Abstracts of 17th Congress of Iranian Society for Reproductive Medicine

A- Oral Presentations

1- Infertility, Gynecology

O-1

The luteal phase defect of stimulated cycles and the possible solutions

Mousavi Fatemi H.

V.U.B./C.R.G., Laarbeeklaan 101, 1090 Brussels, Belgium.

Email: [email protected]

The luteal phases of all stimulated IVF cycles are abnormal. The main cause of the luteal phase defect (LPD) observed in stimulated IVF cycles is related to the multifollicular development achieved during ovarian stimulation. It can be postulated that the main cause of the luteal phase defect in stimulated IVF cycles is the supra-physiological levels of steroids secreted by a high number of corpora lutea during the early luteal phase, which directly inhibit the LH release via negative feedback actions at the hypothalamic-pituitary axis level, rather than a central pituitary cause or steroidogenic abnormality in the corpus luteum. To correct the LPD in stimulated IVF cycles, hCG or progesterone can be administered. HCG is associated with a greater risk of OHSS. Natural micronised progesterone is not efficient if taken orally. Vaginal and intra muscular progesterone do have comparable implantation, clinical pregnancy and delivery rates. However, due to severe site effects, intramuscular progesterone administration should be avoided. Future studies should focus on drugs which increase the LH production during the luteal phase.

Key words: Luteal phase defect, Luteal phase support, IVF, Ovarian stimulation.

O-2

Psychological aspect of infertility

Beyraghi N.

Department of Psychosomatic, Neurofunctional and Neurosurgery Research Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

The inability to conceive children is experienced as a stressful situation by couples all around the world and infertility is a devastating experience, especially for women. Evidences indicate important QOL impairments in infertile women. Among men, it does not appear to be intense. Also little attention has been paid to the psychological status of infertile men from developing countries who have been traditionally stigmatized as feeble and ineffective. The consequences of infertility are manifold and can include societal repercussions and personal suffering. Health professionals need to consider all aspects of holistic care when caring for couple with fertility problems, Cultural; psychological, religious and spiritual dimensions of infertility have received little attention in our society. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. The medicalization of infertility has unwillingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood. Evidence is emerging of an association between stress of fertility treatment and patient drop-out and pregnancy rates. Fortunately, psychological interventions have been shown to have beneficial effects for infertility patients.

Key words: Psychological status, Infertility, IVF.

O-3

Endocrine and male infertility

Amouzegar A.

Department of Endocrine, Research Institute for Endocrine Sciences, Shahid Beheshti Uuniversity of Medical Sciences, Tehran, Iran.

Email: [email protected]

Infertility is an emotionally charged problem affecting an estimated 15% of all couples. The man should be evaluated concurrently with the woman, since a male factor is the primary or contributing cause in 40% to 60% of cases. The evaluation of the infertile male continues to be a clinical challenge of increasing significance with considerable emotional and financial burdens. Many physiological, environmental and genetic factors are implicated. The infertility practitioner should have a thorough understanding of the advantages and limitations of various laboratory tests as well as the indications, costs and success rates of all treatment options. A complete medical history in conjunction with a focused examination can allow for an appropriate choice of laboratory and imaging studies. The semen analysis is a crucial first step, but it is by no means sufficient to determine cause or dictate therapy. Azoospermia factor (AZF) microdeletions of the Y chromosome, which occur in 1-55% of infertile men, are closely associated with severe spermatogenic failure and represent the most frequent molecular genetics causes of azoospermia and severe oligozoospermia. Researches on AZF and its related genes, approaching the mechanisms of spermatogenic failure at the molecular level, are of great significance for the diagnosis, treatment and prognosis of male infertility. The detection of AZF microdeletions can provide scientific basis for correct diagnosis and reasonable. Klinefelter,s syndrome and Y chromosome microdeletions are the most prevalent disorder, together accounting for 10-20% of patients evaluating for genetic cause of male infertility. Other cause of primary testicular failure such as undescended testis and orchiti should be considered as certain causes of infertility. Hypogonadotropic hypogonadism due to pituitary adenoma, panhypopituitarism hyperprolactinemia or idiopathic causes is another treatable etiology of male infertility. For part of infertile patients a genetic factor will be the underlying cause of the problems. The studies, focusing on men with fertility problems, can be subdivided into three groups: studies on deletions on the long arm of the Y chromosome, studies on X-linked genes and studies on autosomal genes. It is obvious that Yq microdeletions should be considered as a cause of male infertility. Therefore, couples with a component of male factor infertility need a systematic evaluation directed at the male partner to maximize their reproductive potential.

Key words: Male factor, Infertility, Y chromosome.

O-4

Endocrine aspects of infertility

Kalbasi S.

Department of Endocrine, Research Institute for Endocrine Sciences, Shahid Beheshti Uuniversity of Medical Sciences, Tehran, Iran.

Email: [email protected]

Infertility is defined as the inability to conceive after 12 months of unprotected sexual intercourse. The National Survey of Family Growth reports a 14% rate of infertility in the United States in married women aged 15-44 years. Infertility can be attributed primarily to male factors in 25%, female factors in 58% and is unexplained in about 17% of couples.

The most common cause of female infertility is abnormalities in menstrual function (46%). These disorders include ovulatory dysfunction and abnormalities of the uterus or outflow tract. A careful history and physical examination and a limited number of hormonal tests will help to determine whether the abnormality is: 1/ hypothalamic or pituitary [low FSH, LH and estradiol with or without an increased PPL (51%)], 2/ PCOS (30%), 3/ ovarian (low estradiol with increased FSH) (12%), or 4/ uterus or outflow tract abnormality (7%).

Key words: Infertility, Hypothalamic, Pituitary.

O-5

Obesity and female fertility

Hekmatdoost A.

Department of Clinical Nutrition and Dietics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Although under-nutrition is the major cause of disease and death in developing countries, obesity is the most common nutrition problem to affect reproduction in developed countries. Since the balance of energy is essential for female reproduction, appetite and the reproductive axis are closely linked to nutritional status. As a safeguard against untimely reproduction due to malnutrition, ovarian activity is suppressed in women with eating disorders through pathways in the hindbrain. It is the balance between energy uptake and expenditure that is crucial more than the body fat mass, thus recovery of ovulation may occur after a small percentage modulation in weight. Fat tissue is metabolically active and its most important activity is modifications of steroid hormones and secretion of many proteins such as adipokines. Many of these factor influences are reproductive hormones; moreover, the secretions of the fat can affect the function of the reproductive system. Many obese women conceive and go through pregnancy without incident; however, being overweight or obese impairs natural fertility and interferes with the response to the assisted reproduction treatments. The mechanisms are not obvious, but the association between insulin resistance and anovulation may contribute. Management should involve a healthy diet and lifestyle to precede or supplement induction of ovulation. Such lifestyle programs will be effective with intensive effort. Fortunately ovulation is often achieved after 5-10% weight modification, perhaps because of the alteration in energy balance. Among overweight and obese pregnant women, there is an increased likelihood of spontaneous pregnancy loss, mainly in the first trimester as well as pregnancy complications (pregnancy-induced hypertensive diseases and gestational diabetes) and pregnancy outcomes. Currently, prevention of obesity is one of the most important programs for health promotion. Thus, we need medical educations for doctors on the art of preventing obesity and managing weight loss in women with established overweight and obesity, and patient education regarding the role of obesity in reproduction, promotion of healthy lifestyle for the woman, her partner and their future family with emphasis on reducing central adiposity and improving metabolic fitness rather than simply on weight and BMI reduction.

Key words: Obesity, Female fertility, Health.

O-6

The luteal phase estradiol versus luteal phase GnRH antagonist: their effects on antral follicular size coordination and basal hormonal levels

Rashidi B1, Nasiri R1, Rahmanpour H1,2, Shahrokh Tehrani- nejad E1, Deldar M1.

1 Vali-e-Asr Reproductive Health Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Obstetrics and Gynecology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

Email: [email protected]

Introduction: The differential efficacy between antagonist protocols with routine long GnRH agonist can partly be due to the preexisting differences in the early antral follicles before ovarian stimulation. This study was performed for comparing the effect of luteal estradiol administration with premenstrual GnRH antagonist administration in antral follicular size coordination and basal hormone levels.

Materials and Methods: In this randomized clinical trial 30 women with infertility and candidate for ICSI were randomized to receive oral estradiol 4mg/day from day 20 of previous cycle or 3 mg cetrorelix acetate single injection, subcutaneously in luteal phase of previous cycle and characteristic of antral follicles with TVS and serum FSH, estradiol and inhibin B levels were assessed in day 3 of cycle before and after treatment.

Results: there was a significant reduction of mean follicular sizes in each group after medical intervention (7.63±2.11 vs 4.30±0.92 in groupA and 8.73±1.96 vs 4.13±1.11 in group B). Two pre -treatment and specially Estradiol cause the attenuation of follicular size discrepancies but this was not significant. Both E2 and GnRH antagonist significantly decreased serum FSH and inhibin B levels. Serum E2 level significantly increased in E2/day3, but did not change on GnRH antagonist/day3.

Conclusion: Both pre-treatment of E2 and GnRH antagonist in luteal phase before antagonist protocol can reduce the follicular sizes and discrepancies, but this matter and their effect on oocyte yield, endometrial quality and COH outcome need further study with more sample size.

Key words: Follicular synchronization, Estradiol, GnRH antagonist.

O-7

Evaluating the effect of intra-vaginal seminal plasma insemination on emberyo implantation and early abortion in infertile women undergoing ICSI

Golmohammadlou S1, Hajishafiha M1, Yekta Z2, Fieroozy E3.

1 Department of Obstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.

2 Department of Social Medicine, Urmia University of Medical Sciences, Urmia, Iran.

3 Department of Obstetrics and Gynecology, Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran.

Email: [email protected]

Introduction: Semen in a co factor in preparing endometrium for embryo implantation. This is in contrast with public believed that immune response to antigen in ejaculated semen will disrupt fertility and pregnancy. New findings support the opposite theory, which indicates that insemination actives maternal immunologic mechanisms which have a positive effect on fertility

Materials and Methods: In this study , a groups of 140 couples who had an indication for intra cytoplasmic sperm injection (ICSI) had on embryo implantation 48-72 hours after ovum aspiration. Followup methods included a β HCG measurement in day 14 and sonographic evaluation in 6th and 12th week. The semen was previously collected and refrigerated, and was prepared for transfer 30-60 minutes before embryo, and was transferred after that. There was no significant correlation between ages, etiology of infertility, type of infertility history of previous IVF, number of embryos, type of embryo, in both groups.

Results: Implantation rate was 25.5% in the control group and 24.3% in the study group (p=1) early abortion rate was 11.1% in the control group and 18.7% in the study group (p=0.5). There was no significant difference in implantation rate and early abortion rate between both groups. Considering the limitations of this study and the considerably little sample size and the limited research conducted about this subject especially our contry.

Conclusion: We suggest that more studies with a large sample size and proper training for couples be preformed.

Key words: Implantation, Abortion, Infertility.

O-8

Ovarian stimulation protocols and pregnancy rate of FET

Mansouri M, Sabouri E, Aram R, Fadavi Islam M, Rustaii H, Khalilifar H.

Novin Infertility Center, Mashhad, Iran.

Email: [email protected]

Introduction: Is there any differences between the pregnancy rate of frozen-thawed embryo transfer (FET) in agonist and antagonist protocols. The aim of this study was to assess the effect of gonadotropin-releasing hormone (GnRH) antagonists/buserelin on embryos by comparing the outcome of cryopreserved-thawed embryo transfers for cycles using a GnRH agonist or GnRH antagonist/buserelin protocol for the controlled ovarian stimulation in the oocyte retrieval cycle.

Materials and Methods: We studied the frozen embryos from 80 women undergoing ICSI which were administered either HCG/GnRH agonist long protocol (Group A, n=52) or GnRH/buserelin antagonist protocol (Group B, n=18) that were thawed in Novin Infertility Center (Mashhad, Iran) from March 2010 to June 2010 (there were no significant statistically differences between two groups in the age and male factor). Frozen embryo transfer pregnancy rate of these two groups were evaluated. Data analyzed by Fisher test (SPSS version 7).

Results: pregnancy rates were similar independent of whether they resulted from the long - protocol cycles with HCG (46.2%) or from the antagonist protocol cycles with buserelin (38.9%).

Conclusion: Frozen-thawed embryo derived from the GnRH agonist cycles have the same pregnancy rates to those derived from the GnRH/buserelin antagonist cycles, Furthermore, in fresh embryo, lower pregnancy rates following GnRH/buserelin-antagonist protocols compared with long GnRH/agonist protocols have been reported, The differences might be due to an impact on oocyte number and quality or on the endometrium, not embryos quality, so according to this point in the patient with the risk of OHSS who received GnRH/buserelin antagonist protocol, it would be better to freeze all the embryos and then transfer them in a better situation .

Key words: Frozen-thawed embryo transfer, GnRH agonist, GnRH antagonist, IVF, ICSI.

O-9

Intravenous ascorbic acid (vitamin C) administration in abdominal myomectomy: A prospective clinical trial

Pourmatroud E, Hemadi M.

Department of Obstetrics and Gynecology, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran.

Email: [email protected]

Introduction: To assess the advantage of ascorbic acid (vitamin C) administration in abdominal myomectomy.

Materials and Methods: A total of 102 patients were enrolled in this prospective clinical trial, in two groups. Group A had several injections of Ascorbic Acid during myomectomy, but group B had myomectomy without any intervention. The time of operation, volume of bleeding, days of hospitalization, post operative complications and rate of blood transfusion were compared between two groups.

Results: The volume of bleeding, duration of operation, days of hospitalization in group A were significantly less than group B (p-value: 0.001). The chance of blood transfusion in group B was about 2.5 times more than group A (7.7% vs. 18%). There was a significant correlation between the volume of bleeding and post operative complications in both groups (p value in group A, 0.03 and in group B, 0.004).

Conclusion: Ascorbic Acid (vitamin C) either as a prophylactic agent or a therapeutic option could be useful in all of gynaecologic and obstetrics attempts without any serious side effects.

Key words: Ascorbic Acid, Gynaecologic, Operation.

O-10

Transfer of cervical infection to the uterine cavity during ET

Ziaie T, Sharomy H, Savadzadeh Sh.

Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Rasht, Iran.

Email: [email protected]

Introduction: The aim of this study was to evaluate the influence of catheter type on transferring of the cervical infection to the uterine via ascending rout during embryo transfer and in the ART results.. It is established that the endometrial inflammation and infections may affect on the implantation rate and decrease the pregnancy rate.

