolution visualization, wristed instrumentation, and invasive movement allow GYN surgeons to perform the most precise, complete, and minimally invasive surgery for endometrial cancer. Patients’ benefits are: shorter hospital stay, less pain, less risk of infection, less blood loss and transfusions, less scarring, faster recovery, quicker return to normal activities, equivalent or better oncologic outcomes and more lymph nodes harvests. The ability to add a 3rd instrument arm for grasping and retraction put the surgeon in complete control of the surgical site. Robotic overcomes the limitations of conventional laparoscopy by enabling GYN oncologists to perform early stage GYN cancer surgery using a minimally invasive approach. Based on our experience, robotic assisted hysterectomy is a promising new technique that can overcome many of the technical limitations of conventional laparoscopy. Complex parts of the operation, such as securing the uterine arteries and cardinal ligaments, performing an accurate culdotomy and over sewing the vaginal cuff are performed with greater ease, thus providing unique advantages as compared with conventional laparoscopy. O-2 Comparing the efficacy of combined metformin letrozole with metformin clomiphen citrate in clomiphen resistant infertile women with PCOS Davar R, Javedani M. Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Polycystic ovary syndrome (PCOS) is a common condition in reproductive aged women with an estimated prevalence of 5-10%. Oligo-anovulation is a very common problem in PCOS. The use of clomiphen citrate, metformin and letrozole increase ovulatory response. Because of antiestrogenic effects of clomiphen, it may be associated with lower pregnancy rate. Letrozole is an aromatase inhibitor which induced ovulation without antiestrogenic effects. Adding metformin to clomiphen and letrozole in clomiphen resistance PCOS patients increases ovulatory response. In total 100 infertile women with PCOS were randomly divided to metformin letrozole and metformin clomiphen groups. All patients received initially metformin 1500 mg/daily for 8-12 weeks and then letrozole 5 mg or clomiphen 100 mg for 5 days starting on day 3 of menstrual cycle. All patients were clomiphen resistance PCOS. The time of intercourse was advised 24-36 hours after hCG injection. The number of follicles, serum E2, endometrial thickness, miscarriage and pregnancy rate were measured in both groups. The mean age and duration of infertility in both groups were similar. Key words: Clomiphen citrate, Letrozole, PCO. O-3 CRP level and pregnancy rate in patients undergoing IVF/ICSI Arefi S, Babashamsi M, Shariat Panahi, Tochmechi R,Sadeghpour Tabaei A, Ebadi P. Avesina Research Institute, Tehran. E-mail: soheilaarefi@yahoo.com Introduction: The present study conducted to determine the possible
correlation of the serum and follicular fluid CRP level and the outcome of
controlled ovarian stimulation and pregnancy rate in patients undergoing
IVF/ICSI. Key words: CRP, ICSI, Pregnancy rate. O-4 Comparing vaginal sonography with hysteroscopy in the detection of intrauterine pathology in infertile patients with normal HSG Asgharnia M, Mehrafza M, Oudi M, Nikpuri Z, Mohammadtabar Z. Azad Islamic University, Rasht, Iran. Mehr Infertility Institute, Rasht, Iran. Introduction: Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. This study was performed to evaluate the accuracy of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. Materials and Methods: In this cross-sectional study 115 infertile women were evaluated in Mehr Infertility Institute between 2006 and 2007. Hysteroscopy and histological evaluation of endometrial biopsy was performed in all women. We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosis was confirmed by histological studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterine cavity specimens. Sensitivity, specificity, predictive and negative predictive values were calculated for hysteroscopy considering the histological study as 100%. Results: Sensitivity and specificity of sonography in diagnosing the polyp were stated 81% and 64% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the polyps revealed 85% and 84% respectively. The results indicated that sensitivity and specificity of sonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myoma were 50% and 93% respectively. Conclusion: Hysteroscopy is a safe and rapid direct visualization of the uterine cavity. We believe it should be replaced by the diagnostic hysteroscopy as a first line of infertility investigation. Key words: Hysteroscopy, Infertility, Uterine Pathology
O-5 Fertility outcome and clinical and laboratory markers of clomiphen resistant PCOS patients after LOD at one year post operation Habibzadeh V. Afzalipoor Hospital, IVF Center, Kerman University of Medical Sciences, Kerman, Iran. Introdcution: LOD operation in clomiphen resistant patients is a therapeutic option before gonadotropin treatment. In this study fertility outcome and clinical and laboratory markers of these patients were investigated. Materials and Methods: In this study 160 clomiphen resistant PCOS patients were selected. Patients with mixed factor (male, endometriosis, tubal) were excluded. All the patients were candidate for LOD operation. Before LOD operation, 24 hr after LOD and 6 months after LOD, hormonal tests were done. In the first 6 month no drug was prescribed. In second six month we prescribed clomiphen to the patients that were not pregnant. Results: There was 40% reduction in the level of LH 24 hr after LOD operation, while this was 10% at 6 month. Regulation of menstrual cycles without clomiphen was 38% and pregnancy rate was 28% until 1 year after LOD operation. Conclusion: LOD operation in our patients is an ideal option before gonadotropin treatment. Key words: LOD, PCO, Clomiphen resistant, Gonadotropin, Infertility. O-6 Evaluation of serum PSA after cyproterone compound treatment compared with oral contraceptives pills in hirsute polycystic ovary syndrome patients Taheripanah R, Sepahvandi M. Infertility and Reproductive Health Research Center, Shaheed Behshti University of Medical Sciences. E-mail: Taheripanahf@yahoo.com Introduction: The aim of this study was to evaluate the effect of oral contraceptive on the serum free prostatic specific antigen (PSA) as a new marker in hirsute women with polycystic ovary syndrome (PCOS) compared with ciproteone compound. Materials and Methods: In this prospective randomized study, 60 hirsute PCOS patients that referred to Imam Hossein Hospital were enrolled. Baseline Freyman Galloway score (FG), Body Mass Index (BMI), free PSA, 17-hydroxy progesterone (17OHP), free testosterone and Dehydroepiandrestandioe sulfate (DHEAS) were measured at the early follicular phase. Then patients were divided randomly into 2 groups. One group received oral contraceptive pills (OCP) and anther group recived cyproterone compound (Diane). Hormonal profile and FG scores were evaluated again after three months of treatment. Data were analyzed by SPSS 13 and p-value <0.05 was considered to be significant. Results: The baseline FG score was 10.06±2.5 in OCP group vs. 11.5±2.3 in Diane group, these scores were reduced after 3 months to 8.06±2.5 vs. 9.2±2.3, respectively (p-value=0.000). There was no significant differences in FG score reduction after treatment between 2 groups (p-value>0.05). Serum free PSA was reduced after treatment in both groups significantly (p-value<0.03). There was no significant differences between 2 groups (p-value>0.5). Free testosterone reduction in OCP group (2.48±1.3 to 2.24±1.0, p-value=0.03) was more than this rate in Diane group (2.00±1.2 to 1.64±0.9, p-value=0.1). There was no statistical differences in 17OHP and DHEAS after treatment in both groups (p-value>0.5). Conclusion: Serum free PSA and free testosterone and FG score were reduced after treatment with OCP or Diane but there was no preference between two groups of antiandrogen activity in OCP or Diane group. Key words: PSA, Hirsutism, Freyman Galloway score, Free testosterone. O-7 Determination of anti-tissue antibodies in sera samples of women with abortion Rabani M, Kazemimanesh M. Department of Microbiology, Faculty of Veterinary Medicine, University of Tehran.
Introduction: Recurrent abortion is thought to have many possible causes. Immunological factors are associated with 20-50% of recurrent spontaneous abortions. The objective of this study was detection of autoantibodies in patient sera samples of women with abortion. It is demonstrated that there are common tissue antigens between species and this heterologous antigens may be used for detection of autoimmune abnormalities in human sera. Materials and Methods: In this study tissue antigens were taken from bovine liver, uterus and ovary. After cutting the tissues into small pieces, they were homogenized in electric homogenizer in buffer at 4oC for 3 minutes. Then the supernatant was centrifuged at 4000rpm, at 4oC for 2 hours. The supernatant was used as tissue antigens. According to the previous studies some specific anti-liver sera were produced with the injection of liver antigens to goat and with using cross absorption method with common tissue antigens. Indeed, this specification was tested by agar gel immunodiffusion (AGID) test. Sera samples of 228 women with abortion and 35 women with normal parturition were included in the present study. The sera samples were used for detection of anti-tissue antibodies that can react to liver, uterus and ovary antigens using AGID. Results: There were at least 3 clearly definable precipitation lines between liver antigens and standard sera and one clearly definable precipitation line between uterus and ovary antigens and standard sera. Absence of any precipitation lines was recorded between patient sera and tissue antigens but there was at least one clearly precipitation line between sera samples of 21 cases and standard sera. In addition there was not any precipitation line between normal sera and antigens. Conclusion: These findings may suggest the presence of some features of autoimmune abnormalities in the patients. Key words: Abortion, Autoantibody serum. O-8 Comparing metformin and LD OCP in improvement of sonographic findings in PCOS patients Tavoosian Z, Haj Seyed Javadi E. Shazand Hospital, Arak. E-mail: z_tavoosian@ yahoo.com Introduction: Sonography may be used as a diagnosis tool for PCOS. In this paper, OCP and Metformin effects in improvement of sonographic findings after a 6 month treatment period are compared. Materials and Methods: In total, 100 PCOS women from Shazand Hospital were studied in 2007. They were 20 to 35 years old and were divided into two equal groups. The first group was treated by LD OCP in a 6 months period, while the second group used metformin BD. After 6 months, the sonography was repeated and some improvements were detected in sonographic findings. Results: Inthe first group (LD OCP), 8 patients (16%) showed improvements in sonographic findings while this improvement in the second group (metformin) was detected in 14 patients (28%). T-test was used to compare the results and the variation was not significant (p-value<0.16). Both LD OCP and metformin are effective treatments in improving clinical signs and sonographic findings of PCOS. Key words: Sonography, Metformin, Ovary, LD-OCP, PCOS. O-9 Thyroid dysfunction in Iranian patients with premature ovarian failure Neisani Samani E, Fallahian M, Salmanyazdi R, Ghazi AM, Ajori L, Mehrabi Y. Shahid Behashti University of Medical Sciences. Email: eneisani@yahoo.com Introduction: This study was carried out to determine the presence of thyroid dysfunction in premature ovarian failure (POF). Materials and Methods: In a case-control study, we assessed 46 consecutive patients with POF who had no history of thyroid dysfunction and 46 normal cycling women from Taleghani Hospital, Tehran, Iran. Thyroid function tests were evaluated in both groups and results were analyzed statistically. Result: Anti thyroid peroxidase and Anti thyroglobulin antibodies levels were significantly higher in patients with POF as compared to controls (p-value=0.02 and p-value=0.01, respectively). Thyroxine, tri-iodothyronine and thyroid stimulating hormone levels were not significantly different between patients with POF and controls. Conclusion: Present study with demonstration of higher titers of anti-TG and anti-TPO antibodies in Iranian patients with POF supports the autoimmune basis of the disease. According to our study, POF happened in patients who were euthyroid according to clinical and laboratory data. Key words: Thyroid function test, POF. O-10 Serum transforming growth factor beta in human normal pregnancy and preeclampsia Ayatollahi M, Samsami A, Entezam M, Azarpira N. Transplant Research Center, Obstetrics and Gynecological School of Medicine, Shiraz University of Medical Sciences, Shiraz. Iran. Introduction: There are some evidences that the same immunosuppressive cytokines contribute to successful pregnancy and transplantation. Transforming growth factor beta (TGF-ß) is a multifunctional cytokine that exhibit potent immune-regulatory and anti-inflammatory properties which might prolong graft survival. Recent reports suggest a role for TGF-ß in the generation of T-regulatory lymphocytes. Also the role of TGF-ß in trophoblast differentiation and hypertension prompted us to evaluate the maternal serum TGF-ß1 level in normal allopregnant women and in pregnancies complicated by preeclampsia (PE). PE is a pregnancy complication characterized by increased blood pressure, proteinuria and end organ damage. Materials and Methods: Sixty one pregnant preeclamptic women (32 cases with severe and 29 with mild PE), 22 normotensive healthy pregnant women, and 20 non pregnant controls formed the studied groups. The active form of TGF-ß1 in the serum from all cases was investigated by indirect ELISA technique. Results: The results show that TGF-ß1 is highly present in all three pregnant groups compared with the non-pregnant controls. No changes in serum levels of TGF-ß1 were found in PE compared with the normal pregnancy. Conclusion: The results suggest that: (1) TGF-ß1 could function as a regulatory factor in fetal allograft survival during pregnancy. (2) TGF-ß1 does not have a pathophysiological role in PE. Key words: Transforming growth factor beta, Normal pregnancy, Preeclampsia. O-11 Pregnancy outcomes in renal transplantation Yassaee F, Moshiri F. Obstetrics and Gynecological Department, Perinatology Center, Taleghani Hospital, Shahid Beheshti Medical Science University, Evin, Tehran, Iran. Introduction: In the last few years advances in surgical techniques and immune suppression have improved not only survival, but also quality of life in organ transplanted patients. Hence, the number of women of childbearing age who decide to have a child- which means resuming a normal life –has increased. Materials and Methods: We analyzed the outcomes from 95 pregnancies in 74 kidney transplant recipients from data collected in questionnaires, hospital records, and phone interviews. Perinatal outcomes (complications, miscarriage, and therapeutic abortion) were evaluated. Results: The mean age of pregnant women was 29.3±6.7years (range 18-38). The mean interval between renal transplantation and pregnancy was 41±9.5 months (range 22-59). The mean gestational age was 255±26 days (range 221-285). No complications occurred in 15 (15.8%) cases. Pregnancy complications in the rest included: abortion in 21 (22.1%) cases, of which 5 (23.8%) were therapeutic abortion and 16 (76.2%) were spontaneously. In 74 deliveries, 2 (2.71%) were still born and 72 (97.29%) were born alive with the following complications; 45 (62%) low birth weight babies, 3 (4.16%) intrauterine growth restriction, 6 (8.3%) small for gestational age, 21 (28.4%) premature rupture of membranes and 4 (5.4%) oligohydraminos. There were no cases of multiple pregnancies, congenital anomalies, and ectopic pregnancies. Maternal anemia was reported in 62 (65%) pregnancies. Cesarean sections were performed in 60 cases (81.1%). Preeclampsia was seen in 45 (47.36%), superimposed hypertension in 34 (35.8%), urinary tract infection in 16 (17.2%), graft rejection in 3 (3.15%), acute renal failure in 2 (2.1%) and finally irreversible rise of creatinine in 3 (3.15%) cases. Conclusion: Pregnancy is possible and can be successful and safe after renal transplantation in recipients with normal kidney function. Post transplantation pregnancies are high risk and they should be managed in a tertiary center. Key words: Kidney transplantation, Neonatal outcomes, Maternal complications. O-12 Causes of multiple pregnancies and their relation with infertility treatment Beigi Sh, Haghiri M. Baghiyatallah University of Medical Sciences, Tehran, Iran. Introduction: Considering the high rate of multiple pregnancies (MP) attributed to infertility treatment and ART, this study intends to evaluate various causes and present some suggestions. Materials and Methods: This cross sectional study was done on 109 MP in 3 hospitals in Tehran in 2006. Results: From the total of 109 Mp, 84 (77.06%) were twins, 21 (19.26%) were triplets and 4 (3.66%) were quadruplets. 47 (43.11%) were after infertility treatment, 47 (43.11%) spontaneous and 15 (13.8%) indefinite cases. From 47 infertility treated patients, 34 (31.2%) patients had the history of infertility, and 13 cases had the request for acceleration of pregnancy. Leaving 15 indefinite cases out, 94 pregnancies were analyzed: 21 (22.34%) cases were treated with C.C. and TI (16 twins and 5 triplets), 6 (6.38%) cases were treated with HMG and TI (3 twins and 3 triplets), ART was used in 19 (20.21%) cases (9 twins, 7 triplets and 3 quadruplets), 8 (42.1%) treated with ZIFT (6 twins and 2 triplets), 10 (52.63%) UET (7 twins and 3 triplets) and only one case (5.2%) was treated with GIFT (1 triplet). 40% of twins were the result of infertility treatment. 88% of triplets associated with infertility treatment (41% ART and 47% C.C and/or HMG). 