Materials and Methods: In a prospective randomized clinical trial, 100 patients aged 23-40 (33.23±1.6) years undergoing ICSI treatment were selected for this study. During embryo transfer, separate samples were collected for microbial examination from the following sites: the cervix and exocervix before washing by the ringer' lactate for direct smear evaluation and culture, the tip of the catheter, and the external and middle sheets. All the samples were separately cultured to identify any bacteria or yeast present. Then patients diveied in two groups randomly for 2 kinds of the catheters Cook and Gaurdia catheter of the cook company. After emryo transfer the tip of sheets cut and sent for cultures.

Results: Direct smear showed WBC in the outher sheet was positive for Entrobacteriaceae (22.2% vs 51%) and Staphylococcusspecies (17.6% vs 44%) were significantly lower than those in the cook catheter without gaurdia (p<0.001). The pregnancy rates do not seem to be affected by the other isolated microorganisms and the catheter type. The pregnancy rate was significantly reduced when the ET catheter was contaminated with microorganisms (15.5 vs 27.1%; p=0.002).

Conclusion: As the implantation is compromised with uterine contamination c, this study was showed the presence of the third closed sheet decreases the contamination of the catheter sheets during the passing the cervix

Key words: Implantation, Pregnancy, ART.

O-11

Addition of low-dose ketamine to Propofol/Fentanyl in anesthesia for patients undergoing gynecologic diagnostic laparoscopy

Atashkhoyi S1, Sadaghiani Mahzad M2.

1 Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Department of Obstetrics and Gynecology, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Diagnostic laparoscopy (GDL) is a brief surgery and it is generally performed on an outpatient basis. Anesthesia with propofol has been popularly used in minor outpatient procedures because of its rapid onset, short duration and smooth patient awaking. But propofol have cardiovascular side effects. Ketamine is an iv anesthetic and short acting analgesic. It could alleviate the hemodynamic effects of propofol because of its sympatomimetic action. The aim of this placebo-controlled trial was to evaluate the addition of low-dose ketamine to propofolfentanyl anesthesia in gynecologic diagnostic laparoscopy.

Materials and Methods: In this randomized and double blind trial, 40 women undergoing gynecologic laparoscopy were studied. As induction of anesthesia, after injection of midazolam and fentanyl in all patients, ketamine 0.5 mg/kg in the study group (n=20) and saline 0.9% in placebo group (n=20) were administered, followed by propofol 2 mg/kg. For maintenance of anesthesia, propofol was infused.

Results: During surgery, mean of propofol dose was 1.8±0.5 mg/kg in placebo group and 0.5±0.2 mg/kg in study group (p<0.001). After induction of anesthesia, 12 (60 %) patients in placebo group and only 2 (10 %) patients in study group had decreases in heart rate (p<0.001). Decrease the mean arterial pressure (MAP) in placebo group was higher (p<0.001).

Conclusion: Use of low-dose ketamine with propofol/fantanyl anesthesia in patients undergoing GDL improved the hemodynamic status.

Key words: Gynecologic Diagnostic Laparoscopy, Anesthesia, Propofol/fentanyl, Ketamine.

O-12

Comparison of final follicular maturation in ovulation induction cycles with recombinant or urinary HCG in polycystic ovary syndrome patients

Foroozanfard F1, Saberi F2, Khaiatian N 2.

1 Department of Obstetrics and Gynecology, Infertility Center, Shahid Beheshti Hospital, Kashan University of Medical Sciences , Kashan, Iran.

2 Department of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.

Email: [email protected]

Introduction: HCG is the most common used drug for inducing final follicular maturation. Recombinant HCG has recently become available. This study designed to compare the in vivo effectiveness of recombinant HCG with urinary HCG during controlled ovarian hyperstimulation cycles in polycystic ovary syndrome patients.

Materials and Methods: This clinical trial study was performed on 90 PCOS patients. Patients randomely assigned in two groups. Control group (n=60) received urinary HCG (Choriomon) 5000 IU intramuscular and case group (n=30) recombinant HCG (Ovidrel) 250 µg subcutaneous. Ovarian stimulation was achieved using letrozole 5mg from 3-7, recombinant FSH (Gonal-F) 75 IU from 3-6 and HMG (Merional) 150 IU from 7-10 days of cycles. Ovarian response was monitored by transvaginal ultrasound. When one or more follicles were ?18 urinary or recombinant HCG was used to trigger ovulation and final follicular maturation. Pregnancy was documented by the serum HCG level 2 weeks after urinary or recombinant HCG injection. Chi-square, t-test and Mann Withney test were used in data analysis.

Results: Two groups were found to be similar with respect to age, BMI, duration and type of infertility. No statistically significant difference was noted in mean number of follicles ?18 (2/93±1/77 and 2/65±1/83) and endometrial thickness (7/98±1/67 and 7/52 ±1/11) between case and control groups , respectively .No significant statistical difference was noted in clinical pregnancy rate (28/3% and 30%) between two groups ,respectively .

Conclusion: Recombinant HCG was found to be as effective as U-HCG in achieving pregnancy during ovulation induction cycles in PCOS patients. This is in agreement with earlier studies on the effectiveness of r-HCG in IUI or IVF cycles.

Key words: Follicular maturation, Ovulation induction, Polycystic Ovary Syndrome, r-HCG, u-HCG.

O-13

Caberguline versus human albumin in prophylaxy of ovarian hyperstimulation syndrome

Ahmadi Sh1, Rahmani E1, Oskouian H2.

1 Department of Obstetrics and Gynecology, Boushehr University of Medical Sciences, Boushehr, Iran.

2 Department of Obstetrics and Gynecology, Azad University of Medical Sciences, Mashhad, Iran.

Email: [email protected]

Introduction: Ovarian hyperstimulation syndrome is one of the most important complications of ART.primary prevention is important in order to ensure the patient's safety. This prospective study evaluated the efficacy of prophylactic use of caberguline with intravenous human albumin in decrease of OHSS in the high risk patients.

Materials and Methods: We randomized 112 patients undergoing ART and were high risk for OHSS. The first group (n=56) received 0.5 mg oral caberguline per day on the day oocyte retrieval for 12 days, and the second group (n=56) received 20 gr intravenous human albumin on the day of oocyte retrieval.

Results: There were no statistically significant difference in the age, BMI, the number of follicles and oocyte retrival and serum estradiole in the day of HCG injection. But OHSS was significantly lower in the first group (p<0.001). There were no signinificant difference in pregnancy rate, implantation and miscarriage in two groups.

Conclusion: caberguline is more effective in prophilaxy of OHSS than intravenous human albumin.

Key words: OHSS, Caberguline, Human albumin, Prophylaxy.

O-14

The effect of good glucose control on menstrual characteristics in type one diabetic adolescents

Vasegh Rahimparvar F, Salehin Sh, Rezaeepoor A, Kazemnejad A.

Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Little is known about the menstruating in patients with type one diabetes. Most studies have focused on adults, who have been asked to recall retrospectively their menstrual histories. A prospective study about menstruating with type one diabetic adolescence recommended.

Materials and Methods: This study is a prospective longitudinal of correlation type. Subjects included 60 diabetic girls aged 11-19 referred to Iranian Diabetes Association.The amount of bleeding in terms of milliliter estimated by Higham pictorial chart. In this chart number and amount of wet pads used during menstruation completed by the patients. Also patients were asked to note starting and ending time of bleeding for 3 menstrual cycles. Twice HbA1c test at the distance 3 months were assessed. Those patients having Poly cystic ovarian syndrome (PCOs) or thyroid disturbance were excluded. 2 test, t-test, Pearson correlation coefficients and odd ratio were used.

Results: Mean HbA1c value was 8.31±1.63 percent. Thirty seven (61.67%) patients had normal menstrual, and twenty- three (38.33%) had menstrual disturbances, including: eight (13.79%) disturbance in menstrual duration, fourteen (24.1%) disturbance in bleeding intensive, six (10.3%) disturbance in the menstrual cycle length and two (3.33%) secondary amenorrhea. No one had primary amenorrhea. Mean age at menarche was 12.83±1.47 years and middle age at menarche was 13 years. There was a statistically significant difference (p<0.045) in mean HbA1c between those with normal menstrual and those with menstrual disturbances. As HbA1c increased, the percent of patients with menstrual disturbances increased. There was statistically significant correlation between mean HbA1c and menstrual duration (r=0.28, p=0.03) and bleeding intensive (r=0.48, p=0.000). There was no statistically significant correlation between mean HbA1c and menstrual interval (r= -0.10, p= 0.45). There were no patients in either group with diabetic hypertension, retinopathy, nephropathy, neuropathy and heart disease.

Conclusion: Tighter glycemic control, as measured by HbA1c concentrations, corresponded to improved menstrual disturbances in type one diabetes adolescents without PCOs and thyroid disturbance.

Key words: PCOs, Menstrual, Diabetes.

O-15

Evaluation of diagnostic value of transvaginal sonography for investigating intrauterine lesions in infertile women in different phases of menstrual cycle

Hajshafiha M, Broumand F, Karimmpoor N, Ghasemi rad M.

Department of Obstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.

Email: [email protected]

Introduction: Intra uterine pathologies may have an important role in decreasing fertility, unsuccessful implantation and abortion. Because of high incidence of these anomalies, uterus cavity evaluation is routinely performed as a part of infertility evaluation. In this study, we have determined the sensitivity, specificity, PPV and NPV of TVS in different phases of menstrual cycle in comparison to sonohysterography, The purpose of this study was to determine the role of the phase of menstrual cycle in diagnostic accuracy of TVS.

Materials and Methods: A total of 506 infertile women, aside from the cause of their infertility, first underwent HSG and then in different days of menstrual cycle, underwent serial TVS. In cases of positive results of TVS (anomalies of uterus cavity) and also in a number of patients who didn't have any anomalies of uterus cavity, SHG was performed. Finally, patients who had Intra uterine lesions in TVS and SHG underwent hysteroscopy; then, sensitivity, specificity, PPV and NPV of HSG and TVS were determined in comparison to SHG in diagnosis of Intra uterine lesions. Also, sensitivity, specificity, PPV and NPV of TVS in diagnosis of intra uterine lesions were calculated in different phases of menstrual cycle.

Results: TVS had high sensitivity and specificity in diagnosis of Intra uterine lesions. The sensitivity, specificity, PPV and NPV of TVS in comparison to SHG were respectively 95%, 98%, 95% and 98.3%. TVS in early luteal phase had the highest sensitivity, specificity, PPV and NPV in comparison to other menstrual cycle phases.

Conclusion: TVS is the best diagnostic method for diagnosis of intra uterine lesions in days 16-19 of menstrual cycle, since it has low cost and is noninvasive. Hysteroscopy can be used as the second line for treatment of these lesions.

Key words: Transvaginal Ultrasonography (TVS), Intra uterine lesions, Menstrual cycle.

2- Embryology, Genetic, Stem cell

O-16

Fresh versus vitrified oocytes and competence of embryos

Al-Hasani S.

Women Hospital, University of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.

Email: [email protected]

In recent years, preservation of fertility in women has been recommended. Thus, cryopreservation of human gametes, embryos and ovarian tissue has become an essential part of assisted reproduction. This approach limits the number of embryos transferred, while supernumerary oocytes and/or embryos can be used in subsequent treatment cycles. Furthermore, cryopreservation reduces the potential risk of hyperstimulation syndrome. Cryopreservation is carried out by two techniques; the slow freezing method, and the more recent rapid procedure called vitrification technology. Both of these methods have finally depended on the freezing and solidification of cell or tissue. Recently, the one known as vitrification has been claimed as the future of cryopreservation because of increased survival and success rates. However, this method is a non-equilibrium technique of cryopreservation that shows critical requirements of much higher concentration of permeable cryoprotectants and a high coolling rate. Thus, it is a more vigorous mean of all possible cell damage except the formation of intracellular ice crystals that is prevented totally by vitrification. Recently due the success and simplicity of vitrification, the balance between those two methods has been changed in advantage of vitrification. The use of slow freezing method has become controversial due to its difficulties, expense and respective low success rates in artificial reproduction. Therefore, vitrification seems to win the battle and will be the cryopreservation method for human oocytes and embryos currently and in the future. Vitrification of oocytes is considered a hope for preserving female fertility especially cancer patients and it shows many advantages over low freezing technique. Thus it is important to evaluate fresh versus vitrified oocytes and competence of embryos. Latest studies show promising results as "oocyte procedure followed by ICSI is not inferior to fresh insemination procedure". In the presentation, the survival rate, the outcomes and the developmental competance of vitrified human oocytes will be compared to the fresh oocytes.

O-17

Advanced preimplantation genetic diagnosis

Hellani A, Al-Akoum Sh, Haddad E.

PGD and Molecular Genetics Laboratory, Saad Specialist Hospital, Saudi Arabia.

Email: [email protected]

Preimplantation genetic diagnosis (PGD) is an established procedure of embryo genetic analysis. It allows couples carrying genetic diseases to have an unaffected child, without facing an invasive prenatal diagnosis and termination of pregnancy. After the first case of PGD in 1991, the last decade witnessed substantial improvements in PGD due to advancement of molecular genetics techniques and IVF enhancement protocols. A major swing toward a new era in PGD was introduced by our group in 2004, where multiple displacement amplification (MDA) technique was used to amplify the whole genome of a single cell. Since then, MDA became the gold standard technique in PGD carried out on many diseases. The two major areas of PGD applications using MDA, besides mutation screening and haplotyping, are Human Leukocyte Antigen (HLA) typing and array comparative genomic hybridization (array CGH) analysis. We present our approach on the use of PGD to obtain normal babies and also HLA matching with the abnormal sibling. We also show our result in term of pregnancy rate (PCR, FISH and array CGH) and our experience on the use of A-CGH to detect aneuploidy in embryos.

O-18

Role of sperm indices in embryo quality: What to do?

Esteves SC.

Andrology and Human Reproduction Clinic, Brazil.

Email: [email protected]

Spermatozoa are highly specializedcells with the purpose of not onlydelivering competent paternal DNA to the oocyte but also to provide a robust epigenetic contribution to embryogenesis. The identification of sperm fertility markers and the ability to selecthealthy spermatozoa for ART have a dual objective of choosing the best treatment strategy and optimizing ART outcomes. Currently, sperm indexes determination in the clinical setting is generally based on cell morphology and DNA content. Both sperm morphology and DNA integrity results, obtained from raw semen samples, have been shown to be of prognostic value for unassisted and assisted conception and useful in the selection of the best assisted conception modality. These assays, however, provide an assessment of the distribution of cells in a given ejaculatethat may not be representative of the sperm population used in the ART treatment cycle. In fact, severe teratozoospermia, using Kruger's strict criteria on pre-ART semen analysis, does notcorrelate to fertilization and embryo formation (including blastocyst development) in ICSI cycles. Nonetheless, if a more holistic approach to sperm morphology is taken, two prognostic groups can still be identified in cases of severeteratozoospermia (<4% normal) because certain morphology patterns and sperm abnormalities are known to affect ICSI outcomes. The first group includes mostly genetically determined sperm pattern defects, such asglobozoospermia, short tail syndrome and small-headed spermatozoa (in most cases combined with very small acrosomes). All of these types represent untreatable conditions that have been associated with abnormal sperm function andpoor ART outcomes. The second group includes unspecifiedor non-genetically determined sperm defects or patternscaused by environmental factors, medication, infection and related infertility conditions, including varicocele. Treatment of these conditions has been shown to optimize sperm morphology indexes with a positive impact on ART outcomes. Although the technician microscopically selects morphologically normal individual sperm during ICSI, form normalcy does not necessarily imply normal DNA content. As such, sperm DNA testing has been advocated to be an independent and reliable marker of fertility potential since sperm chromatin andDNA integrity is essential to ensure that the fertilizing sperm cansupport normal embryonic development of the zygote. At present, conflicting reports exist on the role of sperm DNA fragmentation index for embryo development, and it is apparent that DNA fragmentation does not significantly impair zygote and cleaving embryo morphology because major activation of the embryonic genome only beginafter the 4-cell stage. These observations do no underscore the importance of finding ways to increase sperm DNA integrity, since it has been suggested that DNA fragmentation is associated with late paternal effects that may lead to early miscarriages or diseases in the offspring. The etiology of sperm DNA damage is multi-factorial and may be due to primary (ageing, cryptorchidism, genetic defects, idiopathic) and or secondary (drugs, environmental, tobacco smoking, genital tract inflammation, infection, testicular hyperthermia and varicoceles) factors. Specific or non-specific treatments, including antioxidant supplements, are generally associated with reduced levels of sperm DNA damage and/or improved fertility potential. Taken in conjunction, it is apparent that there is no unique sperm factor able to predict embryo development, but several candidate biomarkers are involved in this complex process.As a result, a wide variety of techniques have been proposed, including externalization of phosphotidylserine (magnetic-activated cell sorting), cell charge (zeta charge), maturity markers (hyaluronic acid binding) and detailed morphological analysis (intracytoplasmic morphologically selection sperm injection). Currently, these are several shortcomings for the routine application of these new methods to a busy IVF laboratory, both financially and logistically, and current data fail to indicate superiority of any of these methods over conventional ICSI. It is clear that better sperm fertility tools are urgently required. In this context, metabolomics and proteomic sperm profiling are under investigation and may be translated into clinical practice in the near future.

O-19

Growth factors enhance in vitro maturation, fertilization and development of oocytes and post-thaw cleavage of vitrified mouse two-cell embryos

Bahadori MH1,2, Ghasemian F3, Nasiri E2.

1 Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

2 Department of Anatomy, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

3 Faculty of Sciences, Tarbiat Moallem University, Tehran, Iran.

Email: [email protected]

Introduction: This study was carried out to investigate the effect of supplemented culture medium with different concentrations of hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF), on mouse oocytes in-vitro meiotic maturation and embryo development. Then, the culture was treated with the best obtained dosage from experiments 1 and 2 for culturing of vitrified two-cell embryos by cryotop method.

Materials and Methods: In experiments 1 and 2, oocytes and embryos were cultured in the following culture medium: in experiment 1, (I) control (TCM199 + 5%FBS); (II) control + 10 ng/ml of bFGF; (III) control + 20 ng/ml of bFGF; (IV) control + 50 ng/ml of bFGF and (V) control + 100 ng/ml of bFGF. In experiment 2, (I) control (TCM199 + 5% FBS); (II) control + 10 ng/ml of HGF; (III) control + 20 ng/ml of HGF; (IV) control + 50 ng/ml of HGF and (V) control + 100 ng/ml of HGF.

Results: Based on the results of experiments 1 and 2, after thawing, embryos were cultured in culture medium supplemented with 20ng/ml of bFGF and 20 ng/ml of HGF until the blastocyst stage. To determine quality of blastocysts, blastocysts were stained with hoechst and propidium iodide (In experiment 3). Supplementation of medium with 10 and 20 ng/ml of bFGF and 20 ng/ml of HGF resulted in a higher (p<0.05) maturation and development rate when compared with control. Also, the cleavage and blastocyst formation rates of thawed embryos for treated groups with FGF and HGF and control group were 83.17%, 72.22% and 60% respectively (p<0.05).

Conclusion: The results of this study demonstrated that, enriching the culture medium with bFGF and HGF improves in-vitro embryo production efficacy in pre- and post-thawing conditions.

Key words: Growth factors, Maturation, Preimplantation development, Vitrification.

O-20

Propagation of azoospermic human spermatogonial stem cells in vitro

Koruji M1, Janan A2, Azizi H3, Shahverdi A3, Baharvand H3, 4.

1 Department of Anatomical Sciences, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Endocrynology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

3 Department of Stem Cells and Developmental Biology, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.

4 Department of Developmental Biology, University of Science and Culture, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: The temporary or permanent infertility after treatment is important subject in childhood and adult cancer patients. Culturing and the access to sufficient numbers of spermatogonial stem cells (SSC) in vitro is nessecery for increasing chance of efficient transplantation. The aim of this study was to compare the in vitro effects of laminin and growth factors on the proliferation of adult human spermatogonial stem cells.

Materials and Methods: TESTE samples were used for cell isolation. Testicular cells were isolated by two steps of enzymatic digestion and cultured in DMEM supplemented with 5% FCS. During the culture, isolated spermatogonial cells were treated either by various concentrations of GDNF 40ng/ml, FGF 10ng/ml, EGF20ng/ml, LIF 10-3 M or on human placental laminin-coated dishes with the same growth factors. Colony assay was performed by means of a light microscopy during culture. Presence of spermatogonia was determined by Ultrastructure study of cell colonies, reverse transcriptase polymerase chain reaction and immunofluorescence for spermatogonial markers (DAZL, PLZF, mVASA, Ig?6 and Igβ1). The presence of functional spermatogonial stem cells in culture was confirmed through xenotransplantation to testes of azoospermic mice. The statistical significance between mean values was determined using statistical tests.

Results: The results indicated that cultivation on human placental laminin-coated dishes with the growth factors and growth factors are the most appropriate factor for in vitro colonization of adult human spermatogonial cells compared control group. The cultivation on human placental laminin-coated dishes showed a significant increase in the number and diameter of colonies compared with growth factors treated and control groups. Also, expression of spermatogonial markers on both the RNA and protein level was maintained throughout the entire culture period. A transplantation experiment, using azoospermic mice with busulfan showed the presence of SSC among the cultured cells. In addition TEM study strongly suggested typical morphology spermatogonial cells among them.

Conclusion: We conclude that the human SSCs are self-renewed in our culture system and this system can be used for the propagation of these cells from small biopsy.

Key words: Spermatogonial Stem Cells, Proliferation, Growth Factors

O-21

The effect of ovulation induction on the expression of ?v and β3 integrins in mouse blastocyst

Fayazi M1, Salehnia M1, Beigi Boroujeni M2.

1 Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Department of Anatomy, Faculty of Medical Sciences, Lorestan University of Medical Sciences, Lorestan, Iran.

Email: mehr.fayazi@ gmail.com

Introduction: Implantation is a critical and complex event in which trophectoderm attaches to the apical uterine luminal epithelial cell surface by cell adhesion molecules (CAMs) like integrins. Integrins are heterodimeric glycoprotein receptors that regulate the interaction of cells with extracellular matrix (ECM). The aim of this study was to investigate the effect of ovulation induction on the expression of ?v and β3 integrins in mouse blastocyst at the time of implantation.

Materials and Methods: NMRI mice were divided into two groups: control and hyperstimulated. In hyperstimulated group, the mice received 10 units of PMSG following by HCG 48 hours later. The mice were then mated with fertile males. The mice in both groups were sacrificed on the morning of fifth day (4.5 day). The estrogen and progesterone level of serum was evaluated. The uterine horns were flushed by PBS+BSA, and then the expression of ?v and β3 integrins of collected blastocysts was examined with Real time RT-PCR.

Results: The ratios of β3 and ?v gene expression to housekeeping gene in hyperstimulated group were 0.00237±0.00089 and 0.00116±0.00044 respectively and these ratios in control group were 0.07972±0.012 and 0.0353±0.002 respectively. These results showed that the expression of ?v and β3 integrins was significantly lower in the ovarian stimulated groups than the control groups (p≤0.05).

Conclusion: These studies demonstrate that ovulation induction by PMSG and HCG caused decrease in expression of ?v and β3 integrins of the blastocyst and it may have an effect on the blastocyst receptivity.

Key words: Integrin, Blastocyst, Mouse, Implantation.

O-22

The effect of three sperm preparation methods on intracellular reactive oxygen species level, DNA fragmentation, mitochondrial membrane potential and apoptosis technique in normospermic semen samples

Rashki Ghaleno L1, Rezazadeh Valojerdi M1, 2.

1 Department Embryology, Cell Sciences Research Center, Royan Institute, ACECR, Tehran, Iran.

2 Department of Anatomy, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: According to the advances in the techniques of assisted reproduction in humans, the need to improve sperm processing and provision of actively motile spermatozoa has been increased tremendously. We evaluated swim-up, direct swim-up and density gradient methods effects on intracellular reactive oxygen species level, DNA fragmentation (DF), mitochondrial membrane potential and apoptosis.

Materials and Methods: Normospermic semen samples (sperm concentration ≥50 ×106, motility ≥50%, and sperm morphology ≥15%) were obtained from 28 subjects who underwent seminal fluid evaluation at the Royan institute, Tehran, Iran. Collected samples were divided into "direct swim-up from semen", "swim-up selected" and "gradient processed" experimental groups. After processing and quality assessment, by the use of DCFH-DA, DHE, PI, YO-PRO, JC-1, TUNEL kit and flowcytometry technique, the mentioned parameters were studied.

Results: H2O2 significant increase was demonstrated in the swim-up group (73.51±4.76, p<0.05), also a meaningful increase of O2-° was shown in direct swim-up group (p<0.01, p<0.05). In other hand, the density gradient group indicated the higher DF percentage compared to swim-up group (p<0.01).

Conclusion: Although the swim-up and density gradient methods increase the H2O2 level and DF, it seems both of them could be advantages for preparation of normospermic semen.

Key words: Sperm preparation methods, ROS, DNA fragmentation, Mitochondrial membrane potential, Apoptosis.

O-23

The role of Bax in fetal ovarian germ cell apoptosis induced by 4 (3H) quinazolinone-2-ethyl-2-phenyl ethyl (QEPE)

Amiri M, Shams Lahijani M, Farivar Sh.

Department of Animal Sciences, Shahid Beheshti University, Tehran, Iran.

Email: [email protected]

Introduction: Recently reports demonstrated quinazolinones, heterocyclic components with biological and pharmacological properties (anti cancer, anti microbial, anti malaria, anti allergic, anti spasm, etc...) as tumor suppressors via programmed cell death (apoptosis). Apoptosis is the main cause of primordial germ cell and oocyte degeneration in developing fetal ovary. Early morphological studies have shown that cell death affects proliferating primordial gem cells or oogonia (12-13 days post coitum, d.p.c.) and mainly oocytes at the zygotene/ pachytene stages of mouse meiotic prophase (from 16.5 d.p.c. through birth). Bax, a proapoptotic member of the Bcl-2 family of cell death regulators, is one of the key genes that regulate apoptosis in fetal ovary. The purpose of this study was to examine the occurrence of apoptosis and investigate the expression of Bax in ovaries of normal and 4(3H) quinazolinone-2-ethyl-2-phenyl ethyl (QEPE) treated Balb/C mice.

Materials and Methods: Pregnant Balb-C mice were divided into three groups of control (intact), sham (receiving 0.05% methyl cellulose as solvent) and experimental group (receiving 100 mg of QEPE/Kg/body weight, the most effective dose), intraperitoneally (IP). Ovaries were removed from normal and abnormal embryos of all pregnant mice on 16.5 d.p.c. and 18.5 d.p.c., 48 hours after injection. Hematoxylin and eosin staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) analysis were used to assess apoptosis. RT-PCR was performed to study the expression of Bax.

Results: Some developing oocytes were detected identified as TUNEL positive by their dark stained nuclei in ovaries of embryos of control and sham groups. TUNEL positive cells were more abundant in ovaries of embryos of experimental group compared with control and sham groups. Bax mRNA was detected in the control and sham embryonic ovaries. RT-PCR analysis revealed that Bax expression increased in experimental embryonic ovaries.

Conclusion: These results suggest that Bax expression and apoptosis in germ cells are common events occurring during development and QEPE as a developmental toxicant would increase Bax expression and apoptosis rate in mouse fetal ovary In agreement with previous studies about other toxicants.Apoptosis of damaged germ cells may serve a critical role in protecting subsequent generations from the diverse effects of toxicants.

Key words: Apoptosis, Bax expression, Fetal ovary.

O-24

Apoptotic genes expression of vitrified sheep cumulus oocyte complexes

Ebrahimi B1, 2, Rezazadeh Valojerdi M1, Eftekhari Yazdi P1, Baharvand H2.

1 Department of Embryology, Royan Institute for Reproductive Biomedicine Research, ACECR, Tehran, Iran.

2 Department of Stem Cells and Developmental Biology, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: Our aim was to compare the expression rate of apoptotic genes of sheep cumulus-oocyte complexes following vitrification by conventional straw and cryotop methods.

Materials and Methods: Cumulus-oocyte complexes (COCs) were harvested from slaughtered sheep ovaries. COCs were divided into three groups: Control, Conventional straw Vitrification and Cryotop Vitrification. In control group, fresh COCs were immediately transferred to the maturation medium. In vitrification groups, good quality vitrified-warmed COCs were matured in vitro as like as the control group. After viability assessment and nuclear stage determination, oocytes were subjected for evaluation of apoptotic genes (Bax, Bcl2 and P53) expression by Real-Time quantitative RT-PCR.

Results: Cryotop vitrification had higher percent of healthy COCs after warming (83.84%) and showed a significant difference with conventional straw vitrification. Mature oocytes were 51.94% and 48.81% in the control and cryotop groups respectively. Conventional straw vitrification showed a significant difference with control group in the expression of Bcl2 gene. Bax and P53 expression were evaluated too but no significant differences were observed.