100% of quadruplets were due to ART (75% ZIFT). Conclusion: Multiple pregnancies have medical, psychosocial, and economical consequences. The best method of reducing the impact of iatrogenic pregnancy is to re-define our concept of success after ART from live birth of any number of fetuses to singleton live birth per treatment. Key words: Multiple pregnancies, Assisted reproductive techniques. O-13 The tubal patency in infertile women with endometriosis is a positive index for fecundity Fesharaky Sh, Emamdoust F. Isfahan University of Medical Sciences, Iran. Introduction: To evaluate tubal patency in the suspected cases of endometriosis. Materials and Methods: This was a retrospective study in the Esfahan Fertility and Infertility Center. In total 59 infertile women with definite endometriosis in diagnostic laparoscopy were included in this study. The rate of tubal patency in endometriotic infertile couples was measured. Results: After systematic approach for implantation and adhesions by anatomic location, the most lesions were in the anterior cul-de-sac, posterior cul-de-sac right/left posterior broad ligament, both uterosacrals and endometrioma. Peritubal adhesion, direct lesion at the tubal surface and spillage were studied. Our findings support tubal patency in 90% of patients. Conclusions: Our data suggest that tubal patency is a positive index for fecundity. Expectant management and control ovarian hyperstimulation plus IUI can be a good way for different stages of pelvic endometriosis, including deep infiltrating endometriosis and rectovaginal septum involvement. Key words: Tubal patency, Endometriosis, Fecundity. O-14 Evaluation of treatment outcomes of infertile women with primary infertility due to hypogonadotropic hypogonadism in Koasar IVF Center, Motahari Hospital, Urmieh, Iran. Sadaghiani M, Ayatollahi H. Urmieh Medical Sciences University, Motahari Hospital, Kosar IVF Center. Introduction: Retardation in puberty and amenorrhea due to hypogonadotropic hypogonadism (H-H) often caused by GnRh deficiency and is a uncommon cause of infertility. The aim of this study was the evaluation of treatment outcomes of infertile women with primary infertility due to hypogonadotropic hypogonadism (Hypothalamic amenorrhea). Materials and Methods: In this retrospective study, 61 infertile patients with the diagnosis of H-H who referred to Kowsar IVF Center (1382-1386) Motahari Hospital, Urmieh, were evaluated. Patients underwent the treatment cycles with gonadotropine ampoules (HMG+HCG) and then treatment outcomes (positive βHCG test) were analyzed on the basis of multiple factors. Result: The age of patients was between 18-42 years. Forty-seven patients underwent the multiple treatment cycles that finally resulted in 21 pregnancies. Ten pregnancy with ICSI, 9 cases with IUI and 2 cases with timed intercourse. Twin pregnancy in 5 cases and triplets in 2 cases were observed. Fourteen patients had singleton pregnancies. Conclusion: In regard to non responsiveness to clomiphene citrate in patients with H-H and the cost and non availability of pulsatile GnRH, treatment with gonadotropins is an alternative, safe and effective treatment for patients with the diagnosis of H-H and it is associated with a acceptable pregnancy rate. Key words: Infertility, hypogonadotropic hypogonadism, IUI, ICSI. O-15 Ovarian response to micro doses of gonadotropin releasing hormone (GnRH) agonist during ovulation induction for in vitro fertilization Moosavifar N, Jahanian M, Vahidroodsari F. Mashhad IVF center, Mashhad, Iran. Introduction: Despite the improvements in assisted reproduction, the ideal approach to poor responders has yet to be identified. The objective of this study was to evaluate ovarian responsiveness of four different categories of poor responders to the administration of micro doses of GnRH agonist. Materials and Methods: This was a retrospective comparative analysis in a university based infertility center. In total 99 patients who were poor responders during ovulation induction with luteal phase GnRH-a suppression followed by gonadotropins were classified into four categories according to their age and basal FSH. Group I were 33 patients under 37 years old with FSH level of under 12, Group II were 45 patients equal or more than 37 years old with FSH level of under 12, Group III were 14 patients equal or more than 37 years old with FSH level of equal or more than 12, and finally Group IV were 7 patients under 37 years old FSH level of equal or more than 12. Micro dose GnRH protocol was administered on follicular phase beginning on 2nd day of cycle and supplemented with 375 IU exogenous gonadotropins beginning on day 3. The number of follicles equal or more than 17 mm, number of mature oocytes, number of embryos and the pregnancy rate were recorded accordingly. Results: The mean ages of patients in groups I, II, II and IV were 31.06, 40.96, 40 and 32.71 years respectively. The percentage of cycle cancellation in groups I, II, II and IV were 6.1%, 20%, 42.9% and 57.1% respectively because of no ovarian response. The mean number of follicles >= 17 mm were 4.82, 3.67, 2.21 and 2.86 and the mean number of retrieved oocytes were 2.94, 2.33, 1.57 and 1.29 in groups I, II, II and IV respectively. The average number of embryos was 1.8 in group I, 1.4 in group II, 0.8 in group III and 0.7 in group IV. There were no pregnancy in groups III and IV, however 4 (12%) and 3 (6.7%) clinical pregnancy achieved in group I and II respectively. Conclusion: Ovarian response to micro doses of GnRH agonist was not significantly different between the four groups; however the pregnancy rate was higher in groups with lower FSH regardless of the age. Key words: Ovarian reserve, Gonadotropin releasing hormone (GnRH), Follicle stimulating hormone (FSH). O-16 Effect of endometrium local injury on pregnancy outcome in patients with IVF/ICSI Karimzadeh Maybodi MA, Ayazi M, Tabibnejad N. Research and Clinical Center for Infertility, Shahid Sadoughi Medical University, Yazd, Iran. Introduction: Implantation failure is the most important cause of recurrent IVF/ICSI failure. It has been suggested that endometrial injury using a biopsy catheter will results in a higher pregnancy rate in the following cycle of treatment. The local endometrial trauma increases the implantation rate through release of chemical mediators such as histamine and growth factor. Therefore we undertook this study to evaluate the influence of endometrial biopsy on increasing implantation rate in patients with multi implantation failure. Materials and Methods: In a randomized control trial study, 48 women undergoing ART treatment cycles with at least two implantation failure were evaluated. All patients underwent induction ovulation with long protocol of gonadotropin stimulation beginning by pituitary desensitization with subcutaneous Buserelin followed by 2-3 ampoules of HMG from day 2 of cycles. Patients were divided into 2 groups randomly. In case group a secretory phase endometrium biopsy was performed by using a Novak endometrial suction curettage in a non medicated cycle before IVF/ICSI. The implantation and clinical pregnancy rate were evaluated and compared with patients in control group. Results: From 48 patients, 2 women in case and one woman in control group become pregnant and the differences were not significant. Key words: Endometrial injury, Pregnancy outcome,IVF/ICSI. O-17 Comparing the effect of oil progesterone with 17-α-hydroxy progesterone caproate (17-HPC) for luteal phase support in IUI cycles Khadem N, Anbar Looii M. Obstetrics and Gynecological Department of Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail: khademn@hotmail.com Introduction: Luteal phase support is used routinely in patients undergoing induction of ovulation (IO) and IUI cycles. The purpose of this prospective randomized study was to compare the effect of oil progesterone with 17-α-hydroxy progesterone caproate (17-HPC) for luteal phase support, in these patients. Materials and Methods: In this prospective randomized clinical trial, a total of 162 patients undergoing IO and IUI in Montaserieh Infertility Center of Mashhad from October 2005 to October 2006 were treated randomly with either 17-HPC (250 mg I.M. weekly) or progesterone in oil (50 mg I.M. daily) until beta-HCG were evaluated. Then in patients with positive beta–HCG (biochemical pregnancy), the treatment was continued until 12th week of gestation. The data were analyzed using T-test, Chi-square X 2 Test or fisher exact test. P-values of < 0.05 were considered as the level of significance. Results: The outcome of IUI in both study groups was compared. No difference was found in the main outcome of biochemical pregnancy (p-value=0.69), clinical pregnancy and ongoing pregnancy (p-value=1). However complication was significantly lower in 17–HPC group (p-value=0.002) while patients’ consent was significantly higher in 17–HPC group (p-value=0.003). Conclusion: The results of the study encourage us to use 17–HPC for luteal phase support in patients undergoing IO and IUI cycles, although more studies are necessary to support this replacement. Key words: 17-α-hydroxyprogesterone caproate, Oil progesterone, IUI, Luteal phase support. O-18 Comparing the IVF patients with and without ovarian hyperstimulation syndrome (OHSS) Vahidroodsari F, Ayati S. Obstetrics and Gynecological Department, Ghaem Hospital, Mashhad University of Medical Sciences. Introduction: Ovulation stimulation is the basis of in vitro fertilization that may be accompanied with potentially fetal complications such as ovarian hyperstimulation syndrome (OHSS), which may occur in 1% of the cases. Materials and Methods: We have compared 40 OHSS cases with 40 infertile patients who were undergone in vitro fertilization in Montaseri Infertility Center from 1999 to 2004. Results: Mean age of the patients was 29 years. Male factor primary infertility was the most common cause of infertility. The history of regular and prolonged menstrual cycles with short menorrhage periods and several IVF cycles in the past were common in OHSS group. Clinical symptoms of polycystic ovarian (PCO) were significantly more common in OHSS cases so PCO was known as a predisposing factor for OHSS. There wasn’t any relation between OHSS incidence and type of ovarian stimulation agent but OHSS was more common in higher doses. More follicles and oocytes predicted OHSS but number and grade of embryos were not different between groups and the pregnancy success rate increased significantly in OHSS cases. Conclusion: PCO signs, irregular menstrual cycles and previous IVF cycles and high doses of ovarian stimulator agents predict OHSS incidence during IVF. Key words: Infertility, IVF, OHSS. O-19 Association of p53 polymorphism with ICSI/IVF failure and recurrent pregnancy loss Dehghani Firouzabadi R, Ghasemi N, Ayazi M, Tabibnejad N. Research and Clinical Center for infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Introduction: The p53 tumour suppressor gene is a well-known factor regulating apoptosis in a wide variety of cells and tissues. Alterations in the p53 gene are among the most common genetic changes in human cancers. In addition, recent data provide evidence that p53 plays a critical role in mediating pregnancy by regulating steroid hormone activation. Several polymorphisms of the p53 tumour suppressor gene have been associated with recurrent pregnancy loss.We evaluated the hypothesis that polymorphisms in the p53 tumour suppressor gene in women may be associated with their response to in-vitro fertilization (IVF) treatment and occurrence of repeated miscarriages. Materials and Methods: The prevalence of a common polymorphism of the p53 tumour suppressor gene (Arg and Pro variants at codon 72) in 50 infertile women with more than two IVF failures was examined and it was compared with 50 women with recurrent pregnancy loss and 50 normal women with at least two alive children as control group. For each patient, two p53 tumour suppressor alleles (Arg and Pro) were identified by using PCR-RLFP technique and genotypes were defined as Arg/Arg,Pro/Pro, or Arg/Pro. Statistical analysis was done by SPSS software and the p-values under 0.05 were considered to be statistically significant. Results: The results will be presented in the 14th Fertility and Infertility Congress in Yazd. Key words: p53 tumour suppressor gene polymorphism, IVF failure, Recurrent pregnancy loss. O-20 Evaluating the follicular inhibition effect of LD OCP in women at Hamedan Infertility Center FarimaniM, Asgari GH, Ramazani N. Obstetrics and Gynecological Department, Infertility Center of Hamedan University. Introduction: Many suggested methods have been created for contraception. Among them, hormonal methods are the most effective ones in terms of cost and its impact. The Mechanisms of oral contraceptive pills with low dose estrogen (LD OCP) varies, including ovulation inhibition, thickening cervical mucus and reduced receptivity of ovum implantation. The degree of follicles suppression always considered as the most questioning issue for physicians and patients. The goal of this study was to determine the degree of inhibition of ovulation in women referred to Hamedan Infertility Center with normal ovulation who take LD OCP during first month. Materials and Methods: This cross sectional study was done on 100 infertile women without ovulatory factor who had been referred to Hamedan Infertility Center for ART. After trans vaginal sonography in the 3rd cycle, if follicles sizes were not greater than 10mm and endometrial thickness was not lower than 5mm, LD OCP started routinely for ART cycles. 14 days later patients rescanned for starting Buserelin. Information about age, follicular sizes in each ovary and endometrial patterns and sizes were collected. Results analyzed with SPSS-10. Results: Mean age of patients was 32.18 years. After 14 days of LD OCP use, 21% of patients had follicle sizes of more than 16mm. An interesting point was growth of multiple follicles in few patients. Only 9% of patients had endometrial thickness lower than 5mm and the rest had more. In addition 14% of them had 3 lines pattern and the others had echogen endometerium. Conclusion: According to the previous studies which showed That LD OCP cannot inhibit LH-surge impact on follicle size above 16mm, follicular growth can be considered as impending ovulation in this study. More studies on this issue are recommended. Key words: OCP, Ovulation. O-21 Laparascopy versus laparatomy in the treatment of ectopic pregnancy Gharabaghi PM, Abdollahi S. Obstetrics and gynecological Department, Tabriz University of Medical Sciences. Introduction: Ectopic pregnancy (EP) is the most important cause of maternal mortality and morbidity in the first trimester of pregnancy. Over the past few decades with serum level of BhCG and vaginal ultrasonography early diagnosis of ectopic pregnancy before rupture has been possible and the management of EP has been revolutionized. Today medical therapy and conservative surgery with the aid of laparoscopy and laparatomy is the management of EP. Materials and Methods: In this study 60 patients with unruptured tubal pregnancy whom hemodynamical status were stable and the size of EP were less than 4 cm were selected in Alzahara Hospital and then randomly in 20 patients laparatomy and in 40 patients laparascopy were performed. The outcome measures included; the success of each treatment modality, the need for second mode of treatment, the duration of hospital stay and the route of drug requirements. Results: The titer of BhCG after operation has been diminished significantly in both groups. In the laparatomy group no patient did require additional treatment by methotrexate or reoperation. But in the laparatomy group one patient (2.5%) required methotrexate although from statistical point of view there was no significant differentiation. The hospitalization period and the rate of drug requirement were diminished significantly in laparoscopic group. Conclusion: EP treatment by laparoscopy and salpingoscopy cause a successful treatment of disease. In addition this method of treatment reduce the hospitalization period, diminish convalescent period and use of narcotic drugs. Key words: Ectopic pregnancy, Laparascopy, Laparatomy. O-22 Evaluating the diagnostic value of visual findings at laparoscopy in endometriosis Salehpour S, Zhaam H, Hakimirard M, Azar Gashb E. Infertility and Reproductive Health Research Center (IRHRC), Shahid Beheshti University. E-mail: saghar_salehpour@yahoo.com Introduction: Endometriosis has been widely implicated as one of the causes of chronic pelvic pain, dysmenorrhea, and infertility. The purpose of our study was to define the correlation between the visual and histological diagnosis of endometriosis from peritoneal findings identified at laparoscopy in a diagnostic trial with a standardized technique; including complete excision of lesions suggestive of endometriosis and systematic biopsies of normal appearing pelvic peritoneum. This study was performed in Mahdieh Hospital and IRHRC between 1383-1384. Materials and Methods: A diagnostic study of 30 patients (15-45yr) undergoing diagnostic laparoscopy for the evaluation of chronic pelvic pain, infertility, dysmenorrhea and dysparonia was carried out (average age was 28.6±5.14 years). All areas suggestive of endometriosis were excised and examined pathologically. Peritoneal biopsy specimens were obtained from areas of normal appearing peritoneum to rule out microscopic endometriosis. The positive predictive value, sensitivity, negative predictive value and specificity were determined for visually identified endometriosis versus the histological findings. Result: The mean prevalence of abnormalities visually consistent with endometriosis was 63%, with 42% confirmed histologically. The positive predictive value was 42.1%, sensitivity 88.8%, negative predictive value 90.9% and specificity 47.6%, for visual versus histological diagnosis of endometriosis. Conclusion: Diagnosis of endometriosis should be established only after histological confirmation. Key words: Endometriosis, Laparoscopy, Histopathology. O-23 Comparing follicular responses to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated by different laparoscopic techniques for ovarian endometrioma Alborzi S. Obstetrics and Gynecological Department, Shiraz University of Medical Sciences, Iran.
Introduction: It is important to compare follicular responses to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated by different laparoscopic techniques for ovarian endometrioma. Materials and Methods: In 65 patients with unilateral endometrioma, laparoscopic ovarian fenestration and coagulation was performed in 24 cases (group 1) and laparoscopic ovarian cystectomy in the other 41 (group 2). In 16 patients with bilateral endometrioma (group 3), cystectomy was done in one ovary and fenestration and coagulation in the contralateral side. Results: The results indicate that the response of ovaries to COH after laparoscopic ovarian cystectomy or fenestration and coagulation was the same and that there was no difference in response to COH between normal ovaries and those operated by the laparoscopic techniques mentioned above. O-24 Comparing the rate of trisomy 21 in ART and non-ART neonates of women over 35 years old Ghahiri A, Firozmand Obstetrics and Gynecological Department, Isfahan University of Medical Sciences, Iran. Introdcution: Nowadays, there are increasing number of women who use assisted reproductive technology (ART) to become fertile. One of the issues that all mothers and clinicians who offer ART are worry about is neonatal trisomies that include by these methods. Materials and Methods: In order to investigate whether ART increases the number of neonatal trisomies or not, we run a historical cohort study. In this study, we selected 450 nulliparous women more than 35 years old. Half of this population received ART (mostly IVF, ICSI) and another half (225) received no ART treatment. Results: Among women who received ART, only 4 infants with trisomy were born. In the other group that received no ART treatment 12 infants with trisomy were born. Although the incidence of trisomies did not differ significantly between two groups (p-value>0.05 chi square) but this incidence was less in ART recipient group in comparison to the other group. Conclusion: So in conclusion in spite of the fact that ART did not reduce the incidence of trisomies in newborns, it did not increase the number of this abnormality at all. Key word: Trisomy, ART, Neonate. O-25 Evaluating the effect of OCP on ongoing IUI cycle Hamdi K, Bergis K, Akbariasbagh F. Tehran University of Medical Sciences, Infertility Ward of Mirza kochak khan Hospital. Introduction: Polycystic ovarian syndrome (PCOS) is the most common cause of infertility with ovarian factor. There are different methods for induction ovulation in these patients. Intra uterine insemination (IUI) of sperm is one of the most important methods for treatment of these patients. It seems that administration of oral contraceptive (OCP) in the cycle before IUI changes the hormonal pattern and may improve the result of IUI. Materials and Methods: In this study, 180 IUI cycle were studied and divided in two groups with and without prior OCP administration. Number of dominant follicles, endometrial thickness, serum progesterone level, chemical and clinical pregnancy were compared in two groups. Results: Overall, 28 cycles out of 180 cycles were cancelled because of arrest of follicle maturation. In total, 70 cycles with prior OCP administration (group A) and 82 cycles without OCP administration (group B) were enrolled in this study. The number of dominant follicle in group A was more than this in group B (p-value<0.01). Evidence of ovulation (serum progesterone), chemical and clinical pregnancy were the same in two groups. Conclusion: OCP administration before IUI cycle can increase the number of dominant follicle but make no difference in ongoing pregnancy. Key words: IUI, OCP, PCOS. O-26 Conservative radical operation will spare fertility in young women cervical cancer Azhar H. Obstetrics and Gynecological Department, Shahid Beheshti Medical School. Introduction: Cervical cancer is one the most important cancers in women especially in pregnancy. Conservative treatments have been reported recently. Materials and Methods: Review of articles about the incidence of cervical cancers and the new conservative treatment in young women. Results:There will be 11,150 new cases of cervical carcinoma in USA at 2007 with 3670 Death. Invasive cervical carcinoma is reported to be 1/2000-1/10,000 in pregnancies. Combination of cervical cancer and pregnancy is about 2%-3%. Conclusion: Conservative treatment is a good option for young women that desire to fertility. Key words: Cervical pregnancy, Fertility preservation. O-27 Ovarian masses during reproductive ages Abdollahifard S. Infertility Department, Alzahara Hospital, Tabriz University of Medical Sciences. Introduction: During reproductive years, the most common ovarian masses are benign. Ovarian masses can be functional or neopalstic and neoplastic tumors can be benign or malignant. Functional ovarian masses include follicular and luteal cysts. The chance that primary ovarian tumor be malignant in a patient younger than 45 years of age is less than 1 in 15. The new routine application of ultrasound technology to gynecological examination has led to the more frequent detection of ovarian cysts. Materials and Methods: The ovarian masses in 10-30 years old women who were admitted to Alzahara Hospital from 1386-1384 was studied. The mean age of the women was 22.7±4 years (range 10-30 years). Only 5% of cases were under 13 years old. 55% were married and 45% were single. Results: The results will report the pathological findings, reason of admission, types of sugary and will compare the laparotomy with laparascopic surgery in regard of duration of hospital stay, pain scores and most important complication. Conclusion: Ovarian masses are common in reproductive age and fertility preservation is one of the most important factors for the surgery type and treatment. Key words: Ovarian mass, Reproductive age. O-28 Fertility preservation in young patients with gynecological malignancy Karimi Zarchi M, Karimzadeh Maybodi MA, BokaeeM. Shahid Sadoughi University of Medical Science, Yazd, Iran. Email: drkarimi2001@yahoo.com Introduction: Progress in preserving reproductive function in patients with gynecologic malignancies has been made owing to advances in surgical techniques, molecular pathology, and combined treatment modalities. These developments have allowed approach without compromising long-term outcome. Although the majority of gynecologic cancers are diagnosed in older women, 21% occur in women of reproductive age. A small but growing number of these women seek alternatives to standard treatments so as to preserve fertility. Conservative management in young patients with stage I (grade 1, 2) of epithelial ovarian tumor and sex cord-stromal tumor, patients with borderline and germ cell ovarian tumors, patients with micro invasive and early stage cervical cancer (stage IA1, IA2 and some of IB1) and endometrial cancer; grade 1 without myometrial invasion, could be performed in order to preserve fertility. Each case is unique and requires a different strategy of fertility preservation given the type of cancer, the chemotherapy regimen, patient’s age, partner’s status, and time frame available before onset of treatment. Patients who have time to undergo ovarian stimulation can cryopreserve embryos or oocytes. Conclusion: Collaboration between gynecologic oncologists and reproductive endocrinologists might optimize fertility preservation for these patients. Key words: Fertility preservation, Young patients, Ovarian cancer, Cervical cancer, Endometrial cancer. 2-Embryology O-29 The effect of BMP4 on globin genes expression in erythroid-like cells differentiated from embryonic stem cells in serum free media Owchi MA, Salehnia M, Forouzandeh M, Hajizadeh E. Anatomy Department, Tarbiat Modares University, Tehran, Iran. Introduction: There are many effective factors and agents that involve in differentiation of embryonic stem cells to erythroid lineage such as cytokines and growth factors like Bone Morphogenetic Protein-4 (BMP4). The aim of this study was to evaluate the effect of BMP4 on differentiation of embryonic stem cell to erythroid lineage in serum free media and primitive (βH1) and definitive globin (βmajor) genes expression Materials and Methods:CCE embryonic stem cells were cultured in DMEM medium and the secondary passage was done in IMDM medium. The cells of two days embryoid bodies were dissociated with Trypsin-EDTA and replated into semisolid medium containing IMDM and knockout serum replacement (20%) with 20 ng/ml concentrations of BMP4. Expression of the βH1, βmajor and β2m genes was evaluated by semi-quantative RT-PCR and Real time PCR. Results:Morphologically, the colonies that formed in BMP4 treated groups were larger than the control group. Analysis of the gene expression showed that both of βmajor and βH1 were expressed and the ratio of βH1 gene expression was higher than βmajor (p-value<0.05). Conclusion:Our results demonstrated that BMP4 is the effective factor to improve the differentiation of embryonic stem cells to erythroid lineage in serum free media and both pattern of erythropoiesis (primitive and definitive) were seen. Key words: Embryonic stem cells, Erythropoiesis, BMP4, Globin genes expression. O-30 Effects of low-intensity ultrasound on osteogenic differentiation of Rat bone marrow mesenchymal stem cell: an in vitro study Hamrahi D1, Shiran MB1, Gourabi H2, Baghban Eslaminejad3, Rouhi L3. 1 Medical Physics Department, Iran University of Medical Sciences, Tehran, Iran. 2 Genetic Department , Royan Institute. 3 Stem Cell Department, Royan institute, Tehran, Iran. Introduction: To test this hypothesis that low-intensity ultrasound (LIUS) may be effective stimulant on differentiation of rat mesenchymal stem cells (rMSCs), we study the effect of LIUS on osteogenic differentiation of rat bone-marrow derived MSCs. Materials and Methods: Ultrasound instrument was calibrated by radiation force and the intensity ratio was calculated (Ipk/IAve=3.561 W.cm-2). The cell chamber was exposed to US in the LAM of circular piston transducer (4 cm area) operating at 3MHz in continues wave. The sonication was carried out for period of 5 minutes daily up to 2 weeks at nominal intensities of 100mW.cm-2 while the control group had no US stimulation. The cells that were used in this investigation were passaged from 3 rat bone marrow-derived mesenchymal stem cells. The cultures were evaluated by alkaline phosphatase activity assay and semi quantitave RT-PCR on days 1, 3, 5, 7, 9, 11 and 14 of post-stimulation. Each experiment was replicated ten times and the mean values were statistically compared. Results: Our results indicated that alkaline phosphatase activity in US group was significantly more than this in control group (88.6±12% versus 30.14±23%, p-value≤0.005). According to semi quantitative RT-PCR analysis, in US group, in all examined days, expression of the bone specific genes including alkaline phosphatase, osteocalcin and osteopontin were significantly higher than these in control group. These genes appeared to be expressed in US groups in early days of cultivation periods compared to that of control group. The important point was that the osteocalcin gene was never expressed in control group. Conclusion: Taken together, it seems that US is able to induce in vitro osteogenic differentiation of the rMSCs. Key words: Low-Intensity Ultrasound, Last Axial Maximum (LAM), Rat Mesenchymal Stem Cells (rMSCs), Osteogenic differentiation. O-31 Evaluating the effects of bFGF on limbal stem cells cultured on amniotic membrane and collagen Ι Taghiabadi E, Ebrahimi M, Valadbeigy T, Baharvand H. Stem cell Department, Royan Institute, Tehran, Iran. E-mail: Marzieh.ebrahimi@gmail.com Introdcution: It has been hypothesized that limbal stem cells (LSCs), a population of SCs located in the basal epithelium at the corneoscleral limbus may be maintained and controlled by intrinsic and extrinsic factors in their local microenvironment, the so-called stem cell niche. Environmental factors that may synergistically act to regulate gene expression and to maintain ‘stemness’ include the limbal extracellular matrix (ECM), particularly the basement membrane, cell-matrix interactions, growth factors in micro environment and cell-cell contacts. Understanding these limbal SC niche interactions is essential if the goal of developing new adult stem cell therapies is to be fully realized. Materials and Methods:In this study we compared the effects of bFGFon culture of limbal stem cells in presence of epithelially denuded-human amniotic membrane and collagen type I as a limbal SC niche in vitro. Cultured cells in different groups evaluated by immunochemistry and RT-PCR for expression of proposed limbal SC markers (P63, ABCG2) and corneal specific markers (K3, Connexin 45). Results: The size of cells cultured on AM in absence of bFGF were small and compact with the lower ratio of nucleus to cytoplasm in comparison with collagen type I. bFGF in the culture media caused increasing of cell sizes and of cytoplasm ratio. Epithelial outgrowth of limbal explants on AM and Co in absence of bFGF expressed more p63 (SC markers) and less K3 (corneal differentiation markers) in comparison with bFGF+ group (p-value<0.05(. However the AM expressed high level of p63 than Co. ABCG2, a protein present in many adult stem cells, expressed in the collagen group without bFGF (25.27±5.6) (p-value<0.05). Moreover, in all groups, the cells expressed ABCG2, K3/12 and p63as shown by RT-PCR. Conclusion: Our results showed that epithelium-denuded AM provides a superior niche for limbal SC proliferation. In addition, phenotype maintenance in vitro and the denuded human AM is a protein enriched ECM in comparison with collagen type I. bFGF increased cell survival in culture cells and play an important role in cell differentiation. Key words: Limbal stem cell, Amniotic membrane, Collagen Ι, bFGF. O-32 Effect of antioxidants on DNA damage in human and mouse germ cells and cytogenetic abnormalities in subsequent generated pre-implantation embryos Mozdarani H. Department of Medical Genetics, School of Medical Sciences, Tarbiat Modares University. Email: mozdarah@modares.ac.ir Introduction: This study was conducted to evaluate DNA damage induced in human normal and subfertile sperms following treatment with chemotherapeutics in the presence of famotidine as an antioxidant and to compare the effects of exposure of NMRI mice with γ-raysin the absence or presence of vitamins E and C and subsequent cytogenetic damage in pre-implantation embryos generated from irradiated gametes. Materials and Methods: Sperms of normal and subfertile men were treated with different chemotherapeutic agents in the presence and absence of famotidine. DNA damage was evaluated using alkaline comet assay. Male and female NMRI mice were whole body irradiated in the presence of vitamins E and C. Various mating schemes were designed for mating of irradiated mice. About 68 hr post coitus, 4-8-cell embryos were flushed out from oviducts and fixed on slides using standard methods in order to screen for chromosome abnormalities and micronuclei. Results: Treatment of human sperms with chemotherapeutics led to a significant increase in DNA damage, although the amount of DNA damage was different for drugs and in sperms from sub-fertile patients. Famotidine reduced DNA damage in all treatment groups effectively. In irradiated mice, there was an increase in both abnormal metaphases and micronuclei frequency in embryos generated after parental or maternal irradiation or both. Vitamin E effectively reduced the frequency of aneuploidy in all irradiated groups and vitamin C was very effective in reducing the frequencies of micronuclei. Conclusion: Data indicated that both radiation and chemotherapeutics are potent inducers of DNA damage in male and female germ cells. These effects may be transmitted to next