Conclusion: According to the less success of immature sheep oocytes cryopreservation, it seems that vitrification by cryotop can reduce cryoinjuries and increase the viability, post-thaw quality and maturation rate of COCs. This kind of vitrification causes more expression of anti-apoptotic Bcl2 gene in comparison with conventional straw vitrification.

Key words: Vitrification, Cryotop, Apoptotic Genes, Sheep, Immature Oocyte.

O-25

Identification of the site effects of morphine on fetal portion of Wistar rats' placenta by using [C14] morphine

Kazemi M1, Sahraei H2, Azarnia M3, Bahadoran H4.

1 Department of Biology, Tehran North Branch, Islamic Azad University, Tehran, Iran.

2 Department of Physiology and Biophysics, Faculty of Medicine and Applied Neuroscience Research Center, Baqyiatallah (a.s.) University of Medical Sciences, Tehran, Iran.

3 Department of Biology, School of Sciences, Tarbiat Moalem University, Tehran, Iran.

4 Department of Anatomy, Faculty of Medicine, Baqiyatallah (a.s.) University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: In previous studies it is stressed that the site of morphine action may be both on the embryo or the placenta. However, there is no doubt concern on the site of morphine action. In the present study, we try to identify the site of morphine action on Wistar rats' placenta fetal portion by using [C14] morphine.

Materials and Methods: Female Wistar rats (260 g) were crossed with male rats and coupling time was recorded (Embryonic day 0-E0). Experimental groups received 0.05 mg/ml of [C14] morphine in drinking water daily. On the 9th and 14th days of pregnancy, groups of the pregnant rats were anesthetized and the placentas and uterus were surgically removed. The placentas were fixed in formalin 10% for two weeks. Then the placentas were processed, sectioned in 25 and 5 µm thicknesses, and fixed on the glasses for further evaluations. The placentas sectioned in 25, the glasses were fixed on the Blanc black and white film for 6 hr. The films then were appeared and their negatives were prepared. The placenta sectioned in 5, the staining hematoxylin and eosin (H&E) by light microscope and MOTIC software.

Results: Our results indicated that the effect site increase of [C14] morphine action was on blood plexus of placenta fetal portion and oral morphine consumption may be inhibiting placenta fetal portion development and function natural.

Conclusion: It could be concluded that morphine effectiveness on reduction of embryos growth and development may be via its effects on placenta fetal portion

Key words: Fetal Portion, Placenta, Development, C14, Morphine, Rat.

O-26

Survival and developmental rates of human immature oocytes (germinal vesicle stage) after vitrification and exposure to IVM media

Zahiri SH1, Ghannady AR2, Karimi H3.

1 Department of Anatomy, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Islamic Azad University, Lar Branch, Lar, Iran.

3 Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Cryopreservation of female gametes is still an open problem because of their structural sensitivity to the cooling and freezing processes and the exposure to cryoprotectants. However human oocytes are able to develop to the blastocyst stage and continue on to birth following virification method. It seems that freezing of oocytes in immature (p or Germinal vesicle) phase, that genetical contents of cell is surrounded by nuclear envelope, is more safe and has less harmful effects versus metaphase II stage (mature oocyte) which have been used routinely nowadays. The aim of this research is determination of survival and developmental rates of human immature oocytes after vitrification method and study the effect of in vitro maturation media on their development.

Materials and Methods: This experimental study was done on 70 immature oocytes were had been collected from infertile women who had referred to Dr Rostami infertility center in shiraz-Iran in 1388-89, They were stimulated for ovulation mostly via long protocol for ovarian stimulation, After oocyte retrieval GV oocytes collected and classified in 4 groups as fallows: C1 (freeze no IVM), E1 (freeze with IVM), C2 (no freeze no IVM), and E2 (no freeze with IVM). IVM media that were been used for this work was package of SAGE that comopse of 3 components and were supplemented with FSH and LH. Freezing period was about 3 month's. Data Analyzed by SPSS 15 and by frequency and t-test.

Results: Our finding showed that survival rate in E1was 87.08 and developmental rate in this group by use of IVM media has been raised considerabley (70.96%) proportion to C1 (7.14%) and C2 ( 36.83%). Increase in degenerating oocyte were 12.9% (E1), may be due to high numbers of GVs in this experimental group.

Conclusion: Since GV oocytes in ART have numerous benefits, we suggest that usage of these oocytes especially for freeze-thaw processing and utilizing of Standard IVM media can cause high survival and developmental rates.

Key words: Immature oocytes, Human, Vitrification, IVM.

O-27

Correlation between fatty acid composition of human follicular fluid with number of mature oocytes in patients undergoing IVF/ICS

Mehdizadeh A, Rahimipour L, Farzadi L, Shahnazi V, Darabi M, Shaaker M, Nouri M.

Infertility Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Extra uterine techniques such as IVF/ICSI have been used to treat a range of infertilities. However, these techniques are not always successful because of various reasons. The aim of this study was to investigate the correlation between fatty acid composition of phospholipids in human follicular fluid and the number of mature oocytes in patients undergoing IVF/ICSI.

Materials and Methods: follicular fluid samples were obtained from 100 patients refered to Tabriz Alzahta hospital. Seventy nine patients underwent IVF the remaining 21 underwent ICSI. Total lipids of follicular fluid were extracted, phospholipids were isolated by thin layer chromatography (TLC) and derivated fatty acids of follicular fluid phospholipids were analysed by gas liquid chromatography (GLC).

Results: According to number of mature oocytes, patients were classified in 3 groups. Group 1 (less than 5 mature oocytes), group 2 (more than 5 and less than 10 mature oocytes) and group 3 (more than 10 mature oocytes). Mean amounts of stearic acid (p=0.03), saturated fatty acids (p=0.001) and the ratio of saturated to unsaturated fatty acids (p=0.002) were related negatively while arachidonic acid (p=0.04) and poly unsaturated fatty acids (PUFA) (p=0.007) were correlated positively with mature oocyte number after adjustment for age, HDL-C and CETP.

Conclusion: According to the results of this survey, fatty acid composition of phospholipids in human follicular fluid was related to oocyte development by affecting the number of mature oocytes.

Key words: In Vitro Fertilization, Fatty acid, Fertility.

O-28

Effect of growth factors on cleavage and blastocyst formation of thawed mouse 2 PN zygotes after vitrification

Ahmadi Jalali Mogaddam M1,2.

1 Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

2 Department of Biology, Science and Research Branch, Urmia Islamic Azad University, Urmia, Iran.

Email: [email protected]

Introduction: In the last years a shift from the well established method of slow-rate freezing to vitrification of 2PN zygotes and embryos could be observed. So the objective of this study was to assess the influence of specific growth factors in the culture medium on the post vitrified-thaw survival and outcome of vitrification of 2PN zygotes.

Materials and Methods: 6-8 weeks old female NMRI mice were superovulated with 5IU pregnant mare,s serum gonadotrophin (PMSG, ip) and subsequent human chorionic gonadotrophin (hCG, ip). Animals were caged with one male mouse for mating. Mated mice were killed by cervical dislocation to collect 2-PN zygotes from oviduct of pregnant 1 d mice. Vitrification solution consisted of 15% EG, 15% DMSO and 0.5 M sucrose. No more than five 2PN-zygotes were placed on each cryotop. A sum of three hundred 2PN zygotes was investigated for evaluating the effect of growth factors on vitrified embryos development. After thawing embryos were cultured in T6 medium supplemented with 20 ng/ml of fibroblast growth factor (FGF) and 20 ng/ml hepatocyte growth factor (HGF) and were cultured to the blastocyst stage and the number of embryo in different stages was recorded under an invert microscope.

Results: Survival rate after thawing in 100 controls thawed 2PN zygotes was 91 %. Similar results concerning the survival rates of the 2PN zygotes after thawing for FGF group (92%) and HGF group (89%) could be seen. FGF and HGF Groups had higher (p<0.05) cleavage and formation of blastocyst stage embryos rate in comparison to control group. There was not any significant difference between the survival rate of thawed embryo, in the control and treatment groups (p>0.05).

Conclusion: Addition of growth factors in the culture has favorable effects on in-vitro production and post-thawing cleavage of vitrified 2-cell embryos

Key words: Growth factors, Development, Cleavage, Vitrification, 2-PN zygotes.

O-29

Comparison of gene expression profiles during germ cell induction from mouse embryonic stem cell in simple and co-culture systems

Makoolati Z1, Movahedin M2, Forouzandeh Moghadam M 3.

1 Department of Anatomy, Faculty of Medical Sciences, Fasa University, Fasa, Iran.

2 Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

3 Department of Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: In this study, the effect of bone morphogenetic protein 4 (BMP4) on the differentiation of embryonic stem cells (ESCs) into germ cells in STO and simple culture medium was evaluated.

Materials and Methods: CCE mouse ESCs were cultured in DMED containing 20% fetal bovine serum (FBS) for 1 day in order to embryoid body (EB) formation (the first step of germ cell induction) and then cultured 4 days in STO and simple culture medium both in the presence or absence of 5 ng/ml BMP4 (the second step of germ cell induction). The expression of Mvh, Stra8, Piwili2, ?6 and β1 integrins that express during germ cell development was calculated quantitatively in the first and second steps of germ cell induction.

Results: Quantitative PCR results showed that Mvh and Stra8 were expressed in a higher significant rate in 5ng/ml BMP4 concentration in the simple system. The expression of ?6 and β1 integrins were elevated nonsignificantly in STO coculture group in the presence of 5ng/ml BMP4 concentration. Also, nonsisnificant increased Piwil2 expression was observed in STO coculture group.

Conclusion: Quantitative RT-PCR was used to estimate the level of germ cell gene expression. The results confirmed that the addition of 5ng/ml BMP4 in a simple culture medium improve the differentiation of mouse germ cells from ESCs.

Key words: Embryonic stem cell, BMP4, Germ cell.

O-30

Sildenafil effect on nitric oxide (NO) secration by human endometrial epithelial cells in in-vitro culture

Khazaei M, Roshankhah SH, Ghorbani R, Chobsaz F.

Fertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Email: [email protected]

Introduction: Sildenafil is a selective inhibitor of c-GMP specific phosphodiesterase type 5 (PDE5). It increases NO production of endothelial cells. There is no available data on sildenafil effect on endometrial epithelial cells. The aim of present work is to investigate sildenafil effect on NO secretion by human endometrial epithelial cells in in-vitro culture.

Materials and Methods: Endometrial biopsies (n=10) were washed in PBS and digested with Collagenase I (2 mg/ml in DMEM/F12 medium) at 37°C for 90 minute. Epithelial glands were collected by sequential filtration through nylon meshes (70 and 40 µm pores) respectively. Epithelial glands were treated by trypsin to obtain individual cells. The cells were counted and divided to four groups: control and different sildenafil dose (1, 10, and 20 µM). Cultures were done for 15 days at 37° C, 5% CO2 and media were changed every 3 days and their supernatant were collected for NO assy. NO were measured by standard Griess methods. Data were analyzed by one way ANOVA.

Results: There is no significant difference between groups in NO secretion, but it increased slightly in cases groups. Epithelial cell morphology changed into long spindle cells in cases groups.

Conclusion: Sildenafil didn't change NO secretion by human endometrial epithelial cells.

Key words: Epithelial cells, Sildenafil, Endometrium, NO.

O-31

Value of sperm chromatin dispersion test in couples with unexplained recurrent abortion

Absalan F1, 2, Ghannadi A2, 3, Kazerooni M2, Jamalzadeh F2, Amiri S2.

1 Department of Anatomical Sciences, Ahvaz Jundishapor University of Medical Sciences, Ahvaz, Iran.

2 Human Assisted Reproductive Center, Shiraz, Iran.

3 Islamic Azad University, Larestan Branch, Lar, Iran.

Email: [email protected]

Introduction: Previous studies have indicated that sperm quality may be related to unexplained recurrent abortion. The aim objective of this work was to correlate sperm DNA fragmentation, measured by the SCD test, with semen parameter in unexplained recurrent abortion.

Materials and Methods: Thirty couples with unexplained recurrent abortion (case group) and 30 fertile couples (control group) referring to Shiraz infertility center were included. Semen samples were collected for each participant analyzed by the SCD test and the results were correlated with semen parameters.

Results: The percentage of sperm staining positive for DNA fragmentation was increased (p<0.001) in the case group compared to control group. In case group, no correlation was observed between semen quality parameters and the SCD data.

Conclusion: This research indicated that some unexplained recurrent abortion patients have a significant increase of sperm DNA fragmentation, which may be causative of pregnancy loss in some patients.

Key words: DNA, Sperm, Unexplained recurrent abortion, Sperm chromatin dispersion test.

O-32

Association of LH, FSH, and testosterone hormon's levels and partial deletions in the AZFc region of Y chromosome in oligospermic male candidate for ICSI

Ataei M1, Salsabili N2, Yaghmaei P1, Hayati N1, Mirfakhraei R3, Montazeri M3.

1 Department of Biology, Islamic Azad University, Tehran, Iran.

2 Faculty membrane of Tehran University, Tehran, Iran.

3 Department of Medical Genetic, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.

Email: [email protected]

Introduction: Today Infertility is a main health problem. About 10-15% of couples suffer this problem and in the 50 % of cases, this is the male factor which affects. Infertility is caused by the disorders in the spermatogenesis process. The human Y chromosome contains genes that are essential for spermatogenesis specially those that are located on four major intervals defined as AZFa, AZFb, AZFc and AZFd. Deletions in these genes may result in spermatogenic failure in patients with oligospermia and azoospermia. Partial deletions of the AZFc region of the Y chromosome were reported to be a significant risk factor for oligo/azoospermia. The main purpose of this study is to investigate the association between Testosterone, FSH, LH serum levels and defining the prevalence of partial deletions in the AZFc region (containing gr/gr, b1/b2, b2/b3) in males candidate for Intracytoplasmic Sperm Injection (ICSI).

Materials and Methods: 30 oligospermia infertile male's candidate for ICSI and 50 fertile men were studied in order to determine Y chromosome microdeletions and the gonadotrophine serum levels. Level of hormons was measured by Imunoenzymatic kit (EIA). After DNA extraction from peripheral blood, Multiplex PCR technique and agarose gel electrophoresis were used to assess complete and partial deletions.

Results: 3.3% of the patients showed Y chromosome microdeletions in the AZFb region. No microdeletion was detected in the control samples. Concerning partial microdeletion in the AZFc region, 17% of the patients showed deletions, in which 13.7% of the patients had gr/gr and 3.4% had b2/b3 deletions. Also we detected that 12% of the healthy individuals had partial deletions in this region, including 10% with gr/gr and 2% with b2/b3 deletions. No significant correlation was detected between the presence of gr/gr microdeletion and the serum level for testosterone hormone (p=0.856). However, the serum levels for FSH and LH were significantly higher in patients with gr/gr microdeletions (p=0.0001 and p=0.0001 respectively).

Conclusion: The present study suggests that applying molecular investigation in oligospermia patients with increased serum levels for FSH and LH may be informative before using assisted reproductive treatments.

Key words: Oligospermia, gr/gr, b1/b3, b2/b3.

O-33

Neuronal kisspeptin immunoexpression of two hypotalamic nuclei in PCOS adult female rat model

Aliabadi E1, Toolee H1, Namavar MR1, Keshtgar S2, Mirkhani MH3.

1 Department of Anatomy, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Department of Physiology, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Department of Pharmacology, Shiraz University of Medical Sciences, Shiraz, Iran.

Email: [email protected]

Introduction: Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder of premenopausal women accompany with chronic anovulation and infertility with high level of testosterone and LH. Kisspeptin, a novel protein, regulate the hypothalamic-pituitary-gonadal (HPG) axis are produced by neurons which located in arcuate (ARC) and Antroventral Periventricular (AVPV) hypothalamic nuclei. The aim of the present study was stereological evaluation of kisspeptin immunoexpresion in ARC and AVPV hypothalamic nuclei neurons in exprimentally PCOS adult female rat model.

Materials and Methods: Sixety mature female rats were divided into two controls (Diestrous, Proestrus), two sham (Tween Diestrous, Tween Proestrus) that received vehicle only (10% aqueous solution of Tween80) and PCOS (Letrozole treatment, 1mg/kg Letrozole in vehicle) groups. The treatment period was once daily orally for 21 days. Serum hormones levels (testosterone, LH), ovaries histological changes and stereologicaly immunoexpression of kisspeptin in ARC and AVPV nuclei neurons were evaluated.

Results: When PCOS group compared with control and sham groups: 1/ Ovaries showed high incidence of subcapsular cysts and capsular thickening. 2/ Testosterone and LH serum levels were elevated significantly (p<0.05). 3/ Immunoexpression of kisspeptin in ARC nucleus neurons were significantely increased (p<0.05), but in AVPV nucleus (compared with proestrus and Tween proestrus) were significantely decreased (p<0.05).

Conclusion: Neuronal kisspeptin immune-expression changes in ARC and AVPV hypothalamic nuclei can show possible importance role of kisspeptin in PCOS.

Key words: PCOS, Kisspeptin, Hypothalamus, ARC, AVPV.

O-34

Antifertility effects of Clobazam in adult male rat

Shariati M, Khatamsaz M, Baboli S, Ghavami MA.

Islamic Azad University, Kazerun Branch, Kazerun, Iran.

Email: [email protected]

Introduction: Clobazam is an anticonvulsant drug. Its side effects on reproductive functions have not been sufficiently studied. This study was designed to evaluate the effect of clobazam on pituitary-gonad axis and spermatogenesis in adult male rats.

Materials and Methods: 40 adult male rats wistar strain were randomly divided into five groups. Animals in group1 (Control group) were injected with any treatment. Animals in group2 (Sham group) received the three-component solvent (propylenglycol, ethanol and distilled water in a ratio of 5:2:3) in a corresponding volume, i.e. 1ml/kg.bw. Animals in groups 3, 4, and 5 received clobazam (dissolved in solvent), respectively, in doses of 2.5, 5, and 10 mg/kg.bw/day i.p. for 21 days. At the end of the study, blood gonadotropins (LH and FSH) levels as well as testosterone of rats in five groups were determined. The animals were sacrificed, then, spermatogram and histological changes of their testes were studied under light microscope.

Results: The results show that in clobazam treated groups, particular experimental group 3, blood testosterone levels were significantly decreased as compared to the control group. Plasma concentrations of LH, FSH assayed and there were no significant differences among the clobazam treated groups as compared with control group. Body weight in clobazam treated relatively increased. However, sperm density and testes weight were not different from those of the control group.

Conclusion: These findings indicate that clobazam has a relative suppressive influence on reproductive function in rats. We suggest that clobazam directly affects production of testosterone in leydig cells or centrally increased estradiol biosynthesis subsequently lowered testosterone levels by negative feedback.

Key words: Clobazam, Testosterone, Gonadotropin, Sperm.

O-35

Morphometric study of ovary and fertility in mice exposed to tamoxifen during emberyonic development.

Hassanpour S, Roshangar L, Soleimani Rad J.

Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Tamoxifen is a nonsteroid drug which is used for preventive and treatment of breast cancer, CNS tumours, stimulation of ovulation in infertility protocoles. Tamoxifen binds to estrogen recptors and inserts its activity into the cellcycle.in this manner it arrests the G0, G1 part of cell cycle and induces the cells apoptosis. Regarding to the affinity of tamoxifen to estrogen receptors and the possible role of estrogen on follicular differentiation, the aim of the present study was to investigate the folliculogenesis and the fertility of the mice that their mother had received tamoxifen during pregnancy.

Materials and Methods: In this study, 30 adult female mice and 15 adult male mice were used. The mice were mated and the pregnant mice received 100 µg/kg tamoxifen on 13th day of pregnancy as IP. The mice in control group didn't receive tamoxifen treatment. After delivery ,the female pups were kept under standard condition up to their adulthood. For evalution of fertilitey, the mice have been superovulated using hMG and hCG, and the oocytes were collected by flashing. To evaluate the folliculogenesis the ovaries were fixed and processed for light microscopic study and for determinig the range of fertilization the collected oocytes were transferred into the culture medium and sperms were added. 48 hours post insemination the number of fertilized oocytes was determined.

Results: Histological studies revealed that the number of primordial, graafian and corpus luteum in ovaries from experimental group were significantly lower than of the control group (p<0.05). This study showed that the rate of fertilization of oocytes in experimental group was significently lower than those of control group (p<0.01).

Conclusion: findings of this study that the maternal exposure to the Tamoxifen during pregnancy, causes disorders in folliculogenesis and fertility of the involved embryos, when reaching their adulthood.

Key words: Tamoxifen, IVF, Ovary, Mice.

O-36

Association study of three polymorphisms in two folate-related enzyme genes with non-obstructive male infertility

Aleyasin A 1, 2, Davoudi A3, Amini sadr M 1, 2, Javadi Gh 1.

1 Department of Genetic, Faculty of Sciences, Azad Islamic University of Tehran, Iran.

2 Navid Infertility Institute of Tehran, Tehran, Iran.

3 Department of Medical Genetic, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran.

Email: [email protected]

Introduction: Two typical folate metabolism enzymes methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) in the folate cycle play a critical role in DNA synthesis and methylation reactions. Because DNA synthesis and methylation is an integral part of spermatogenesis, folate metabolism is probably important to this process. Therefore, SNPs of the MTHFR and MTRR genes in the folate cycle could be related to male infertility. Several single-nucleotide polymorphisms (SNPs) of folate metabolism-related genes have been identified and these have been studied to discover their implications in the pathogenesis of cardiovascular disease, neural tube defects and colorectal cancer. These SNPs include MTHFR A1298C, MTHFR C677T and MTRR A66G. We evaluated whether polymorphisms of these three enzymes are associated with non-obstructive male infertility.

Materials and Methods: In this research 100 ferile men as the control group and 100 infertile men as the case group were selected. Case group was divided into oligospermia and azospermia subgroups. PCR and RFLP thechniques were used for the study of these polymorphisms.

Results: Our results showed no correlation between these genotypes: MTHFR 1298 A®C and MTRR 66 A®G with male infertility (p= 0.132 and 0.172 respectively), but a positive correlation between MTHFR 677 C®T and male infertility was observed (p= 0.006).

Conclusion: Our data revealed that MTHFR has a pivotal role in male infertility and thus MTHFR 677 C®T can be one of the genetical risk factore for the male infertility.

Key words: Azoospermia, Oligospermia, Folate metabolism, MTHFR, MTRR, Polymorphism.

O-37

The correlation between total antioxidant capacity and nitric oxide concentration in seminal plasma with sperm DNA damage

Amir I, Sheikh N, Najafi R, Taghi Goodarzi M.

Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Email: [email protected]

Introduction: Sperm DNA quality is important in male fertility. Oxidative stress increases sperm DNA damages. Antioxidants decrease production of free radicals and scavenge them. Nitric oxide is a free radical which produces by most of cells and has a dual role on cells. Low concentrations of NO, are essential in biology and physiology of systems but high level of NO has a detrimental effect on cells. The aim of this study was to determine the role of the nitric oxide concentration and total antioxidant capacity (TAC) in seminal plasma with sperm DNA damage.

Materials and Methods: Semen samples from 45 infertile men and 70 normozospermic men were examined for DNA damage, nitric oxide concentration and TAC. DNA damage was measured by comet assay; nitric oxide concentration was evaluated by Griess assay. TAC was measured in seminal plasma based on the generation of peroxyl radicals from 2, 2-azinobis (2-amidino propane) dihydrochlorid (AAPH).

Results: Our results implied that the means of DNA damage and nitric oxide concentration in infertile men was higher than fertile men. TAC level in infertile men was significantly lower than fertile men. DNA damage was significantly correlate with nitric oxide concentration in infertile men (p=0.001, r =+0.598) and TAC (p=0.04, r = -0.3) in infertile men.

Conclusion: In conclusion sperm DNA damage in infertile men may be induced by nitric oxide-mediated oxidative stress and low levels of TAC.

Key words: Nitric Oxide, Male infertility, Total antioxidant capacity, DNA Damage.

O-38

Are polymorphisms in the factor V gene associated with recurrent spontaneous abortion?

Sakhinia E1,2, Poursadegh Zonouzi A3, Firoozi A2, Karimi Ansari N2, Chaparzadeh N3, Mehrzad Sadaghiani M4, Farzadi L4, Ghasemzadeh A4.

1 Department of Biochemistry, Molecular Medicine Division, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Tabriz Genetic Analysis Centre (TGAC), Sheikh Alraeis Clinic, Specialized and Subspecialized Outpatient Clinic, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Department of Cellular and Molecular Biology, Faculty of Sciences, Azarbaijan University of Tarbiat Moallem, Tabriz, Iran.

4 Department of Obstetrics and Gynecology, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Thrombosis in decidual vessels during pregnancy is a one of the risk factor for first trimester recurrent spontaneous abortion (RSA). Therefore, mutations in main and specific genes such as factor V which promote possibility of thrombosis could lead to RSA. The objective of our study was to evaluate the prevalence of Factor V (1691G/A) and Factor V HR2 (4070A/G) risk factor mutations in RSA patients and compare it with healthy controls in North West of Iran. The FV G1691A is a missense mutation causes amino acid substitution of glutamine for arginine at the cleavage site (codon 506), that reduces its sensitivity to inactivation by activated protein C and the FV (4070A/G) is a complex haplotype in exon 13 of FV gene mutation causes amino acid substitution of histidine for argnine at the (codon 1299).

Materials and Methods: We studied 89 women with two or more consecutive miscarriages and 50 controls. Genomic DNA was extracted and amplified with four gene specific primers, and then specific PCR were carried out using Amplification Refractory Mutation System (ARMS-PCR) method and the fragments were analyzed on 1.5% agarose gel.

Results: Our results were shown that the 1691 G/A and 4070 A/G genotypes were detected in 2.3%, 2% of patients and in 0%, 1% of controls, whereas 1691 A/A and 4070 G/G genotypes were not founded in any samples.

Conclusion: Our data have indicated that homozygosity and heterozygosity for the 1691 G/A and 4070A/G genotypes of the factor V gene are not associated with the significant increase in the risk of RSA in North west of Iran, however we may need to examine more samples for the study.

Key words: Recurrent spontaneous abortion (RSA), Factor V, Thrombosis.

3- Urology

O-39

Sperm retrieval techniques for the azoospermic male

Esteves SC.

Andrology and Human Reproduction Clinic, Brazil.

Email: [email protected]

Spermatozoa can be retrieved from either the epididymis or the testis, depending on the type of azoospermia, using different surgical methods such as PESA, MESA, TESA, TESE and micro-TESE. In obstructive azoospermia (OA), sperm production is normal and gametes can be easily retrieved from the epididymis or the testicle in most cases, irrespective of the technique. PESA or TESA are simple and efficient methods for retrieving epididymal or testicular spermatozoa in men with OA. According to our data on OA, the etiology of the obstruction and the use of fresh or frozen-thawed epididymal/testicular sperm do not seem to affect ICSI outcomes in terms of fertilization, pregnancy, or miscarriage rates.In cases of nonobstructive azoospermia (NOA), the efficiency of TESA for retrieving spermatozoa is lower than TESE, except in the favorable cases of men with previous successful TESA or testicular histopathology showing hypospermatogenesis. The use of microsurgery during TESE may improve the efficacy of sperm extraction with significantly less tissue removed, which ultimately facilitates sperm processing. Testicular histology results, if available, may be useful to predict the chances to retrieve sperm in men with NOA. Our data demonstrate that micro-TESE performs better than conventional TESE or TESA in cases of maturation arrest and Sertoli cell-only histological patterns, where tubules containing active focus of spermatogenesis can be positively identified using microsurgery. Testicular spermatozoa can be obtained even in the worst case scenario except in the cases of Y chromosome infertility with complete AZFa and/or AZFbmicrodeletions. In both OA and NOA, sperm retrieval technique itself seems to have no impact on ICSI success rates. The main goal of PESA/TESA/TESE sperm processing is the recovery of a clean sample containing motile sperm. Such specimens are more fragile, and often compromised in motility, as compared to the ones obtained from ejaculates. Laboratory techniques should be carried out with great caution not to jeopardize the sperm fertilizing potential. Surgically-retrieved spermatozoa can be intentionally cryopreserved for future use. Spare left-over specimens that would be discharged after ICSI can also be cryostored. Different strategies can be developed according to each group's results. If freezing of surgically-retrieved specimens provides results similar to those with the use of fresh sperm, then the use of freezing specimens would be preferable. If not, fresh specimens are preferable. The reproductive potential of infertile men undergoing ART is related to the type of azoospermia. According to our data, the chances of retrieving spermatozoa (odds ratio [OR] = 43.0; 95% confidence interval [CI]: 10.3-179.5) and of achieving a live birth by ICSI (OR=1.86; 95% CI:l 1.03-2.89) were significantly increased in couples whose male partner had obstructive rather than non-obstructive azoospermia. Children conceived using sperm retrieved from men with OA and NOA should be followed-up because it is still unclear if there is an increased risk of birth defects when ICSI is carried out with non-ejaculated sperm.

Key words: Retrieving spermatozoa, PESA, MESA, TESA, TESE.