generation pre-embryos leading to implantation failure or loss. Administration of antioxidants before treatment with chemotherapeutics or irradiation effectively reduced DNA damage and the frequency of chromosomal abnormalities. The way these antioxidants reduces genotoxic effects of chemicals or radiation might be via radical scavenging mechanism. Key words: DNA damage, Chromosomal abnormalities, Antioxidants, Human sperm, Mouse preimplantation embryo. O-33 Assessment of morphological and functional changes in the mouse testis and epididymal sperms following unilateral and bilateral cryptorchidism Absalan F, Movahedin M, Mowla SJ. Department of Anatomical Sciences, School of Medical Sciences, Tarbiat Modarres University ,Tehran, Iran. Introduction: This study was conducted to evaluate the long term effect of experimental bilateral and unilateral cryptor-chidism on sperm parameters and structure of mouse testis. Materials and Methods: To induce bilateral and unilateral cryptorchidism model, immature mice (age under 2 months) were anesthetized and a small incision was made in the abdominal skin and peritoneum then fat pad at the upper end of testis was sutured to peritoneum. Testes were removed 2, 4, 6 and 8 weeks after surgery, weighted and processed for light microscopy study. Weight of testis, spermatogenic cell numbers, tubular ectasis (rate of tubular lumen comparing to the germ cell layer) as well as epididymal sperm parameters were measured. Results: Spermatogenesis was arrested and the testicular weight and seminiferouse tubular diameters were significantly reduced in the bilateral undescended testis compared with unilateral undescended testis and the control mice. However complete depletion of seminiferous tubules and absence or sloughing of germ cells was not found in any of the animals. Spermatocytes and spermatids were the main type of germ cells undergoing apoptosis in all groups. Conclusion: In general, high temperature caused a decreased in all analyzed parameters except spermatogonial cell number probably due to the apoptosis and these changes significantly increase in bilateral groups compared with unilateral groups. It is suggested that although apoptotic cell death induced by bilateral cryptorchidism might be affected by changes in systemic factor, apoptosis increase in male germ cells after unilateral cryptorchidism regulated by local testicular factors. Also this model is suitable for enrichment of spermatogonial stem cells. Key words: Cryptorchidism, Testis, Spermatogonial stem cells. O-34 Effects of Retionoic acid (RA) on differentiation of embryonic stem cells to nervous system cells with study on neural specific gene expression Djahanbakht H, Parivar K, Akhondi MM, Safapour KCE. Azad Islamic University, Karaj, Veterinary College. Azad Islamic university, Science and Research campus, Zoology, Tehran, Iran. Monoclonal Antibody Research Centre, Reproductive Biotechnology Research Centre, Avesina Research Institute, ACECR, Tehran, Iran. Azad Islamic University, Ghom Branch, Science College, Ghom, Iran. Introduction: Embryonic stem cells are pluripotent cells that can not only be differentiated to all types of specific adult cells but also can be used for cell therapy. In this survey pluripotent and undifferentiated mouse embryonic stem cells were cultured and surveyed for differentiation into neural and glial cells upon treatment with the Retinoic Acid (RA) that is effective on neural tube development. Materials and Methods: Mouse ES cell line CCB from strain 129 were cultured on inactivated mouse embryonic fibroblasts and the resulting Embryoid Bodies (EBs) were transplanted in two ways; on culture plates that covered by fibronectin and poly-L-lysine. The RA (1micromollar) was added to specific neural precursor cells. Otherwise we culture the stem cells in suspension for 4 days with RA. The expression levels of specific neural genes, including Nestin (marker of neuroepithlial cells), Nkx2.2 (ventral neurons in spinal cord), nurr1 (primary dopaminergic neurons), S100 (Astrocysts), Olig-2 (oligodentrocytes) were mesured by RT-PCR and densitometry. In addition, the formation of dendrites and soma in neurons was assessed through immune-cytochemistry assay on microtubule association protein (MAP2). Results: The expression of Nestin showed RA caused neural induction and suspension culture was more effective than hanging drop assay. Moreover we showed that differentiation of the primary dopaminergic neuron formation that express nurr1 gene was induced by RA. Some of ES cells under treatment with RA expressed S100 and were accordingly proved to be astrocystes. However the expression of Olig2 and Nkx2.2 were not demonstrated and consequently no differentiation into ventral spinal cord neurons and oligodendrocytes had happened. Immuno-cytochemistry assay of MAP-2 confirmed the formation of dendrites and neurons. Conclusion: The present study demonstrated that multiple steps of development and differentiation of embryonic stem cells to mainly CNS cells can be analyzed in culture. Moreover, the RA signals involved in neural differentiation and in vitro generation of embryonic stem cells culture for therapeutic use. Key words: Stem cell, Neural differentiation, Retinoic acid. O-35 Flow cytometric analysis of antral follicles isolated from vitrified and non vitrified ovaries in vitro Mazoochi T1, Salehnia M2, Rezazadeh Valojerdi M2, Mowla SJ3, Nikougoftar M4. 1 Department of Pathology, Kashan University of Medical Sciences, Kashan, Iran. 2 Department of Anatomy, Tarbiat Modares University, Tehran, Iran. 3 Department of Genetics, Tarbiat Modares University, Tehran, Iran. 4 Research Center of Iranian Blood Transfusion Organizations, Tehran, Iran. Introduction: Vitrification is a simple and ultra rapid technique for the conservation of fertility. This study was carried out to evaluate the effect of mouse ovarian tissue vitrification on the follicular cell death during culturing. Materials and Methods: This experimental study was carried out on 12-14 day old female mice (NMRI). Ovaries were vitrifies with a solution containing ethylene glycol. After fast warming, preantral follicles were mechanically isolated from vitrified and non vitrified ovaries and were individually cultured in α-MEM (Gibco, UK) supplemented with 5% FBS, 100 mIU/ml rFSH, 1% ITS and 20 ng/ml mrEGF nonspherically for 10 days. At the end of culturing period percentage of intact and dead cells was determined by AnnexinV-Propidium Iodide (AV-PI) staining and flowcytometric analysis in two groups of study. Chi-square test was used to analyze the data. Results: The percentage of cells that were intact (AV-/PI-), early apoptotic (AV+/PI-), necrotic (AV-/PI+) and late apoptotic or necrotic (AV+/PI+) were 56.5±5.1, 36.4±3.9, 5.0±1.1 and 2.1±0.3 respectively in antral follicles of vitrified group, while these percentages were 68.8±3.8, 29.7±3.3, 1.4±2.2 and 4.0±0.8 respectively in non vitrified groups. There was no significant difference between the control and vitrified groups in percentage of early apoptotic cells. But in the other variables the differences were significant. Conclusion: Ovarian vitrification using ethylene glycol has no significant impact on percentage of early apoptotic cells. Key words: Vitrification, Ovary, Cell death, Flowcytometry. O-36 The assessment of viability and in vitro maturation (IVM) of cumulus-Germinal vesicle break down (GVBD) oocyte complexes after vitrification in mouse. Khosravi Farsani S1, Mahmoudi RM2, AbdolvahhabiMA1, Abbasi M1, Anvari M3, Sobhani A1. 1 Department of Anatomy, Faculty of Medicine, Medical Sciences/University of Tehran, Tehran, Iran. 2 Department of Anatomy, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran. 3 Department of Anatomy, Faculty of Medicine, Yazd University of Medical Sciences, Yazd, Iran. Introduction: Vitrification is assumed to be a promising method to cryopreserve human oocytes but still needs optimizing. The aim of this study was to improve the single step and step-wise vitrification effects on maturing mouse GVBD by ethylene glycol (EG) in conventional straws. Materials and Methods: Oocytes with compact cumulus cells were cultured for 3 hr in TCM199 supplemented with 10% fetal bovine serum (FBS) in 5% CO2 in air. GVBD oocytes were randomly allocated into three groups. (1) Control (non-vitrified group), (2) exposed to single-step vitrification (contained of EG 20% + 0.5M sucrose), and (3) exposed to step-wise vitrification (2%, 5%, 10%, 20% EG + 0.5M sucrose). Then oocytes underwent additional 21 hr maturation (in vitrification groups after thawing). Viability of oocytes and maturation to MII stage were analyzed using inverted microscope and additionally by staining of propidium iodide and Hoechst 33342. Results: All non-vitrified oocytes were viable after 24 hr; however, viability of vitrified samples in single-step group was significantly lower than that of the step-wise and control Groups. Also, the maturation rate in the step-wise group was significantly higher (p-value<%5) compared to single-step. Conclusion: these results suggest that step-wise vitrification of GVBD oocytes as compared to single step vitrification was better in the rate of survival and in vitro maturation of oocytes. Key words: Vitrification, Viability, In vitro maturation, GVBD, Oocyte, Mouse. O-37 Effect of granulosa cells co-culture and retinoic acid on maturation and development of immature mouse oocytes in vitro Eimani H1,2, Tahaei LS1,3, Parivar K3, Rezazadeh M1, Kazemi S1, Shahverdi A1, Eftekhari P4, Baharvand H4. 1 Department Of Embryology, Royan Institute, Tehran, Iran 2 Department of Anatomy, Faculty of Medicine, Baqiyattola University, Tehran, Iran 3 Department of Animal Biology, 4 Department of Stem Cells, Royan Institute, Tehran, Iran E-mail: info @ Royan Institute .org Introduction: Our purpose of this study was to develop appropriate medium for in vitro maturation (IVM) of immature mouse oocytes. Materials and Methods: Germinal vesicle of NMRI female mouse (6-8 weeks old) oocytes were collected from ovaries and cultured in maturation medium MEM-α contained: 100 IU/ml rFSH+7.5 IU/ml hCG+5% FCS (Control group) and 2 μM all-trans retinoic acid (t-RA) in the presence or absence of granulose cells. Ethanol (Sham group) 0.2% (v/v) was the vehicles. After 24 hours the matured oocytes were fertilized with spermatozoa in T6 medium and cultured for 5 days. Their development to the morula and blastocyst stages was studied. Results: The retinoic acid supported progression and resumption of meiosis and also increased advancing the oocytes to Metaphase II, formation of morula and blastocyst compared to control group. When there were not 2 μM t-RA and granulose cells in IVM medium, a significantly lower maturation rates was observed, followed by a decrease in the percentage of embryos reaching the blastocyst stage. Whereas, when 2 μM t-RA and granulose cells monolayer were present from the IVM medium, better results in comparison with control group were obtained. Conclusion: The results indicated that co-culture of granulose cells with 2 μM all-trance retinoic acid during in vitro maturation enhanced mouse oocytes maturation and improved embryonic development. Key words: Granulose cells, Retinoic acid, In vitro maturation, Mouse, Oocytes. O-38 Effects of different doses of Bone Morphogenetic Protein 4 on the viability and proliferation of CCE mouse embryonic stem cells Makolati Z1, Movahedin M1, Forouzandeh-Moghadam M.2 1 Department of Anatomy, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran 2 Department of Biotechnology, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran Introduction: With regard to the importance of BMPs roles in the formation, development and function of various vital systems during fetal life, the aim of this study was to evaluate the effect of different doses of BMP4 on the viability and proliferation of CCE mouse embryonic stem (ES) cells. Materials and Methods: CCE ES cells were tripsinized and cell suspension was prepared. The cells were counted and cultured in 96 well microplates. Each well of this plate containing 3Χ104 cells in 20% FCS in DMEM media. The cells were incubated for 1 day, washed with PBS and cultured in DMEM containing different doses of BMP4 (1, 5, 25, 50 and 100ng/ml) as experimental groups. Control group was cultured in BMP4 free medium. ES cells incubated at 37°C overnight, washed with PBS, tripsinized and cell suspension was prepared separately from each well. In order to investigate the viability and proliferation rates of CCE ES cells, staining with trypan blue and counting were done. The mean number of whole cells and living cells were considered as proliferation and survival rates respectively. Data analysis was done with ANOVA test. Results: No significant differences were found between the mean number of whole cells in the different doses (p=0.18), but the mean percentage of living cells showed that BMP4 in 5 and 100 ng/ml concentration had the best and the worst effects on the viability of ES cells respectively (65.56% vs. 27.24%). Conclusion: Evaluation of proliferation and viability rates using cell count and data analysis showed that addition of 5ng/ml BMP4 increased the proliferation and viability rates of CCE ES cells whereas high doses decreased these criteria. This suggests that different doses of BMP4 signaling may have different effects on ES cells behavior. Key words: Embryonic stem cell, CCE, BMP4, Proliferation, Viability. O-39 Correlation between sperm parameters with reactive oxygen species (ROS) and total antioxidant in fertile and infertile males Hassani Bafrani H1, Shahaboddin M2 . 1 Department of Anatomy, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. 