O-40

Comparing treatment with recombinant human follicle stimulating hormone, human chorionic gonadotropin and human menopausal gonadotropin on semen parameters after varicocelectomy

Amirzargar MA1, Yavangi M2, Basiri A3, Hosseini Moghaddam SM3, Babbolhavaeji H1, Amirzargar N3, Amirzargar H3, Moadabshoar L3.

1 Department of Urology, Hamadan University of Medical Sciences, Hamadan, Iran.

2 Department of Obstetrics and Gynecology, Fatemieh Infertility Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

3 Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: The most frequent physical finding in infertile men is varicocele which affects seminal parameters due to oxidative stress. For the first time, we aim to compare the efficacy of recombinant human follicle stimulating hormone (rhFSH), Human Chorionic Gonadotropin (HCG) and Human Menopausal Gonadotropin (HMG) on sperm parameters and fertility after varicocelectomy.

Materials and Methods: 113 infertile men with varicocele were divided into four groups. Group A received HCG 5000 IU weekly, group B received HMG 75 IU three times a week, group C received rhFSH 75 IU three times a week and group D received no medical treatment after varicocelectomy. After three months treatment, group A illustrated improvement only in morphology (p=0.007) and pregnancy rate was reported to be 32%. In group B sperm motility (p=0.023) and morphology (p=0.014) improved which caused 57% of pregnancy rate. In group C all of the investigated conventional semen parameters increased (p<0.05) and pregnancy rate was 62.5%. Only Gonal-F improved sperm concentrations >20x106?mL (p=0.027). In group D sperm morphology increased (p=0.038), but other parameters had no changes and no pregnancy occurred.

Conclusion: It can be concluded that drugs can reduce the time of inducing spermatogenesis and fertility in comparison with varicocelectomy alone and rhFSH is more effective than other drugs.

Key words: Male Infertility, Semen Analyses, Varicocele, Varicocelectomy, Human Chorionic Gonadotropin, Human Menopausal Gonadotropin, Human Follicle Stimulating Hormone.

O-41

Serum inhibin B concentration as a prognostic factor for prediction of sperm retrieval in testis biopsy of patients with azoospermia

Nowroozi MR, Radkhah K, Ayati M, Jamshidian H, Ranjbaran AR, Jabalameli P.

Department of Urology, Imam Khomeini Hospital, Tehran University of Medical Sceinces, Tehran, Iran.

Email: [email protected]

Introduction: This study was conducted to determine if serum inhibin B concentration can predict spermatogenesis in azoospermic infertile men.

Materials and Methods: This cross-sectional study included 70 patients with male-factor infertility referred to Alvand and Vali-e-Asr Infertility Centers, Tehran, Iran. All patients had azoospermia. Standard evaluation consisted of history and physical examination with extreme attention to sexual history and testis examination including testis size, consistency, and presence of varicocele. Laboratory evaluation done for all cases consisted of FSH, testosterone, LH, prolactin, and inhibin B. Testis biopsy was performed in all cases with acceptable testis volume and FSH. The mean inhibin B level was compared in groups with positive and negative sperm retrieval.

Results: The mean±SEM age of 70 azoospermic patients was 32.1±6.2 (range: 20-50) years. All couples had primary infertility with mean±SEM duration of infertility of 74.3±7.7 months. The mean±SEM testicular volume was 10.14±0.75 mL. The mean±SEM FSH and LH levels were 17.55±1.68, and 11.33±0.99 mIU/mL, respectively. The mean±SEM serum prolactin and testosterone levels were 308.77±17.35 and 5.45±0.91 ng/dL, respectively. The mean±SEM serum inhibin B concentration was 138.23±28.58 (range: 15-1500) pg/mL. Sperm was not retrieved in 82% of the patients; in 13% of the cases, biopsy revealed spermatogenesis. The mean±SEM serum FSH level of positive and negative groups was 9.78±2.13 and 22.56±2.46 mIU/mL, respectively (p<0.05). The mean serum LH, prolactin, and testosterone levels were not statistically different between the two groups. The mean±SEM serum inhibin B was 129±45.46, and 158.93±47.24 pg/mL in positive and negative groups, respectively (p>0.05).

Conclusion: Inhibin B concentration is not an appropriate predicting factor for testicular spermatogenesis.

Key words: Azoospermia, Inhibin B, Sperm retrieval.

O-42

IS karyotyping and Y chromosome microdeletion study necessary in father's candidate for ICSI?

Nowroozi MR1, Radkhah K1, Ranjbaran A1, Sedighi MA 2, Gourabi H2.

1 Department of Urology, Imam Khomeini Hospital, Tehran University of Medical Sceinces, Tehran, Iran.

2 Royan Institute, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: Advanced reproductive techniques can help patients with severe oligospermia and even azoospermia to conceive with Intracytoplasmic sperm injection. Since the sperm number and function may be affected by karyotype abnormalities or microdeletion in Y chromosome, this may be transmitted to their children, or occur de novo. In this study we aim to determine the frequency of karyotype abnormality and Y chromosome microdeletion in severe oligospermic or azoospermic men who father sons by ICSI, and karyotype anomaly in sons. Vertical transmission of Y chromosome microdeletion can be evaluated in case of detection in fathers.

Materials and Methods: Patients who had sons by ICSI in Alvand hospital IVF center and Rooyan institute were included in this study. The sons and their fathers are called for general examinations and blood sampling for karyotype and Y chromosome study.

Results: The total of 70 fathers was evaluated with their 70 sons. The mean age of fathers at the time of ICSI was 35.11 years and for the mothers 30.5 years. The mean duration of infertility was 8.7 year and the sons were 2.4 years in average at the time of examination. The mean age of neonates at the delivery was 33 weeks. 42.9% were delivered prematurely, and 40.5% of them were twins. 8.6% of the sons had hypospadiasis and 7.1% had UDT. Most of side effects were due to prematurity. 6 of fathers had karyotype amonaly. 4 of their sons had karyotype animaly too. Only one son had karyotype anomaly without affected father. No case of Y chromosome microdeletion was seen in our fathers.

Conclusion: Y chromosome microdeletion is not prevalent in fathers with successful ICSI. Karyotype anomal may transmit to the sons. All together ICSI is a reliable and safe method for treatment of severe oligospermia and azoospermia. Most of the complications are the result of premature delivery, we recommend limiting the number of transferred embryos.

Key words: ICSI, Premature delivery, Embryo.

O-43

Efficacy letrozole on semen parameters in infertile men

Pouyan O, Aghahossini M, Aleyasin A, Saeedi H.

Department of Infertility, IVF Center, Omid Clinic, Tehran, Iran.

Email: dr omid [email protected]

Introduction: The effect of letrozole, aromatase inhibitor on spermatogenesis has not been clarified. The study was to investigate the effect of letrozole, on serum hormone and semen parameters.

Materials and Methods: The study included 50 infertile men with a low serum testosterone to estradiol ratio (<10) of the patients 30 were azoospermic and 20 were oligospermic. All men were treated with letrozole 2.5 mg/d for at least 3 months. Serum testosterone and estradiol levels, testosterone to estradiol ratios and total motile sperm count (TMSC) were compared before and after the treatment in all patients.

Results: The range age was (25-42ys) and treatment duration was 3 months. Pre-treatment and post-treatment. Serum testosterone and estradiol levels, testosterone to estradiol ratios and TMCS are compared. In all patients, serum testosterone level significantly increased and serum estradiol level significantly decreased after the treatment. Testosterone to estradiol ratios and TMCS were significantly increasd in all patients. In patients with oligospermia, TMSC significantly increased from 3.12±1.2 milion to 12.4±2.5 milion after the treatment (p=0.005) in the azoospermic men, spermatozoa in the ejaculate, with a mean of 0.7±0.2 milion TMCS in 7 of 30 patients who were totally azoospermic before the treatment, although 23 patients remained still azoospermic after the treatment.

Conclusion: letrozole as an aromatase inhibitor may be effectively used improve sperm parameters in infertile men with a low testosterone to estradiol ratio. In addition letrozole may have some improvements by providing sperm in the ejaculate infertile men with azoospermia.

Key words: Letrozole, Spermatogenesis, Azoospermic.

O-44

Association between seminal cratin and cratinkinas level and sperm motility in infertile patients and healthy controls

Haghany L, Ostadkhalil F, Safari M.

Student Research Committee, Hormozgan University of Medical Sciences, Hormozgan, Iran.

Email: [email protected]

Introduction: Infertility is a major social problem and cause of 25%divorces in the world. Aim of this study was to evaluate the association between seminal cratin and cratinkinas level in infertile patients and healthy controls.

Material and Methods: 74 infertile men and30 controls were enrolled in this study. Infertile men divided to two groups: one sub motility 34 patients (50%> motility) and another with normal motility. Seminal protein profile, cratin and cratin kinas level measured and comprised in all groups. Results analyzed by SPSS 16.

Results: There was a significant relation between Seminal cratin and cratin kinas with total sperm account and concentration, membrane function and sperm total motility (all p<0.05).

Conclusion: Analyzes investigate that expression cratin and cratin kinas associates with spermatic motility, impaling that this indexes may be a candidate for evaluation of spermatic motility.

Key words: Cratin kinas, Cratin, Sperm motility.

O-45

Comparison of spermatozoal protein profile in infertile patients and normal sperm donors

Haghany L, Ostad Khalil F, Kargosha A.

Student Research Committee, Hormozgan University of Medical Sciences, Hormozgan, Iran.

Email: [email protected]

Introduction: The present study was conducted to comprise spermatozoal protein profile in infertile patients and healthy mens.

Materials and Methods: A total 54idiopathic asthenozoospermia and 38 control men enrolled and semen sample collected. Sperm protein extraction, western blot analysis, SDS-PAGE electrophoresis were conducted. SPSS 16 was used to analyze the results.

Results: Optioned information show a significant difference in densities, correction value and volume of DEAD-box protein4 (p<0.001).

Conclusion: We found that DEAD-box protein4 may be use full marker for diagnosis of male factor infertility.

Key words: Male infertility, Spermatozoal protein, DEAD-box protein4.

O-46

How can you appraisal the effect of occupational factors on male reproductive function?

Rasekh Jahromi A, Davari S, Mehrabipoor F.

Department of Obstetrics and Gynecology, Jahrom Universiry of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Humans are constantly exposed to a range of chemicals and toxins in their environment which can affect their health, including their reproductive health. For men, a range of environmental exposures are associated with reduced sperm concentration and quality. Men whose sperm is sub-optimal in either quantity or quality are less likely to conceive, and will, on average, take longer to do so, should they manage to successfully conceive. There are also many more environmental exposures which potentially increase the risk of male infertility but have not yet been studied. The aim of this research is detection of association of occupational factors with semen parameters and male infertility.

Materials and Methods: This prospective clinical study was performed on 106 infertile couples that referred to Dr. Rasekh's Clinic during 18 months. The patients had two semen analyses at least. Semen samples were collected by masturbation directly into a clean container after an abstinence period of 2 to 3 days. Questionnaires were prepared for patients which was registered last parameter of semen analysis, job, and occupational contacts. The patients were inserted in different groups due to exposure or no exposure to materials. The study population consisted of 106 consecutive male patients attending an infertility clinic. Average age was 33 years. 64 (60.3 %) patients had abnormal semen analysis, according to WHO, 2000 guidelines. The patients were inserted in different groups due to exposure or no exposure to environmental materials. Exposure groups include 39 (36.4 %) patients: 18 (16.9%) drivers, 12 (11.3%) agriculturists, 3 (2.8%) welders, 3 (2.8%) bakers, 1 (0.9%) car planisher, and 2 (1.8%) coalmen who had decreased sperm count 26 (24.5%), decreased motility 24 (22.6%), and abnormal morphology16 (15.09%). Unexposure groups include 25 (23.5%) patients: 9 (8.4%) workers, 7 (6.6%) employees, 5 (4.7%) teachers, 2 (1.8%) barbers, and 2 (1.8%) policemen who had decreased in sperm count 15 (14.15%), decreased motility 14 (13.2%), and abnormal morphology12 (11.3 %).

Results: Abnormal semen analysis was detected in occupational groups include exposure or no exposure to materials. The most impairment of semen analysis in exposure groups was in agriculturists due to impact to pesticides and then in order to drivers, welder, baker, coalman, car planisher (impact to heat, solvents) in semen quality. But, it is interesting witch unexposed groups (worker, teacher, employee, barber, policeman) were damaged in semen parameters that may be due to special position witch induced heat. The most disorders of semen analysis were in count and the next, motility in exposure groups but in unexposure groups were disorder in motility index. Abnormal semen parameter is twofold in exposure patients than unexposure's.

Conclusion: Expanding knowledge about materials and exposures that could adversely affect male fertility has great importance in maintaining a workers' health, his family life, and the health of his progeny. As such, protecting workers from exposures that could impact their fertility will generally protect them from other negative health effects, which could ultimately result from such exposures. Therefore, it may be prevented of semen disorders with avoiding to exposure of toxic materials before medical treatment.

Key words: Occupational factors, Infertility, Sperm parameter.

O-47

Relationships between vasectomy and libido impotence

Ahmadipour Sh, Daeichin S.

Department of Pediatrics, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Email: [email protected]

Introduction: Vasectomy is a safe and effective method to prevent fertility. This method is practical in most regions because it doesn't require complex technology. In spite of this in some regions of Iran it hasn't been approved because of general believes that vasectomy cause impotence. Purpose of this study is to evaluated 2 items libido and impotence between vasectomies.

Materials and Methods: In this cross-sectional study 110 vasectomied persons who had referred to Khoram abad health centers during 1999-2002 were participated. Demographic information, libido and impotence variation evaluated.

Results: After necessary evaluations of the cases it was found that 60% of people hadn't any libido variation and even 30% had increased libido, also 85.5% of them were seen without impotence.

Conclusion: In this study vasectomy as a safe and successful method for contraception was prone. In most cases it hasn't side effect such as libido and impotence reduction, therefore vasectomy in families with optimal number of children to prevent fertility is recommended.

Key words: Vasectomy, Libido, Impotence.

O-48

The study of Y chromosome microdeletions and mutations in the androgen receptor gene in Iranian patients with idiopathic non-obstructive azoospermia

Mirfakhraie R1,2, Montazeri M2, Kalantar SM3, Salsabili N4, Houshmand M2, Pourmand Gh 5.

1 Department of Biology, Islamic Azad University (IAU), Science and Research Branch, Tehran, Iran.

2 Department of Medical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.

3 Department of Genetics, Research and Clinical Centre for Infertility, Yazd, Iran.

4 Department of Infertility, Mirza Kouchak Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran.

5 Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Genetic factors, including Y chromosome microdeletions and androgen receptor (AR) gene mutations are responsible for male infertility. Genes located in the azoospermia factor (AZF) region, including AZFa, AZFb, AZFc and AZFd on the long arm of Y chromosome are considered to be the most important for spermatogenesis and deletions in these regions are thought to be involved in some cases of male infertility associated with azoospermia or oligozoospermia. Alternatively, androgen receptor is essential for development and maintenance of the male phenotype and spermatogenesis and AR gene mutations cause a variety of defects related to androgen insensitivity, ranging from complete feminization to phenotypic males with infertility. The aim of this study was to determine the incidence of AZF deletions and the prevalence of AR gene mutations among Iranian infertile men with idiopathic non-obstructive azoospermia.

Materials and Methods: A total of 100 Iranian azoospermic infertile men were selected for the molecular study of Y chromosome microdeletions and mutations in the AR gene. The presence of eight sequence tagged site (STS) markers from AZF region was investigated using multiplex PCR. Screening for AR gene mutation was performed using PCR-SSCP (Single-strand conformational polymorphism) and sequencing.

Results: 12% of the patients showed Y chromosome microdeletions and among these patients, deletion in AZFb region was the most frequent (66.67%). PCR-SSCP and sequencing analysis detected a novel 1510C?A transversion in the exon 1 of the AR gene resulted in p. Pro504Thr substitution in the transactivation domain of the protein in one patient.

Conclusion: According to the relatively high incidence of Y chromosome microdeletions among Iranian azoospermic patients molecular screening should be advised to infertile men before using assisted reproductive treatments. Furthermore, the present study indicates that molecular analyses of AR gene play an important role in diagnosing the cause of infertility in patients with azoospermia and therefore, may be useful for genetic counseling of candidates for assisted reproductive techniques.

Key words: Y chromosome, Microdeletion, Androgen receptor gene, Azoospermia, AZF.

O-49

Can altered expression HSPA2 in varicocele patients lead to abnormal spermatogenesis?

Abbasi H1, Nasr-Esfahani MH1,2, Tavalaee M2, Deemeh MR1,2, Ghasemi N3, Mirhosseini Z4.

1 Isfahan Fertility and Infertility Center, Isfahan, Iran.

2 Department of Andrology and Embryology, Reproductive Medicine Research Center, Royan Institute, ACECR, Tehran, Iran.

3 Department of Anatomy, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Department of Reproduction and Development, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran.

Email: [email protected]

Introduction: Heat shock protein A2 (HSPA2) expression affects sperm maturity and function. Therefore, dysfunctional expression of this gene results in abnormal spermatogenesis. On the other hand, DNA damage in spermatozoa is considered an important cause of male infertility. The presence of sperm with DNA fragmentation and chromatin abnormalities in human ejaculates is well documented, in particular in men with poor semen quality. The aim of this study is to evaluate HSPA2 expression and it's correlation with DNA fragmentation and protamine deficiency in varicocele patients in comparison to fertile men.

Materials and Methods: Sperm DNA fragmentation, protamine deficiency and relative HSPA2 expression are evaluated by the sperm chromatin dispersion test, chromomycine A3 staining and RT-PCR, respectively.

Results: Unlike CMA3 staining and DNA fragmentation, relative HSPA2 expression in varicocele patients is significantly lower than fertile individuals (p<0.05). Unlike varicocele patients, the results show a significant correlation between relative HSPA2 expression with protamine deficiency and DNA fragmentation in the fertile group. Therefore, improper expression of HSPA2 in varicocele patients may account for protamine deficiency, higher DNA fragmentation and abnormal spermatogenesis.

Conclusion: Thus, the results suggest that low expression of HSPA2 could possibility decrease fertility potential in varicocele patients.

Key words: Varicocele, HSPA2, Protamine Deficiency, DNA Fragmentation.

O-50

Innate immunity and paternal interaction with none self entities

Shapouri F 1,2,3, Saeidi S 1,2,3, Janan A2, Lakpour M2, Pouyan O4, Seddighi Gilani M2, Pacey A4, Aflatoonian R2.

1 Islamic Azad University, Science and Research Branch of Tehran, Tehran, Iran.

2 Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

3 Faculty of Medicine, Dentistry and Health, University of Sheffield, UK.

4 Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: The whole process of conception, pregnancy and child birth is full of examples of how immune and reproductive systems successfully manage to work together. Human TLRs are a family of ten microbe-recognition receptor that called TLR 1-TLR10. TLR 2 and TLR4 are very important receptors in this family. TLR2 recognizes a variety of microbial components; these include lipoproteins /lipopeptides from various pathogens, peptidoglycan and lipoteichoic acid from Gram-positive bacteria Chlamydial infection is the most common cause of male infertility. Recent reports indicated that in Chlamydia trachomatis infection, TLR2 is enriched in the cytoplasm around the inclusion membrane and may form part of an intracellular signalling system. TLR4 is receptor for bacterial LPS and chlamydial heat shock proteins. Furthermore, TLR4 has been shown to be involved in the recognition of endogenous ligands, such as heat shock proteins (HSP60 and HSP70). There fore, in this investigation the expression of TLR2 and TLR4 in different regions of male reproductive tract and spermatozoa was studied.

Materials and Methods: Biopsies from testis, vasa defran, prostate and prepuce were obtained from men who underwent TESE, Vasectomy, prostatectomy for benign reasons and prepuce surgery. All men taking part in this study had not history of infection and congenital disorder. In this study RT-PCR was used to show the existence of TLR4 and TLR2 gene in the male reproductive tract, real-time PCR analysis used to investigate the relative expression of this gene and Immunoblot analysis was used to detect TLR4 and TLR2 on spermatozoa.

Results: TLR2 and TLR4 are abundantly expressed in different part of the male reproductive tract. Existence of TLR2 and TLR4 in spermatozoa has been shown using immunoblot. Q-PCR has shown relative TLR2 expression in TESE (-) patient is lower than TESE (+) patient. However, there was no difference between TLR4 expression in TESE (+) compared to TESE (-) by using Q-PCR.

Conclusion: Presence of TLR2 and TLR4 in the male reproductive tract provides broad spectrum detection of bacteria and viruses that may enter the tract to protect both spermatozoa and the epithelial linings of reproductive organs. Q-PCR analysis in patients undergoing TESE may indicate that TLR2 expression in testis is under effect of spermatozoa but spermatozoa have no effect on TLR4 expression in testis.

Key words: Innate Immunity, Male reproductive tract, TESE, TLR.

4-Midwifry

O-51

The impact of body mass index (BMI) at 24-28 weeks and maternal weight gain, on the glucose challenge test (GCT) in pregnancy

Arjmandifar M, Ziaei S, Kazemnegad A.

Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Email: Arj 7087 @ yahoo. Com

Introduction: The aim of this study was to determine impact of BMI at 24-28 weeks as a predictor for abnormal GCT and weight gain pregnancy in women with an abnormal GCT.

Materials and Methods: This was a prospective (case-control) study conducted between 1388-1389, at two center (Kosar and Shahid Solaymani), Shahrrey, Tehran. 820 pregnant women between age 18-35 years were screened at 24-28 weeks of gestation with a 50-g oral GCT with 140 mg/dl cut of point. Pre pregnancy BMI and BMI up to the time of GCT testing, as well as other demography data, were recorded. The participants were grouped according to their pre pregnancy BMI and Institute of medicine (IOM) recommendations, for pregnancy weight gain, to normal, above normal and below normal. Then women divided into two groups as following, case group (n=119) subjects with GCT ? 140 mg/dl and control group (n=234) subjects with GCT<140 mg/dl. Gathered data were analyzed using SPSS and chi-squares test.

Results: BMI at 24-28 weeks ? 30 kg/m2 was significantly correlation with abnormal GCT. [OR 3.791, 95% CI (2.462-6.404)] (p=0.000).there was no difference between two groups in gestational weight gain. (p=0.221).

Conclusion: Maternal BMI at 24-28 weeks is as a predictor for abnormal GCT and weight gain in women with abnormal GCT is maybe related to low carbohydrate diet in these women after GCT results.

Key words: GCT, BMI, Pregnancy weight gain.

O-52

The effect of companionship during labour, on anxiety of primiparous mothers and making disturbance in Iran Hospital, Iranshahr city, 2009-2010

Samieizadeh Toosi T, Absalan N, Mohamadinia N.

Department of Nersing and Midwifery, Zahedan University of Medical Sciences, Iranshahr, Iran.

Email: [email protected]

Introduction: Child birth is the most emotional experience near the primiparous women, which effects on their health or illness in their whole life .being alone in childbirth environments, leads to anxiety and complication due to such situation in labour. So we decided to evaluate the effects of psychosocial support during labour, delivery and the immediate postpartum period provided by a female relative companion on state anxiety in nuliparous women in Iran hospital .in Iranshahr 2009-2010. The effects of the intervention were assessed by means of a randomised clinical trial. Emotional support by a female relative was provided to women in the intervention group, while women in the control group received routine care. Two hundred and ten women with a single fetus, no previous vaginal delivery, <3 cm of cervical dilatation, and no indications for an elective caesarean section were randomly assigned to be in control group who received routine care, or being in support group. Intervention group accompanied by a relative woman, who accepted to remain by the laboring mother at time of admition utill one hour after birth .she must talk, and taking mothers, hand, giving reassurance and praise them. Mother's state -anxiety score in admit time, mother's state-anxiety score in 6-8 cm dilation of cervix, duration of labour, mother perception to the birth, newborn's appgar score, and making disturbances of the companions in delivery ward.

Materials and Methods: Blinded interviewers obtained data and the clinical records from admit time, for 210 primiparous mothers who were 18-35 years old at 37 weeks gestational age or grater at onset of labour. They randomly assigned to be in two groups (n=150) with or without support from female relative companionship. The questioner in delivery ward of Iran Hospital, was filled in spielberger anxiety score at the first admit time and then on 6-8 centimeter during labour. Where as all data about labour and time of breastfeeding where being collected at that time .we compare duration of labour, time of delivery, Apgar scores, and demographic factors of mothers. Analyzes were conducted for the whole 210 women by spss statistical software.

Results: There were no significant difference between demographic and some factors in two groups such as age, gestational age, fetal weight and state anxiety score at admit time. mothers' anxiety score on 6-8 centimeter during labour was significantly lower in support group (43.9 vs 51.4 p=0.0001 ). Mother anxiety score in control group significantly increased compare to intervention group (44.6 on admit time then 51.4 during labour in control group vs 44.5 on admit time vs 43.9 during labour in support group p=0.000), More women in the intervention group perceived a high degree of control over the delivery experience, and the duration of labour was significantly shorter in support group compare to the control group. Maternal satisfaction was 81.9%, newborn apgar scores was higher in control group making disturbance of companions in delivery ward was 14.3 %.

Conclusion: Psychosocial support by female relative had a positive effect on anxiety and duration of labour. Because of the strict routine in hospital admit procedures, we can modify it by permition of being companion with mothers to increase their satisfaction and perception s to the child birth.

Key words: Labour, Anxiety, Companionship, Making disturbance.

O-53

A comparative study of the quality of life between man and woman in infertile couples

Erfanian Ahmadpoor M, Azizi H, Joneidi E, Mansoori M, Seifi B.

Islamic Azad University, Mashhad Branch, Mashhad, Iran.

Email: [email protected]

Introduction: Infertility is a serious disabling condition and medical problem which often leads to many health and social issues and affects couple's quality of life. Studies on the impact of infertility on quality of life mostly focus on the female partner and few of them compare the quality of life between male and female. The aim of this study was compare the different aspects of quality of life between female and male in infertile couples.

Materials and Methods: This analytical cross sectional study was carried out on one hundred infertile couples referred to our infertility treatment center, Mashhad, Iran between 2009 April to 2010 July. Data was collected through interview and questionnaire based on WHOQOL-BREF. The primary outcome measure was score of Quality life in every aspect. Data was analyzed by SPSS 16 software and t-test was used in order to compare men and women's score. p<0.05 was considered as the level of significance.

Results: There was a significant difference between men and women in physical and psychological aspects of quality of life (p=0.002 and p=0.001 respectively).

Conclusion: Results suggest that quality of life in women is affected significantly more than men. Therefore, psychological support and psychiatric treatments should be considered in infertile couples especially in women.

Key words: Quality of life, Infertility, Gender.

O-54

Opinion of hospital staff, teachers, infertile couples and common population about surrogacy for infertility treatment

Ghasemi M, Janghorbani M, Noori M, Ghasemi M.

Midwifery Ward, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Email: [email protected]

Introduction: Some couples with defect on their spermatozoid, ovum, or even uterus structure could have baby with donor sperm, ovum or uterus. One of the newest methods for infertility treatment is uterine donation (surrogacy). The aim of this study is comparing opinion of 4 groups (hospital staff, teachers, infertile couples and common population about surrogacy for infertility treatment.

Materials and Methods: This is a descriptive analytic study which has been done on 400 persons in 4 groups (hospital staff, teachers, infertile couples and common population) on spring and summer of 2010 in Isfahan. Cases selected as simple sampling and a questionnaire fielded out by each cases. Demographic information and cases` opinion about surrogacy were gathered and analyzed by SPSS.

Results: The 4 groups were the same in age categories, marriage and social status. The most knowledge about surrogacy was in teacher group. The most desire for privacy of surrogacy was in hospital staff group. About half of all groups (53%) have no information of Islam permission for surrogacy. All groups believed that using surrogacy is better than adoptation.

Conclusion: Being aware about recipient and donor characteristic was important in hospital staff group more than other groups. Also the most agreement for advertising in multimedia about surrogacy was shown in hospital staff group. All groups were agreed for psychiatric consulting for uterus donor and recipient (94%).

Key words: Infertility, Surrogacy, Hospital staff, Teachers, Infertile couple.

O-55

The relation between sleep disorder at early third trimester and depression at later stage of pregnancy in Hamadan

Asl Toghiri M, Iran Ghodsi Z.

Faculty of Midwifery, Azad Islamic University of Tuyserkan, Tuyserkan, Iran.

Email: [email protected]

Introduction: Women are subject to depression during pregnancy in the childbearing age, which is associated with serious complications for the mother, infant and the family. Its cause is not known. Many studies have the effect of psychosocial factors in this regard but there is meager information on the biological grounds. Recently, sleep disorder has been on the focus as causing depression. This study was conducted to determine the relation between sleep disorder at early-mid second trimester and depression at later stage in pregnancy.