2 Department of Biochemistry, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. E-mail: hasanhasani@yahoo.com Introduction: Human sperm cell plasma membrane is particularly susceptible to oxidation due to the existence of a high concentration of polyunsaturated fatty acids in these membranes. The reactive oxygen species (ROS) derived from abnormal sperms or from WBC which represents an additional powerful source of ROS in semen are responsible for the peroxidation damage that has been proposed as a major factor in male infertility. A simple tool to evaluate the effect of lipid peroxidation on the spermatozoa is the assay of sperm and seminal plasma malondialdehyde(MDA) which is a stable lipid peroxidation product. The aim of this study was to determine total antioxidant and abnormal patterns of reactive oxygen species (ROS) production in male factor infertility patients and its possible correlation with sperm parameters. Materials and Methods: Semen was obtained from partners of 25 consecutive cases attending to the clinic for IUI treatment. Semen was collected after 3 days of abstinence. The conventional semen parameters were analyzed. Semen was centrifuged at 1200 × g for 5 min to separate seminal plasma. The aliquots were stored at −80 °C until analyzed. Seminal plasma and serum were resuspended in phosphate buffer saline for FRAP and MDA levels in seminal plasma by spectophotometric assays. Results: The results are expressed as µmol/l total antioxidant and nmol/l MDA in seminal plasma and serum. In normal conditionROS level is 104 cpm/20×106 sperm. Normal, healthy donors had significantly higher (p-value<.0001) sperm concentration, motility, and morphology compared with all male factor infertility patients. The classical semen parameters were negatively related to lipid peroxidation in spermatozoa motility and morphology (p-vlaue < 0.05).Motility and viability were inversely correlated with semen MDA levels. Conclusion: MDA as an index of lipid peroxidation provides a sensitive assay for diagnostic dysfunction of spermatozoa and may be a good tool for analysis of infertility in the patients. We suggest the inclusion of ROS measurement as part of idiopathic infertility evaluation. Treatment with antioxidants may be beneficial in such patients. Key words: Antioxidants, Human sperm, Lipid peroxidation, Oxidative stress, Reactive oxygen species, Sperm parameters. O-40 The long term effects of methoxsalen on ovary in the mice Fattahy E, Parivar K, Kouchesfahan HM. Biology Department, Islamic Azad University, Amo.l E-mail:esmail_fattahy@yahoo.com Introduction: Methoxsalen is a photoactive drug. Methoxsalen UV-A therapy is used for the treatment of cutaneous disorders (e.g. psoriasis, vitiligo). This drug inhibits the synthesis of DNA, suppresses cell division and destroys of epidermal cells. However, this study evaluated the effect of methoxsalen on ovary structure and fertility in the mice. Materials and Methods: For this study, fifty immature female mice were divided to three groups of control, sham and experiment. Shams were injected by corn oil. The methoxsalen group mice were injected with consecutive doses (30mg/kg ip), five consecutive days per week for one month. Animals were scarified 2 days after the latest methoxsalen injection. Then, the mice ovary sections were made and morphologic aspects of ovary and oogenesis processes were assessed. Results: Our observations indicated that in these animals, methoxsalen significantly decrease the numbers of corpus luteal, Graafian follicle, primordial follicle compared to control group. Also diameter of corpus luteal, granulosa layer, oocyte and graf follicle decreased. Conclusion:Our results showed that the long term exposure of methoxsalen affect the oogenesis and can induce infertility in mice. Key words: Methoxsalen, Psoriasis, Granulose, Oocyte. O-41 Prevalence of antisperm antibody in men from infertile couples in Khorramabad city Nasiri MR, Shahsavar F, Kheirollahi AR, Farhadi A. Department of Immunology, Iran University of Medical Sciences, Tehran, Iran. Introduction: The precise mechanism for antisperm antibody (ASA) mediated fertility impairment is unclear. In the male reproductive tract, ASA may have an adverse impact on sperm maturation and function or overall semen quality. In this study, the percentage of ASA-IgA was determined by the direct mixed agglutination reaction (MAR) test in men from infertile couples in Khorramabad city. Furthermore, the semen parameters were evaluated to see if there was any correlation with the presence of ASA. Materials
and Methods: In total85 men
were tested for ASA as a part of an infertility evaluation. Patients were grouped
according to the percentage of ASA of < 10% or Results: overall 20% of this population was ASA-positive. Volume less than 2ml was not associated with ASA by direct MAR (p-value=0.56). Concentration less than 20×106/ml was not associated with ASA by direct MAR (p-value=0.51). Motility less than 50% was significantly associated with ASA by direct MAR (p-value=0.005). Conclusion: The incidence of ASA in men from infertile couple in Khorramabad city was 20%. Antisperm antibodies can disrupt normal sperm function by damaging sperm motility. Therefore, it can be suggested that patients with sperm motility of less than 50% should become candidate of ASA assay. Key words: Antisperm antibody, Infertility, Semen parameters, Mixed antiglobulin reaction. O-42 Effect of Antioxidants supplementation on human sperm parameters after freezing Nazm Bojnordi M1, Movahedin M2, Ghasemi H3, Amanpour S1. 1 Vali-e-asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2 Anatomy Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran. 3 Anatomy Department, Tehran University of Medical Sciences, Tehran, Iran. Introduction: Atioxidant reduces oxidative stress and improves sperm parameters during cryopreservation. This study was aimed to find out the effects of vitamin E and vitamin C on sperm parameters after cryopreservation. Materials and Methods: Human semen samples were obtained from the Vali-e-asr Hospital. The samples were divided into two groups (normal and oligospermia groups) according to WHO criteria. After adding cryopreservation medium, semen was pooled in liquid nitrogen. After thawing, samples were centrifuged for 5 min and in one group vitamin E (1, 2, 5Mm) and in another group vitamin C (1, 2, 4Mm) was added to medium and then the aliquots were incubated for 45 min in CO2 incubator. In control group no antioxidant was added to medium. Sperm parameters were analyzed according to WHO criteria. Data were analyzed by T-test and all values were given as means±SEM. Statistical significance was indicated by a p-value less than 0.05. Results: There was a significant increase in the sperm motility, progressive motility and viability in the samples which were supplemented with 1 and 2 Mm vitamin E (p-value<0.05). Vitamin C didn’t show significant effect on sperm parameters with 1 and 2 Mm concentration and it decreased sperm parameters in 4 mM dose. Conclusion: Supplementation of preparation media with alpha-tocopherol is beneficial for sperm motility and viability rates after cryopreservation and it could be of clinical value in assisted conception procedures. Key words: Alpha-tocopherol, Ascorbic acid, Sperm motility, Sperm morphology. O-43 Differentiation of mouse embryonicstem cells to neuron like cells after transfection with GFP+, Prur+, and Non-Silencing shRNA vector Estiri H1, Movahedin M2, Fallah A1, Aghazadeh M3, Chaparzadeh N1. 1Biology Department, Science Faculty, Tarbiat Moalem Azarbayjan University. 2 Anatomy Department, Medical Faculty, Tarbiat Modares University. 3 Microbiology Department, Medical Faculty, Medical University of Tabriz. Introduction:The purpose of this research was the possibility of detection, selection and knockdown of genes in mouse embryonic stem cells. Materials and Methods: At first shRNA cassette whit human microRNA-30 (miR-30) patterns was cloned in pGIPZ shRNA vector. Then by using Arrest-In transfection reagent this vector was transfected into mouse embryonic stem cells (CCE Line) and a new modified cell line that was GFP+, Prur+, and Non-Silencing shRNA was produced. On the other hand mESC were cultured on the feeder layer (Mouse Embryonic Fibroblast) that was provided from 13.5 day mouse embryos. After that, embrioid bodies were produced by hanging drops and using of non adhesive plates. Then according to 4-/4+ protocol in the lack and present of retinoic acid, EBs matured in eight days and neural induction stage was performed. In 8th day EBs were transferred on the gelatin coated plates. Then differentiated neuron like cells immigrated from EBs and matured in adhesion condition. For confirmation of neural characters of cells immonocytochemistry for Nestin was performed. Result:Consequences showed that most of the cells were GFP+. In addition immonocytochemistry for nestin showed that more than %80 of cells differentiated to neuron like cells and also these cells were GFP+. Conclusion: Byusing this cell line and differentiation of these cells we can detect them after transplantation in spinal cord-brain injuries for advanced cell therapy. Key words: Embryonic stem cell, GFP+ , Neuron like cells. O-44 The effect of polycystic ovarian patient's serum on early developmental stages in mouse embryo Nikzad H, Naderian H, Atlasi MA, Aliasgharzadeh A. Cellular and Molecular Biology Research Center, Kashan University of Medical Sciences, Kashan, Iran. E-mail:hnikzad@yahoo.com Introduction: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders which cause anovulatory infertility and hyperandrogenism in young women. One of the medical management in PCOS patients emphasize in increasing the chance of fertility. There are some evidences that the biochemical factors of serum and increased androgen hormone effect on embryo in early developmental stages. The aim of this study was to investigate the effect of PCOS patients’ serum on early development stages in mouse embryos from two cells to hatching blastocyst. Materials and Methods: After superovulating and fertilizing Balb/c mouse, 219 two cells embryos were retrieved, 109 embryos were cultured in 10% PCOS patients’ serum and 90% HTF medium. While 110 embryos were cultured in 10% normal serum and 90% HTF medium. The early developmental stages of embryos were studied in 2, 4, 8 cells, morula and early, late and hatching blastocyst. Results: The laboratory findings of PCOS patients’ serum show that the concentration level of testosterone, estradiol, prolactine and DHEA-S increased. The statistical analysis confirm the rate of embryo development decreased in 2, 4, 8 cells and morula stages, while the decreasing in developmental stages were significant in early, late and hatching blastocyst in comparison between two groups. Conclusions: Probably the decreasing in developmental stages of embryos is caused by increased androgen hormone of PCOS patients’ serum. It should be considered in treatment of infertility in PCOS patients in IVF techniques. Key words: PCOs, Serum, Embryo, Development. O-45 Endometrial maturation of blastocyst in uterine of mice received superovulatory drugs and progesterone Roshangar L, Soleimanirad J, Rashidi B, Azami I. Department of Histology and Embryology, Medicine and Drug Applied Research Center , Tabriz University of Medical Sciences, Iran. Introduction: The effect of superovulatory drugs on endometrial maturation at ART cycles is debated. Since the comparison of human specimens in ovulation- induced women with those at natural cycle is almost impossible, the animal studies are unavoidable. Regarding morphological characteristics as a criterion for evaluation of endometrial maturation, the aim of the present study was comparing histological characteristics of mice endometrium in controls with those at superovulated cycle received progesterone. Materials and Methods: In this study, 30 adult female Souri mice with average weight of 25–30 gr and 15 adult male mice were used. The female mice were divided into 3 groups as controls, gonadotropin and gonadotropin+progesterone. In experimental groups, the mice received 7.5 IU HMG as intraperitoneal injection and 48 hours later 7.5 IU HMG. Then in all groups, 2 female and one male mice were placed in a cage for mating. In the gonadotropin+ progesterone group, the mice received 1mg progesterone at 24, 48 and 72 hours after HMG injection. 96 hours after HMG injection, the mice in experimental groups together with control mice were sacrificed and their uterine were flashed for blastocyst. Uterine specimen, only from those that their uterine contained blastocyst, were fixed and prepared for light microscopic study. The sections were stained with H and E and PAS. Results: Microscopy revealed that in control group endometrial epithelium composed of tall columnar cells containing several PAS+ granules which were mainly basally located. In gonadotropin group, the granules were found both at basal and apical portions and the cells were taller than those in control group. In gonadotropin+progesterone group the granules were found in apical and basal portions and the heights of the cells were average of previous groups. PAS staining also revealed that mucous layer at luminal surfaces of the cells and secretory mucous in the lumen of the endometrial glands in experimental groups were more abundant than the control group. Conclusion: Evaluation of endometrial maturation according to its morphological characteristics indicates that superovulatory drugs in mice stimulate endometrial maturation but progesterone injection do not accelerate it. O-46 The long-term effect of Hinosan on spermatogenesis in the Balb/C Mice Fattahy E1, Jorsaraei SG2, Parivar K3, Moghaddamnia AA4. 1 Assistant Professor of Biology, Islamic Azad University, Amol Branch. 2 Assistant Professor of Anatomy and Embryology, Babol University of Medical Sciences. 3 Professor of Biology, Islamic Azad University, Research and Science campus, Tehran. 4 Professor of Physiology and Pharmacology, Babol University of Medical Sciences. Introduction: Hinosan is an organophosphate that inhibits acetylcolinesterase activity, which could be resulted in damages of genital organs. This compound has been used extensively in the agriculture, for pest control. Therefore, in the present study, we investigated the effect of Hinosan on spermatogenesis in mice. Materials and Methods: For this study, the male mice were divided into three groups. In the experimental group, mice were injected with Hinosan consecutive doses (20mg/kg ip, five consecutive days per week for one month), sham (water injection) and control (no injection). Animals were scarified 7 days after the latest Hinosan injection. Then, the mice testis sections were made and morphologic aspects of testis and spermatogenesis processes were assessed. Data were analyzed using of one-way ANOWA. P-value<0.05 was considered significant. Results:Our results showed that using Hinosan will cause a significant decrease in the number of germ cells, spermatocyt, spermatids, Leydig cells, blood vessels and also diameter of seminiferous on testes of the mice. Conclusion:These results suggested that Hinosan is effective on spermatogenesis and seminiferous tubule structure. Therefore Hinosan can induce infertility in mice. Key words: Organ phosphorus, Hinosan, Testis tissue, Leydig cells, Spermatozoid. O-47 In-vivo effect of Diazinon treatment on testes and spermatogenesis in rat Sarabi E, Jorsaraei SG, Firoozjahi A, Fattahy E, Beiky AA. Babol University of Medical Sciences. Introduction:Our objective was to evaluate alterations in rat testes tissue and spermatogenesis by the influences of Diazinon (DZN) organophosphates pesticide. Materials and Methods: In this study, 3 groups of Wistar rats were included. 2 groupswereinteraperitonealy injected with multiple and single dose of DZN with concentrations of 0.25 and 2.5 mg/kg (5 doses were injected per week and 20 times in month totally). Then the animals were killed 55 days after treatment andthe testes were removed for histomorphometric and histopathological evaluation. The histomorphometric parameters were assessed as follow: germinal cells, primary and secondary spermatocyt and lydig cells counting and measurement of seminiferous tube diameters. Results: In comparison with control group, all the parameters showed a significant decrease in injected groups (p-value<0.000) and also there was a dose dependent behavior decrease in all of them (p-value=0.000) and also a mild edema was detected. Conclusion: According to the results, however, histomorphologic alterations of the testes and spermatogenesis could be induced after multiple dose treatment exposure of Diazinon with except of mild edema, no obvious other histopathological alterations were seen. Key words: Diazinon, Rat testes tissue, Spermatogenesis. O-48 Non-enzymatic antioxidant activity and lipid peroxidation in sperm and seminal plasma of asthenoteratozoospermic men and their relationships with semen parameters Nouri M1, Ghaffari Novin M2,3, Ghasemzadeh A2, Farzadi L2 , Shahnazi V2 . 1 Biochemistry Department, Tabriz University of Medical Sciences, Tabriz, Iran. 2 Infertility Center, Tabriz University of Medical Sciences, Tabriz, Iran. 3 Reproductive Biotechnology Research Center, Avesina Research Institute, Tehran. E-mail: nourimd@yahoo.com Introduction: The aim of the present study was to determine the level of lipid peroxidation as indicated by Malondialdehyde (MDA) and vitamins E and C in sperm and seminal plasma of asthenoteratozoospermic and normozoospermic men and its relationships with semen parameters. Materials and Methods: One hundred male patients attending our infertility center: 40 men with normozoospermic and 60 infertile men with asthenoteratozoospermic semen profiles were randomly selected. Semen analysis was done according to the WHO standard. Sex hormonal profiles were measured by ELISA methods. The level of vitamins C and E and MDA were measured by HPLC and tiobarbiotic acid, respectively. Results: MDA concentration in the spermatozoa and seminal plasma of asthenoteratozoospermic was significantly higher than this in normo-zoospermic males (p-value<0.001). The level of vitamins E and C in seminal plasma of normo-zoospermic were significantly higher than in asthenoteratozoospermic males (p-value<0.01). However, the amount of vitamin C in the spermatozoa of normozoospermic was significantly less than this in asthenoterato-zoospermic males (p-value<0.01). Sensitivity, specificity, positive and negative prognostic value of MDA of seminal plasma and spermatozoa were more than vitamins C and E. The level of vitamin C of spermatozoa had more diagnostic value when compare to vitamins C and E in seminal plasma. Conclusion: The level of MDA in seminal plsama and spermatozoa and vitamin C in spermatozoa may be a diagnostic tool for the analysis of infertility in the asthenoteratozoospermic patients. Key words: Asthenoteratozoospermia, MDA, Vitamin E, Vitamin C, Infertility. O-49 Human embryology and Quranic verses, a comparative study Yadegari S1,Anvari M1, 2, Abbasi A1, Nahangi H1. 1 Department Of Anatomy, Shahid Sadoughi University Of Medical Sciences, Yazd. 2 Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd. Introdcution: The Holy Quran mentions the problems of human creation, embryonic life, and its miraculous stages. It is pointed in this article that thinking of these stages of embryonic life leads us to monotheism, theology and the great power of the creator. Along with the progress of the sciences, a tremendous movement has been found and great secrets have been detected in human embryology. Materials and Methods: In this article, we conducted a comparative research on the relationship between embryology and the Quranic verses. The ideas of great embryologists were revised, for example the noble ideas of Dr. Keith L. Moor. Also, the ovulation and fertilization from the viewpoint of Quran and science were studied. Results: Furthermore, the foundation and stages of the development of the embryo have been defined and the benefits and importance of embryology explained. Finally, the relation between embryology and the afterlife was also considered. Conclusion: The research findings concluded that Quranic verses are more developed than the modern ideas of embryology. Key words: Embryology, Embryo, Quran, Quranic verses, Ovulation, Fertilization. 3-Urology O-50 Assessing sperm DNA damages on ART outcome Tavalaee M, Nasr-Esfahani MH, Razavi S. Andrology Department, Royan Institute, Isfahan, Iran. Introduction: In this research, we evaluate the influence of chromatin status; including DNA fragmentation, protamin deficiency, and DNA methylation on ART. In addition, the relations between these parameters in infertile men were evaluated. Materials and Methods: Semen samples were obtained from 92 couples referred to Isfahan Fertility and Infertility Center for ICSI and IVF treatment. The semen samples were examined for concentration, morphology and motility according to the WHO guidelines (WHO, 1999). Semen samples were processed for routine ICSI and IVF using discontinuous pure sperm gradients. After insemination of oocytes, the remaining semen samples were used for evaluation of global DNA methylation, protamine deficiency, and DNA fragmentation using immunostaining, chromomycin A3 (CMA3) and sperm chromatin dispersion (SCD) test, respectively. Results: The percentageof CMA3 positivity and DNA fragmentation showed a significant correlation with the percentage of abnormal morphology (p-value<0.01). However, no correlation was found between sperm abnormal morphology and global DNA methylation. In addition, a significant negative correlation between the percentage of CMA3 positivity and fertilization rate was found (p-value<0.05). The percentage of DNA fragmentation showed a significant negative correlation with fertilization rate in ICSI patients (p-value=0.036). However, this parameter did not significantly affect the fertilization rate in IVF patients. The results revealed a significant negative correlation between global DNA methylation and the percentage of DNA fragmentation. Furthermore, the percentage of CMA3 positivity showed a significant positive correlation with the percentage of DNA fragmentation. During this study we analyzed the relation between protamine deficiency, global DNA methylation and DNA fragmentation with cleavage, embryo quality score and pregnancy. No significant correlation was observed between these parameters. Conclusion: Semen samples are heterogeneous, and may contain sperm with different defects. Some of these defects are related to each other and may have confounding effect on fertilization and development. Thussperm defects assessed during this study may affect fertilization but does not affect subsequent development and pregnancy. However, effect of these defects on future of ART children awaits further research. Key words: DNA methylation, Protamine deficiency,DNA fragmentation, Intra Cytoplasmic Sperm Injection (ICSI), In Vitro Fertilization (IVF). O-51 Relationship between in vitro fertilization rate and the level of antisperm antibody in seminal plasma measured by flow cytometry Shahsavar F, Rezaei A, Nasr Esfahani MH, Adib M, Oreizi F. Department of Immunology, Iran University of Medical Sciences, Tehran, Iran. Introduction: The aim of this study was to investigate relationship between antisperm antibodies measured by indirect flow cytometry and fertilization rate in infertile couples undergoing IVF. Materials and Methods: Semen samples were collected from men of 80 infertile couples undergoing IVFin Isfahan Fertility and Infertility Center. Couples were grouped according to fertilization rate. Overall, 52 couples had high fertilization rate (>50%) and 28 couples had low fertilization rate (≤50%). Seminal plasma samples were incubated with normal motile spermatozoa from donor men. Sperm bounded antibody was detected with FITC- labeled immunoglobulin against IgAand IgGin the flow cytometry. Procedure statistical analyses were performed using χ², t-test, and Pearsons correlation. Results: There was statistically significant difference between the mean levels of antisperm antibodies in high and low fertilization rate groups (p-value<0.001). Statistically significant inverse relationship was observed between IgA antisperm antibody level and fertilization rate (r=-0.47 and p-value<0.001). Statistically not significant inverse relationship was observed between IgG antisperm antibody level and fertilization rate (r=-0.2 and p-value=0.08). Conclusion: The results of this study clearly show that high level of IgA antisperm antibody decrease the fertilization rate. Therefore, it can be suggested that patients with high level of IgA should become candidate of ICSI. Key words: Antisperm antibody, In vitro fertilization, Flowcytometry, Infertility. O-52 The antioxidantal effect of pomegranate juice on sperm parameters and fertility potential in mice Amini-Rad O, Khalili MA. Research and Clinical Center for Infertility, Shahid Sadughi University of Medical Sciences, Yazd. Introduction: The antioxidants are defenses against free radicals that can be effective in tackling the problems caused by them and help fertility. Pomegranate juice is among the fruits that has a very high antioxidant effect. This study was an attempt to explore the antioxidant effect of pomegranate juice on sperm parameters (count, morphology, motility) and fertility potential in mice. Materials and Methods: In total 15 male mice were studied with regard to their sperm parameters and fertility potential. Sperms were categorized into three groups regarding to their motility: progressive, non-progressive, immotile. Morphology consisted of normal and abnormal sperms. Mice were divided into control group (n=5) and experimental group (n=10). The experimental group received 20% pomegranate juice for 1 month (duration of spermatogenesis is 1 month in mice). The control group had free access to water. We took one generation from each group to study the fertility rate. After killing the animals, a sample from the tail of epididymal region was taken to test the sperm parameters by light microscope. Results: The results showed that motility and count of sperms didn’t change significantly in both groups. However, the normal morphology and the fertility potential of the experimental group improved significantly. Normal morphology in control group was 68.8±4.76%, and in experimental group was 79.1±6.26% (p-value=0.007). The rate of fertility in control group was 5.8±4.08% and in experimental group was 10±1.26% (p-value=0.004). Also the rate of progressive sperms in control group was 35.6±9.91%; while, this rate in experimental group increased to 47.5±11.10% (p-value=0.06). Conclusion: The pomegranate juice is an effective antioxidant that is able to improve the quality of sperm parameters, especially sperm morphology, as well as fertility potential in mice. Probably, intake of this antioxidant by infertile men improves the quality of their sperm parameters. Key words: Pomegranate juice, Sperm, Fertility potential, Mouse. O-53 Sensitivity and specificity of serum FSH and testicular size in predicting sperm presence in azoospermic men Falahatkar S, Hamidi Madani A, Atrkare Roshan Z, Sazegari E, Zareyan M, Nikpour S. Guilan University of Medical Sciences, Urology Research Center. Introduction: Introduction of a reliable marker that be able to predict the presence of spermatozoa in azoospermic men, in order to apply assisted reproductive techniques without requirement of invasive method of testicle biopsy for prediction of sperm presence, will be valuable. Therefore, there is diverse opinion about distinction value of using serum FSH level and testicle size determination as conventional markers for prediction of the presence of testicular spermatozoa in azoospermic men. Materials and Methods: In this research, 80 azoospermic infertile men who had been referred to Urology Clinic within 2 years and their azoospermia in 2 semen analysis test were approved have been studied. We took action to receive the condition description, physical examination and hormonal evaluation including serum FSH level measuring and scrotal sonography for testicle size determination and then bilateral biopsy of testes performed. Data statistical analysis was performed by one-way ANOVA test and serum FSH and testicle size sensitivity and specificity in affected men was calculated. Results:Among testicle biopsy of 80 affected men, 53 were azoospermic and 27 were normal men with different levels of spermatogenesis. In testicle biopsy of 53 azoospermic men, 41 patients were azoospermic on the basis of FSH level (sensitivity=77.3%) and of 27 patients who have spermatogenesis in biopsy of testicle, 27 patients were normal on the basis of serum FSH level (specificity=85/2%). Of 53 azoospermic men in biopsy, 50 patients distinct azoospermic on the basis of testicle size (sensitivity =94/4%) and of 27 patients with rows of spermatogenesis in testicle biopsy , 17 patients were normal on the basis of testicle size (specificity=63%). Conclusion: Serum FSH and testis size measurement have reliable sensitivity and specificity in proportion of testis biopsy as a gold standard for diagnosis of azoospermia. Of this 2 current conventional markers, testicle size has a greater sensitivity and fewer specificity in proportion of FSH level. Thus it seems that we can make profit of these two conventional markers in place of invasive method of testicular biopsy in order to predict the sperm presence in azoospermic infertile men and use these markers in order to introduce to use as assisted reproductive techniques. Key words: Azoospermia , Biopsy , FSH , Male infertility. O-54 Fertility in patients with persistent azoospermia post chemotherapy for malignant tumor, or following renal transplantation Pouyan O, Alyasin A, Aghahoseini M, Saeeidi H. IVF Wards , Omid Clinic, Mojahedin Ave, Baharestan Sq, Tehran, Iran. Laleh Hospital, Simaye Iran Ave, Shahra-e-Ghods, Tehran, Iran. E-mail: dr_omid_pouyan@hotmail.com Introduction: The possibility of future fertility is important. A patient's fertility status after chemotherapy or renal transplantation is variable depending on the type and dose of chemotherapy agents used, and cannot be predicted. Therefore, sperm cryopreservation before chemotherapy is recommended. Nevertheless many patients still miss their sperm banking before chemotherapy. Recent advances in ART allow infertile males with non-obstructive azoospermia after chemotherapy to retrieve sperm using testicular sperm extraction (TESE) and father a child by ICSI. Materials and Methods: Ten patients with azoospermia were studied. For all of the patients multiple testicular biopsies were done. The examinations in them showed that FSH was 21.6–59.4 mIU/mL, LH was 15–24.3 mIU/mL, testes volume were > 20 mL. Three out of five patients with testes tumor had normal focal spermatogenesis (Group 1). Three from Three patients with renal transplantation had normal focal spermatogenesis (Group 2). One of two patients with lymphoma has normal focal spermatogenesis (Group 3). All of patients with normal focal spermatogenesis undergone TESE + ICSI Results: Group 1: In two out of three patients with fertilization ongoing pregnancy were achieved. Group 2: In two out of three patients with fertilization ongoing pregnancy were achieved. Group 3: Ongoing pregnancy was not achieved. Conclusion: Chemotherapy impairs germ cells. These patients with persistent azoospermia after chemotherapy have traditionally been considered sterile. However, recent reports showed that it is possible to recover sperm using TESE. Thus, patients with permanent azoospermia after chemotherapy may provide viable sperm with TESE, which may enable them to father a child. However, an increased incidence of sperm chromosomal abnormalities has been reported in cancer patients during or immediately after chemotherapy. Key words: Chemotherapy, Male infertility, Azospermia. O-55 The free testosterone levels in serum of Iranian veterans suffering from sulfur mustard induced asthma: 15 years postwar time Agin KH1, SarvGady F1, Saheb Kashaf S2. 1 Loqman Hakeem Teaching Hospital, Shaheed Beheshti University of Medical Sciences. 2 Navid Institute of Infertility. Email: Agin@Atiehhospital.com Introduction: The aim of this study was to assess the status of free testosterone (FT) levels among patients suffering from sulfur mustard (SM) induced asthma and to compare this with non-exposed asthmatic population and healthy subjects, and also, to determine frequency of hypogonadism in target population. Martial and Methods: Protocol of study was based on random selection of target population by self-report questionnaire, physician diagnosed asthma, and ratification of SM exposure. Two control groups were enrolled according to age, sex- matched as a non-exposed asthma and healthy subjects. The serum samples of FT, follicles stimulating hormone (FSH), luteinizing hormone (LH) and dehydroepianderstone (DHEA) were measured according to laboratories documentation. Results: In total43 male, chemical veterans were enrolled as case group with the mean age of 53.95±6.80 years. The mean serum FT levels were 15.70±10.54. Overall 32.6% of subjects had FT below the lower normal range. The means serum values of FSH, LH, and DHEA were 11.91±9.21, 10.33±7.46, and 1.31±0.71, respectively. Non-chemical asthmatic patients group were 46 patients with the mean age 52.67±6.44 years. The mean FT levels were 16.97±10.15. Overall 22.2% of asthma control group had low level FT. Healthy control group were 46 subjects. The mean FT levels were measured 22.73±8.30. The ANOVA and post hoc (Tukey, HSD) tests were carried out between groups. The significant differences were observed between case and non-exposed asthma groups with healthy control group. Conclusion: The highly significant of the hypogonadism was notable in case and asthma control groups. One of the reasons of our results may be due to toxic effects of SM on testosterone biosynthesis after long postwar time. But further investigation should be required in the future. Key words: Testosterone, Hypogonadism, Glucocorticoid, Mustard gas, Asthma, Lung diseases. 4-Midwifry O-56 The effect of counseling on sexual satisfaction of infertile men Pakgohar M, Ramezanzadeh F, Babaee GR, Vijeh M, Amel Valizadeh M. Midwifery Department, Faculty of Nursing and Midwifery, Tehran, Iran. E- mail: mehr_amel@hotmail.com Introduction: Infertility is a major factor of sexual dissatisfaction in infertile Males. They believe that their inability to conceive had serious negative effects on their lives, particularly their sexual relations. The purpose of this study was to determine the effect of counseling on infertile Male's sexual satisfaction, who referred to the Valliasr Reproductive Health Center in Tehran in 2007. Materials and Methods: This was an interventional study. In total 100 infertile men, who had eligible criteria, were recruited in this study by convenience sampling method. Participants randomly allocated into two groups (50 men in counseling and 50 men in control groups). Study was designed in two phases of pretest before intervention and follow up 3 month later. Counseling group participated in 2 hours sessions twice a week. Data was collected by 2 questionnaire including 1/ demographic characteristics and 2/ standard sexual satisfaction questionnaire. Data were analyzed with SPSS software and χ2, Mann Whitney and Willcoxon test (p-value<0.05). Results: Results show that the mean sexual score in counseling group was 33.37±7.9 and in control group this was 6.52±6.63. There was a significant difference between two group 3 months after intervention (U=746/500, p-value=0.02). Also, there was a significant difference between men of counseling group before and 3 month after intervention (z=-3.051, p-value=0.002). Conclusion: The results of this study supported that the counseling improved the sexual satisfaction of infertile men. Key words: Counseling, Sexual satisfaction, Infertility. O-57 The effects of education in preventing STDs on health beleif model in the couples Mirmohammad Ali M, Modaress M, Ashtary M, Moshrefi M. Nursing and Midwifery Department, Tehran University of Medical Sciences. E-mail: mirmohamad1@yahoo.com Introduction: The purpose of this study was to determine the effects of education in preventing STDs on health belief model in the couples who come to health–treatment centers of Medical Sciences University of Tehran. Materials and Methods: This study was a semi-experimental survey conducted in case-control method in health centers. The couples in experimental group were educated based on health belief model, during two 30 minutes educational sessions and the control group participated in the routine counseling classes. The data of this research was gathered by a questionnaire in two stages; before and 4 month after education, then was analyzed by SPSS software. Results: The results of this study indicated that there were no significant differences between two groups in demographic characteristics. In the experimental group, there was significant differences in perceived susceptibility (p-value<0.0001), perceived severity (p-value<0.0001), perceived benefits (p-value=0.001) and barrier (p-value<0.0001) before and after education. Comparing of these groups indicated that after education, there were significant differences between perceived susceptibility (p-value<0.0001), severity (0.0001), benefits (0.0001), barriers (p-value<0.002), and practice (p-value<0.009). Conclusion: The results of this study showed that education through health belief model was effective in preventing STDs. Then this educational model can be applied in educating adolescents and other people for preventing STDs. Key Words: STDs, Family planning, Barrier methods, Infertility. O-58 The necessary of education of Islamic ART religious rules to Iranian midwives Vasegh Rahimparvar SF, Noughani F, Mehran A. Nursing and Midwifery Faculty, Tehran University of Medical Sciences. Introduction: It seems that answering the simple questions of the women who are devoted to their religious rules, can have an effective role in their psychological health. The aim of this study was to determine the knowledge of Iranian midwifery teachers about Islamic religious rules about assisted reproductive technology (ART), and the necessity of educating these rules to midwives in Iranian midwifery teachers' opinion. Materials and Methods: In this descriptive (cross sectional) study the questionnaires were sent to all of the Iranian midwifery teachers (272 individuals) who worked in Iran universities of medical sciences. About half of the questionnaires were returned. Descriptive analysis was used for analysis of the data. Results: The majority of Iranian midwifery teachers had low level of knowledge regarding religious rules of ART. The majority of the midwifery teachers were completely satisfied with all of the questions about the necessity education of Iranian midwives about ART religious rules. They reported that training of these rules is very important in midwifery. The majority of the subjects believed that workshop method is the most suitable method for education of Iranian midwifery teachers and the educated midwifery teachers can teach these rules to midwifery students. Conclusion: According to the finding of this research, Islamic religious rules about ART can be taught to volunteer Iranian midwifery teachers by workshop method. Key words: Islamic religious rules, Assisted reproductive technology (ART), Education, Knowledge. O-59 Sexual problems during pregnancy in fertile women Taghizadeh Z. Nursing and Midwifery Department, Tehran University . Introduction: Myths about intercourse during pregnancy include the fear it may cause miscarriage, premature labour, or fetal damage. Scientists found no significant increase in fetal problems in women who continued to be sexually active throughout pregnancy. They noted that 27% of these women had uterine contractions after orgasms that sometimes were painful. Those who experienced painful contractions were less likely to have sexual intercourse often, if at all. Any examination of a couple's difficulty in conceiving must include overt and clear questioning about their sexual activity.Infertility may interact with a couple's or individual's sexuality and sexual expression in two main ways. Sexual problems may be caused or exacerbated by the diagnosis, investigation, and management of infertility (or sub fertility) or they may be a contributory factor in childlessness. Therefore if fertile women will be pregnant, they have some sexual problems. O-60 The effects of stress on infertility treatment Seddigh Mobarak Abadi S, Khodakarami N, Hashemi S. Nursing and Midwifery School, Shaheed Beheshti Medical Science University, Tehran. E-mail: sedighehsedigh@gmail.com Introduction: Stress is typically defined as a stimulus which produces mental tension or physiological arousal, such as the situation of infertility or its treatment. Distress is the term used described the suffering or anxiety as a result of the stressor. There is now evidence that distress levels influence the outcome of fertility treatment, as well as contributing to patients' decisions to continue treatment. The most common way that researchers evaluate patient distress level is by the use of self-report questionnaires. Though efficient and easy to administer, such self-assessment approaches may under-report the true level of distress since patients may pretend emotional well-being in order to appear psychologically appropriate for infertility treatment. Therefore, the gold standard in psychological assessment is a structured personal interview with a trained mental health professional, e.g. a psychiatrist or psychologist. Indeed, it has been found that many IVF patients report depressive symptoms prior to beginning their cycle, which likely reflects the cumulative effect of previously unsuccessful and less invasive forms of treatment. Mild depression symptoms is seen in over half (54%) of patients who previously started IVF cycle, and 19% of them show mild to severe symptom. In fact in many of patients that treat via IVF, usually psychological and physical stresses exist. Materials and Methods: In this article, we assess effect of stress on patient who undergoing treatment with IVF or GIFT procedure and assess some factors like number of previous treatment cycles, number of oocytes retrieved, fertilization rates, number of embryos transferred, embryo quality, presence or absence of a confirmed pregnancy, and pregnancy outcome. Results: Major findings from this study showed that the baseline level of stress was significantly related to numerous biologic end-points, including number of oocytes retrieved and fertilized, pregnancy, live birth rate, and birth weight. Further, the stress level on the day of the procedure was significantly related only to the number of oocytes retrieved and fertilized. At baseline, the frequency of no live birth was 93% lower in women with the least distress compared to those with the most distress. Following the failure of IVF treatment, 66% of women and 40% of men describe depression symptoms and in one third of participants in this study, depression remained until 18 month later. Conclusion: Studies showed that psychological factors like depression, anxiety and distress could increase the heart beat and blood cortisol level. Increasing distress and anxiety level, could increase tumor necrosis factors (TNF) and natural killer cells (NK) and it can cause induction of apoptosis in ovary cells. We suggest for better outcome of IVF procedure patients should receive counseling, support and education for decrease their stress level. Key word: Infertility, Stress, IVF. O-61 Experiences with infertility, dropping out of treatment, psychiatric mental society crisis Hashemi S, Khodakarami N, Seddigh Mobarak Abadi S. Nursing and Midwifery School, Shahid Beheshti Medical University, Tehran. E-mail: mw1363_sh@yahoo.com Introduction: Since infertility is treated as medicine problems, psychological aspect of these problems is ignored. This study was performed as systematic review to assess psychological problems of infertile couples and their experiences in psychological and mental aspects. Materials and Methods: At first we assessed 32 articles which entitled “assessing infertile couple’s psychological, mental problems”. Then we selected 10 articles through them that related with our research aims, and assessed their results. Results: The results are classified in 5 aspects: psychological aspects, social and cultural problems, sexual issues, effects of stress on infertility treatment and psychological interactions. Studies suggested that women show higher level of depression than men. In total 11.0% of the infertile women met the criteria for a current major depressive episode, compared with 3.9% for the fertile women. In another study, infertile women's scores on measures of depression, anxiety, and hostility were significantly higher than the scores among a large normative sample. In one study on infertile women, the prevalence of a psychiatric disorder was found to be 40% in 112 infertile women. Of these, the most common diagnosis was anxiety disorder (23%), followed by major depressive disorder (17%). These findings reflect a much higher prevalence of psychiatric disorders in this sample of infertility patients than the 10–12% seen in the primary care setting. In one study that performed by Khosravi on 50 infertile couples to assess sexual role in psychiatric health, it was reported that comparing to men, infertility has more negative meaning for women. One of the most difficult aspects that infertile women describe is the difficulty in social settings, such as dealing with feelings of jealousy and envy when learning of other women's pregnancies or being in the presence with others who have infants. It has been reported that as many as 13% of women experience passive suicidal ideation after an unsuccessful IVF attempt. In a report by the World Health Organization on the social consequences in developing countries, some childless women choose suicide over the torturous life and mental anguish caused by infertility. Conclusion: Results showed that infertile couples have bitter experiences in their life and faced psychological, mental, and social stress. Key words: Infertility, Psychiatry, IVF. O-62 The barrier of child adoption among infertile women in IVF center in Yazd Bokaee M, Farajkhoda T, Vaziri F, Rahimdel M. Department of NursingandMidwifery, Shahid Sadughi University of Medical Sciences, Yazd, Iran. Introduction: Child adoption seems as a useful way for couple that did not respond to ART. The major reasons of unwilling to adopt a child are: adoption is not a solution to the infertility, adoption is psychologically unacceptable, and fear of unknown parental background and abnormal behavior. Materials and Methods: To determine the barrier of child adoption among infertile women we undertook a questionnaire survey of infertile women seen in IVF center in Yazd. The data were analyzed by means of simple percentages, using t-tests, chi-square tests and regression equations at the 95% confidence level. One hundred and questionnaires were analyzed. Results: In total 95.3% of couples did not perform child adoption and 82.4% of them never wanted to adopt a child. Type of infertility had no influence on child adoption. In 72.3% of them the baby sex was not important. Conclusion: In the presence of such factors, especially when the probability of treatment of infertility is small, child adoption as a treatment option should be offered early so that willing couples can initiate the processes. Key words: Child adoption, Infertility. O-63 The factors effective on sexual dysfunction and infertility in patients with chronic renal failure (CRF) Zeighami SH. Nursing and Midwifery Group, Islamic Azad University of Karaj, Karaj, Iran. Introduction: Problems in sexual function are common feature of CRF. Approximately 50% of men with CRF complain of erectile dysfunction. More that 50% of CRF women have complain of disturbance in menstruation and infertility and sexual dysfunction. Both men and women experience decreased libido and decline in the frequency of intercourse. Infertility and sexual dysfunction can affect the quality of life. Materials and Methods: This is a review article that review 40 full and abstract study about sexual dysfunction and infertility in male and female with chronic renal failure published between 1999-2007. Results: The cause of sexual dysfunction and infertility in male and female with chronic renal failure is multifactorial and several factor such as neuropathy, autonomic insufficiency, anemia, hyperparathyroidism, peripheral vascular disease, drugs, uremia and fatigue play important role in this problem . Also anihypertensive therapy agents and antidepressants and other chronic disease such as diabetes play role in genesis of this problem. Chronic renal failure is associated with testicular function damage, impaired spermatogenesis, decrease volume of ejaculation and azoospermia. In women with CRF, disturbances in hormonal status and other agents lead to amenorrhea, disturbances in menstruation, galactorrea, repeated abortion, infertility, decrease libido, vaginal dryness, disparonia and reduction ability to reach orgasm. Some of the intervention available to decrease sexual dysfunction include the use of sildenafil, prolactin antidotes, administration of testosterone, controlling of secondary hyper-parathyroidism, and administration of erythropoietin for treatment of anemia. Conclusion: Appropriative assessment in clinical setting and use of appropriate intervention can help to decrease sexual problem and improve quality of life in CRF patient. Key words: Sexual dysfunction, Infertility, Chronic renal failure. O-64 Evaluation of Isfahan female’s opinion about ovum donation and surrogacy program for infertility treatment Ghasemi M, Ghasemi M. Research Office, Shahid Beheshti Hospital, Isfahan. Introduction: Infertility is one of the most problems of couples today. Many of infertile couples could have baby by using new methods of ART. Two of the newest methods for infertility treatment are ovum donation and surrogacy. The aim of this study was determining females` opinion about these procedures for infertility treatment. Materials and Methods: This is a descriptive analytic study which has been done on 200 women in 2007 in Isfahan. Cases selected as simple sampling and a questionnaire was fielded by each cases. Demographic information and general information about knowledge and cases` opinion about ovum donation and surrogacy were gathered and analyzed. Results: Most of the cases (35%) were in two age group of (30-39) and (40-49) years old and the least cases (6%) were in age group (50-65) years old. In total 65% of cases were married, 28% had high school degree and 71% were graduated from university. Overall, 53% of cases had no information about ovum donation and surrogacy program. The results showed that 69% of cases were agree for surrogacy and 59% were agree for ovum donation. While 43% of them were disagree for them if they were infertile. Most of cases believed that having baby by using surrogacy (56%) or ovum donation (59%) are better than adoption. Many cases didn’t know anything about religion roles about surrogacy (44%) or ovum donation (46%). Regarding advertisment by multimedia, 49% of them were agreeing for surrogacy procedure and 60% were agreeing for ovum donation. At the end mostly (88%) believed that psychiatric consulting is necessary for donor and recipient uterine. Conclusion: More than half of cases had no information about surrogacy and ovum donation procedure. Also more than half of cases were agree with surrogacy and ovum donation procedures for infertile couple treatment. About Islam opinion to do these procedures for infertile couples, 45% of cases didn’t know anything, so informing population for this method of infertility treatment seems to be necessary. Most of the women (82%) believed that infertility treatment by using surrogacy and ovum donation must be secret for everybody including the baby which has been born by this method. Key words: Infertility, Surrogacy, Ovum donation. O-65 The prevalence of infertility causes in patients who referred to Fatmeh Zahra Infertility Center, Babol Medical University from September 2003 to September 2006 Firouzpour M, Esbakian B. Fatmeh Zahra Infertility Center, Babol. Introduction: Infertility is one of the greatest gynecology problems that can make psychology pressures on family and society. It consist about 10 to 15% of couples. With exact assistance we can find 85-90% of infertility causes and treat them. This study is about the prevalence of each causes of in fertility in couples refer to Fatemeh Zahra Infertility Center. Materials and Methods: This study was a descriptive study based on existing data from infertility patients’ files that refer to Fatemeh Zahra Infertility Center. Results: From 2230 patients who refer to our center 78.5% had primary infertility and 21.5% had secondary infertility. In total 38.5% of infertile women were 17-24 year old, 46% were 25-35 year and 15.5% were more than 35 year old. The percentage of different causes of infertility were as fallows; ovulation disorder 44%, tubal 11%, uterine 8%, unknown factors 3.5% and in 4% the file information were insufficient. Conclusion: Regarding to this study finding the prevalence of female factors were more than male factors and between female factors, ovulation problems has the most frequency. Key words: Infertility, Prevalence, Ovulation problems. O-66 Investigating the marital satisfaction of infertile women referring to Infertility Center of Imam Khomaini Hospital, Sari Salmeh T, Yaghoobi T, Zakizad M, Yaghoobian M. Mazandaran University of Medical Sciences, Babol. Introduction: Infertility induces crises in all aspects of infertile couples' lives. One out of six couples is infertile worldwide. Marital dissatisfaction is one of the outcomes of infertility and women show more psychological reactions than their spouses. Marital satisfaction is an important factor to fortify the basis of family. Infertile women are exposed to emotional pressures and feelings of depression, anger, anxiety, fear, misbehavior, and psychiatric deprivations. Such feelings severely affect the couple's relationship. This study was conducted on to determine the marital satisfaction of infertile women referring to Infertility Center of Imam Khomeini Hospital in Sari. Materials and Methods: This analytic- descriptive study was carried out on 30 infertile women. The gathering tool of information was a questionnaire designed in two sections of demographic characteristics and marital satisfaction. Descriptive statistics was used. Results: The majority of women (85%) were in the age group of 26-30 years old. 92% were housewives. 65% had a high school diploma. 75% of women were satisfied with personality and personal habits of their spouses. 65% of women claimed that their spouses and they understood each other deeply. 28% of women stated that their spouses sometimes spoke to them contemptuously. 53% of women were satisfied with lovely speech by their spouses before sexual contacts. 15% of women had diversity of opinions in their marital life. 64% of women requested their needs easily from their spouses. 42% of women did everything to avoid engagement with their spouses. Conclusion: Infertility as one of the bitterest experiences of life imposes several marital problems upon couples. Psychiatric consultation besides infertility treatment is recommended to infertile couples to boost marital relationship. Key words: Marital satisfaction, Infertile women, Infertility. O-67 The effect of counseling on depression and anxiety after a traumatic childbirth Taghizadeh Z, Jafarbegloo M, Arbabi M, Faghihzadeh S. Tehran University of Medical Sciences, Tehran, Iran. Introdcution: Adverse childbirth experiences as a trauma can evoke fear, anxiety and depression for some women. This study was conducted to investigate the effect of counseling on mood disorders after a traumatic childbirth. Materials and methods: This research was a clinical trial and conducted at Kamaly Hospital in Karaj. In total 300 women who had experienced a traumatic childbirth were selected by simple sampling and randomized into an intervention (n=150) or a control (n=150) group. The intervention group received face-to-face counseling within 72 hours of birth. The data collection tool was questionnaire, completed via interview. Measuring variables were demographic characteristic, reproductive history, maternity social support, depression and anxiety. Data were analyzed by descriptive statistics and inferential tests (chi-square, Fisher's exact test and McNemar test) using SPSS version 13 software. Results: At 4-6 weeks follow-up intervention group women reported less anxiety (p-value=0.005), for depression (p-value=0.203) there was no significant different between two groups. At 3-month follow-up, intervention group women in comparison with control group reported less depression (p-value=0.012) and less anxiety. Conclusion: A midwife-led counseling was effective in reducing depression and anxiety after a distressing childbirth. Key words: Counseling, Traumatic childbirth, Postpartum depression, Aanxiety. O-68 Sexual function of infertile women referring to Infertility Center in Sari Salmeh F, Yaghoobi T, Zakizad M, Yaghoobian M. Nasibeh Nursing and Midwifery Department, Mazandaran University of Medical Sciences. Introduction: Proper sexual contact is an important agent to exist and strengthen the bases of family. Sexual disappointment produces many disorders from temporary annoyance up to depression. Infertility as the bitterest experience of life affects sexual function. In this situation sexual relationship will be disappointing and torturing. Hypoactivity in sexual desire and constant disagreement about it, frigidity and changes to achieve orgasm phase are the usual challenge and disputes of couples about sexual function. Some of infertile women believe that they are sexually disabled and unacceptable in view of their spouses. They lose their self-esteem that lasts to weakness of sexual relationship and affects family functions. This study was designed to determine the sexual function of infertile women referring to infertility center in Sari city. Materials and Methods: This descriptive study was conducted on 26 infertile women referring to infertility center in Sari city. The gathering tool of information was a questionnaire. Descriptive statistics was used to analyses the data. Results: In total 13.3% of women stated that they had no sexual contact with their spouses during recent month. In 61.5% of couples, men began sexual activities. Only 34.6% of women always gave positive responses to sexual requests of spouses satisfactorily. 15% of cases stated that they hadn't been stimulated with sexual stimulants at all. The majority (38.4%) stated that they sometimes achieved orgasm during sexual activities in recent month and it was difficult somehow. Also 38% didn't achieve orgasm phase so far. Conclusion: Education and consultation of infertile couples to better sexual function seems necessary in Infertility clinics. Kew words: Sexual function, Infertility, Infertile women. O-69 Seroprevalence of cytomegalovirus in spontaneous human abortion in Ilam Falahi Sh1, Sareban MT.2 1 Tarbiat Modares University. 2 Iran Medical University. Introduction: Despite the established implications of human cytomegalovirus (HCMV) in congenital infection, there are still conflicting reports regarding the association of HCMV with spontaneous abortion. HCMV antibodies were already described in blood from abortion cases, but did not indicate HCMV pathogenical role. This study performed to access seroprevalence of viral IgG and IgM in pregnant women in abortion process, regarding to the age. Materials and Methods: Blood samples from 42 patients in abortion process were collected, then serologic tests were performed by ELISA kits (Genessis) on all specimens. Results: Viral IgG seropositivity (>3EU/ml) was found in 9.75% and IgM seropositivity (>10EU/ml) was determined in 26.82% of cases. Results show that IgG seropositivity was related to rising in age, but IgM was not show relationship with age in this study. Conclusion: This seroprevalence rate is according to previous surveys in Iran. Although viral seropositivity for IgG and IgM had been found in 9.75% and in 26.82% of the cases respectively, these results do not support HCMV as a major abortion-related factor as we could not found any correlation between abortion and active HCMV. If active infection due to viral reactivation occurred during the abortion process, it cannot be accessed by IgG or IgM assays and more sensitive and specific methods (such as PCR) are needed. Key words: Seroprevalence, Spontaneous abortion, HCMV. O-70 Effect of soy on hot flashes in menopausal women Enjezab B, Mozaffari H, Khoshbin A, Faraj khoda T, Bokaee M. Midwifery Department of Shahid Sadughi Medical University. Introduction: Hot flash is common and discomfort sign of menopause that is shown with blazing sweatiness, hotness feeling, tachycardia and agitation. Hot flashes cause disturbance in daily activity and night sleep quality. Despite the effect of hormone replacement therapy (HRT) on hot flashes, nowadays there are diversity of opinions about HRT and long consumption of it. In addition the acceptances of HRT between Iranian women are very low. Study of numerous texts are shown that isoflavone in nut soy is phytoestrogen that may be effective in control of hot flashes. We did this study to examine the change in hot flashes in response to consumption of daily 74 mg Isoflavone in 60 gr nut soy in menopausal women. Materials and Methods: This study was clinical trial with before and after design. In total 31 menopausal women was involved in this study. All participants were assessed daily at baseline and after one, two, and there months of intervention. Results: The data showed a decrease in times of hot flashes in baseline 5.88±2.61 to 3.45±1.82 after one month, to 2.73±1.57 after two months and to 2.16±1.48 after three months consumption of nut soy (p-value<0.001). Nut soy caused a reduction in the level of FSH, LH and estradiol after 3 months but this was not significant (p-value>0.05). Conclusion: This study suggests that nut soy (60 gr daily) may decrease the times of hot flashes. Key words: Hot flashes, Nut soy, Isoflavone, Phytoestrogen, Menopausal syndrome. O-71 Uterine arteries impedance changes in pregnancy prediction after intrauterine insemination by transvaginal color Doppler ultrasonography Farzadi L, Ghasemzade A, Ghatresamani F. Department of infertility, Alzahra Hospital, Tabriz University of Medical Sciences. Introduction: Unexplained infertility is diagnosed when all of the standard elements of the infertility evaluation yield normal results. One of methods of infertility diagnosis is transvaginal color Doppler ultrasonography. It is useful to determine pulsatility and resistance index of uterine arteries in prediction of implantation after assisted reproductive technology. The purpose of this study was to determine the uterine arteries impedance changes in pregnancy prediction after intrauterine insemination by transvaginal color Doppler ultrasonography. Mrterials and Methods: 50 women with unexplained infertility, and the mean age 27.5 years, were evaluated for hemodynamic of uterine arteries, endometrial thickness and echogenicity on 2nd day of menstruation. After induction ovulation by clomiphene and HMG again, the same parameters was measured on HCG injection IUI was done. Results: Mean pulsatility index (MPI) of uterine arteries was 2.12 (r=0.28) and 2.25 (r=0.67) in pregnant and 2.25 (r=0.67) in pregnant and 2.25 (r=0.24), 1.98(r=0.71) in non-pregnant, respectively on second day and HCG injection day. Mean resistance index (MRI) was 0.81 (r=0.04) in pregnant and 0.82 (r=0.05), 0.8(r=0.86) in non-pregnant respectively on second day and HCG injection day. On injection day, difference of MPI between two groups was 0.27(p=0.14). Mean endometrial thickness was 7.55 mm (r=2.83) in pregnant and 7.25 mm (r=2.89) in non-pregnant. MPI was raised with increase of endometrial thickness in non-pregnant (p=0.4) and MPI was decreased with increase of endometrial thickness in pregnant (p=0.5). 75% of pregnant, and 37.5% of non pregnant had endometrial hypoechogenicity, 25% of pregnant and 62.5% of non-pregnant had hyperechogenicity (p=0.05). Conclusion: The results of this study suggest probably, transvaginal color Doppler ultrasonography may not be a reliable method to pregnancy prediction in women with unexplained infertility pregnancy, although further studies are needed to more evaluation. Keywords: unexplained infertility, transvaginal color Doppler ultrasonography, intrauterine insemination. © Copyright 2008 - Iranian Journal of Reproductive Medicine |
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10% . Semen parameters (volume less than
2ml, concentration less than 20×106/ ml, and motility less than 50%)
were calculated for each group. Statistical analysis was performed using
Fisher’s exact test.