Materials and Methods: This prospective describe-analytical study was conducted on the population of women admitted to the Tamin Ejtemaee Health Center in Hamadden city ,Iran in 2010 .The study sample included161 normal ( non depressed confirmed by the beck test ) pregnant woman who were selected by convenient non-probability methods. With a gestational age of 28-30 weeks, they were divided into two groups of sleep disorder and normal sleep by The Pittsburgh Sleep Quality Questionare.They was homogenized as for the confounders. On 38-40 weeks, they completed the beck Questionare. The relationship between their depression and sleep disorder was assessed. Chi-square, t-test, Mann Whitney, v-cramer and logistic regression were used in spss to analyze the obatained data.

Results: 11.4 % of women with normal sleep and 56.2 % of women with sleep disorder were found depressed on 38-40 weeks and sleep disorder had increased the chances of depression by 9 times (p< 0.001).

Conclusion: Findings revealed that sleep quality at early third trimester in pregnancy predicted higher levels of depressive symptoms at later stage in pregnancy. It suggests that screening for sleep problems during pregnancy may be of clinical significance.

Key words: Pregnancy, Sleep disorder, Depression.

O-56

The relation of maternal pre pregnancy Body Mass Index (BMI) with abnormal GCT (Glucose Challenge Test)

Arjmandifar M, Ziaei S, Kazemnegad A.

Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Email: Arj 7087 @ yahoo.com

Introduction: Gestational diabetes mellitus (GDM) complicates 1-5% of all pregnancies and the feto-maternal outcome is strongly related to early diagnosis of GDM. GCT is a universal screening for GDM, between 24-28 of gestation, with a 50-g oral glucose challenge test. Plasma glucose is measured 1 hr after ingestion of the glucose load. A value over 140mg/dl is considered positive. The aim of this study was to determine impact of pre pregnancy BMI as a predictor for abnormal GCT.

Materials and Methods: This was a prospective cohort study between 1388-1389, at two center (Kosar and Shahid soleymani), Shahrrey-Tehran, 674 pregnant women between 18-35 years were screened at 24-28 weeks of gestation with GCT. Pre pregnancy BMI as well as other demography data, were recorded. The participants according their pre pregnancy BMI were grouped to underweight (<19.8), normal (19.8-26), overweight (26.1-29) and obese (>29 kg/m2).Gathered data was analyzed using SPSS and Chi-squares test.

Results: 13.4% was underweight, 51% normal, 18.1% overweight and 17.5% obese. The prevalence of abnormal GCT in the first group was 6.7%, in second group 12.5%, in third group 18.1% and in the fourth group 28.8% (p=0.000) .

Conclusion: Abnormal GCT in overweight and obese women (respectively) is 1.5 and 2.3 times more than women with normal weight .We recommend that women before pregnancy must gain normal weight.

Key words: GCT, BMI, GDM.

O-57

Effect of perineal massage on dimensions of episiotomy

Rezaei Habib Abadi Z1, Granmayeh M1, Mazaheri pour Z2.

1 Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

2 Imam Sajad Hospital, Tehran, Iran.

Email: [email protected]

Introduction: Episiotomy which is designed to prevent perineal tears during childbirth has morbidities such as pain, bleeding, sexual dysfunction and etc which it may reduce with decrease dimensions of episiotomy. This study has been done to determine effect of perineal massage with Vaseline on dimensions of episiotomy during childbirth.

Materials and Methods: This was a randomized clinical trial and has been done on the ninety low risk nulliparous women in experimental and control groups. In experimental group after crowning and cowering genital region, swiping and revolving perineal massage with vaseline was performed. Consequences was recorded including dimensions of episiotomy.

Results: This study showed that in experimental group dimensions of episiotomy on the skin (p=0.095), in the vagaina (p=0.016) and in the mucle (p<0.001), was lesser than control group.

Conclusion: The results indicate that perineal massage with Vaseline reduces dimensions of episiotomy. It is suggested perineal massage with Vaseline in second stage of childbirth perform by midwives for reduce dimensions of episiotomy.

Key words: Episiotomy, Perineal massage, Childbirth.

O-58

Investigating the pregnant mothers' educational needs regarding the delivery type based on the health belief model

Bahri N1, Mohebi S2, Davoodi S3, Khodadoost L3, Mirmoezy M1.

1 Faculty of Nursing and Midwifery, Social Development and Health Promotion Research Centre, Department of Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.

2 Department of Health Education, Qom University of Medical Sciences, Qom, Iran.

3 Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran.

Email: [email protected]

Introduction: At present, the increase in caesarian has worried the health authorities in many countries. Unfortunately, one of the important reasons of caesarian is mother's willingness for it which seems to be because of her not knowing the caesarian side-effects. Therefore, this study was carried out with the aim of investigating mother's educational needs regarding the delivery type according to health belief model.

Materials and Methods: This study was a kind of cross-sectional one which was done in 1388-89. The participants were 100 primiparae who were selected through stratified sampling method. They showed no side-effect during their pregnancy and their gestation period was over 28 weeks. Also, they did not work in the medical science fields and had an education of primary school level. They filled in a demographic questionnaire, a fertilization characteristic form, a form for the assessment of different aspects of health beliefs regarding delivery type, and a delivery tendency form in the presence of the researcher. The obtained data were analyzed through SPSS software version.16 using frequency distribution, mean, correlation and a one-way analysis of variance.

Results: The results showed that 60% of the pregnant mothers had good knowledge regarding the delivery type. Moreover, investigating the different subsections of the health belief model led to the following results: sensitivity mean: 19.19±3.14, intensity mean: 20.68±2.67, benefit mean: 21.71±3.84, obstacles mean: 17.75±3.58 and threat mean: 20.27±2.40. With respect to the external guidance, the results indicated that the participants had chosen the delivery type based on the gynecologist's suggestion. In addition, there was a significant relationship between the mother's knowledge regarding the delivery type and the number of times she referred to the gynecologist for check-up and mother's obeying her friends and relatives' suggestions in this regard.

Conclusion: The findings showed that 80% of the pregnant mothers had desirable knowledge regarding the delivery type. Also, the obtained mean scores from different subsections of health belief were desirable while the external guide was the gynecologist. Considering the findings of this study, to encourage the pregnant mothers to choose the vaginal birth, an extensive education based on the model and theory specially the health belief model can be employed. Further, to implement effective education in this regard, other influential people such as gynecologist, family members, like husband, and health centers personals can be involved.

Key words: Health belief model, Vagina birth, Caesarian, Pregnancy.

O-59

Anxiety-related factors in ARTs pregnant woman

Chehreh H1, Neisani Samani L2, Seyed Fatemi N3, Hosseini F4.

1 Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.

2 Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

3 Nursing Research Center, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

4 Faculty of Management, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Pregnancy after assisted reproduction technology is the one of risk factors that can result in anxiety. Many studies showed that for up to 20% of infertile women, the emotional burden of infertility persist even after successful treatment. This study aims to determine anxiety levels and its related factors in ARTs pregnant women undergoing sample infertility centers in Tehran.

Materials and Methods: In this cross sectional study, 100 ARTs pregnant women were participated. Data was collected by Beck Anxiety Inventory (BAI) and personality/demographic questionnaires. Data analysis was performed with SPSS.V.14.

Results: Mean age was 33.7±6.81 and mean of married duration, gestational age, infertility duration and number of treatment failures was 8.70±5.18, 20.18±10.8, 7.37±6.81 and 1.9±1.6 respectively. Of 45 pregnant women in the first trimester, 28.9% (n=13) have moderate and sever anxiety. Of 20 pregnant women in the second trimester, 35% (n=7) have moderate and sever anxiety and finally, of 20 pregnant women in the third trimester, 40% (n=14) have moderate and sever anxiety. There is a significant relation between anxiety levels with duration of infertility and history of treatment failure (p=0.03) (p=0.02).

Conclusion: Careful consideration and psychological consultation for ARTs pregnant women is necessary to detect high-risk pregnant and reduce the anxiety and poor pregnancy outcomes.

Key words: Anxiety-related factors, Assisted reproductive technology, Pregnant women.

O-60

Relevance between consumption of daily food groups with daily intake of iron and zinc and its comparison with iron and zinc DRI (Dietary Reference Intakes) in the first half of pregnancy

Babaei M1, Soltanmorady S1, Moghadam Banaem L2, Ghodsi D3.

1 Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

3 Nutritional Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: One of the factors that affect pregnancy outcomes is nutritional issues that affect pregnancy outcomes clearly. This study conducted to compare the diet of pregnant women in Tehran with the Dietary Reference Intakes.

Materials and Methods: This cross sectional study was conducted on 436 18-35 year-old pregnant women, whose gestational age was equal or less than 20 weeks and had singleton pregnancy who attended prenatal clinics in the hospitals of Shahid Beheshti, Iran and Tehran Universities in 2010. The prenatal clinics were selected by stratified cluster sampling. All subjects completed two questionnaires that included demographic characteristics and food frequency questionnaire (FFQ). Received food for each person was determined by using nutritional software. To descriptive tests, Pearson's correlation coefficient and linear regression analysis, we used SPSS Version16.

Results: Of 436 pregnant women studied 121 (27.7%) received standard doses of zinc and 57 (13.1%) received standard doses of iron. Results showed that there is a significant relationship by t-test procedure between daily intake of meat (p<0.001), dairy (p<0.001), fat (p<0.001), fruit (p<0.001), vegetables (p<0.001) and the standard rate of zinc received. For a more precise assessment of factors affecting standard rate of zinc and relationship of factors including daily consumption of all food groups, along with maternal age, parity and smoking logistic regression was run. In addition, daily Consumption of dairy (odds:1.335, CI:95%, 1.099-1.622), vegetables (odds:1.229, CI:95%, 1.040-1.452), fruits (odds:1.091, CI:95%, 1.40-1.144), bread and cereal (odds:1.096, CI:95%, 1.042-1.154), meat (odds:1.204, CI:95%, 1.103-1.315), and fats (odds:1.192, CI:95%, 1.114-1.276) with DRI of zinc had the significant relationship. Moreover, other Results showed that there is a significant relationship by t-test procedure between daily intake of meat, fats, fruits, and vegetables (p<0.001) with the standard rate of iron received. Logistic regression was run to extra accurate valuation of factors that affects the standard rate of zinc, and relationship factors, including daily consumption of all food groups, along with maternal age, parity number and smoking. Additionally, Consumption of vegetables (odds:1.195, CI:95%, 1.040-1.373), fruits (odds:1.062, CI:95%, 1.022-1.105), bread and cereal (odds:1.141, CI:95%, 1.082-1.204), meat (odds:1.059, CI:95%, 1.021-1.099), and fats (odds:1.065, CI:95%, 1.003-1.13) daily with DRI of iron had the significant relationship.

Conclusion: The obtained results in this study shows that, the daily consumption of all food groups and receiving the standard iron and zinc are related and consuming just milk and dairy products has no effect on the intake of iron standards. Overall, most mothers (over 70%) in this study, had not received standard doses of zinc and iron nutrition that indicated more attention to maternal nutrition.

Key words: Pregnancy, Nutrition, Zinc, Iron, Dietary Reference Intakes.

B- Poster Presentations

1- Infertility, Gynocology

P-1

Health effects in neonatal meconium delivery

Tavoosian Z1, Haj Seyed Javadi E2, Tavoosian S1.

1 Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Qoosar Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.

Email: [email protected]

Introduction: One of the methods to prevent adhesions causing secondary infertility is prevention of cesarean section without correct indication. However, the best way is natural birth delivery, but sometimes we have to operate cesarean section for infant and mother health. But the high incidence of cesarean section in the world especially in Iran is regrettable and some programs should be implemented to limit it. Meconium in the amniotic fluid leads to many cases of cesarean section. Many gynecologists and midwives think that in each case of meconium patient must be send to the operating room. But, only in special conditions meconium cases need cesarean. This observational research studied meconium deliveries in Zyayyan Hospital during a one year period from April 2009 to April 2010.

Materials and Methods: In this study, all women with meconium in the amniotic fluid were considered. Apgar score at birth and subsequent complications during one week after birth of the infants were measured and compared regarding natural delivery and cesarean section. Where addition of meconium and fetal distress were excluded.

Results: 106 pregnant women delivered meconium infants and two of them were excluded. Among the 104 women were 44 cases of cesarean delivery, and 60 infants were born by natural delivery (NVD). Overall, 6.7% infants were born with poor Apgar score and complications. In fact, four of the NVD newborns and three cesarean infants, were suffering from these problems. 9.09% of the cesarean infants and 5% of NVD infants were suffering from meconial complications. This difference was not statistically significant (p=0.02).

Conclusion: It seems that type of delivery in meconium cases without fetal distress, has no effect on infant prognosis. So, if we consider each meconium equal to cesarean delivery, we will rise the cesarean rate.

Key words: Infant, Fetal, Meconium, Delivery.

P-2

Does moderate alcohol consumption affect fertility follow up study among couples planning first pregnancy?

Akhbardeh M.

Boston Medical University, Boston, USA.

Email: [email protected]

Introduction: To examine the effect of alcohol consumption on the probability of conception. Design: A follow up study over six menstrual cycles or until a clinically recognised pregnancy occurred after discontinuation of contraception.

Materials and Methods: 430 Danish couples aged 20-35 years trying to conceive for the first time. Main outcome measures: Clinically recognised pregnancy. Fecundability odds ratio: odds of conception among exposed couples divided by odds among those not exposed.

Results: In the six cycles of follow up 64% (179) of women with a weekly alcohol intake of less than five drinks and 55% (75) of women with a higher intake conceived. After adjustment for cycle number, smoking in either partner or smoking exposure in utero, centre of enrolment, diseases in female reproductive organs, woman's body mass index, sperm concentration, and duration of menstrual cycle, the odds ratio decreased with increasing alcohol intake from 0.61 (95% confidence interval 0.40 to 0.93) among women consuming 1-5 drinks a week to 0.34 (0.22 to 0.52) among women consuming more than 10 drinks a week (p=0.03 for trend) compared with women with no alcohol intake. Among men no dose-response association was found after control for confounders including women's alcohol intake.

Conclusion: A woman's alcohol intake is associated with decreased fecundability even among women with a weekly alcohol intake corresponding to five or fewer drinks. This finding needs further corroboration, but it seems reasonable to encourage women to avoid intake of alcohol when they are trying to become pregnant.

Key words: Pregnant, Conception, Reproductive.

P-3

Overweight and obesity disorders amongst infertile couples

Yaghoubi M1, Peyman H1, Soheili F1, Jalilian A2, Delpisheh A3.

1 Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.

2 Department of Obstetrics and Gynecology, Ilam University of Medical Sciences, Ilam, Iran.

3 Department of Epidemiology, Ilam University of Medical Sciences, Ilam, Iran.

Email: [email protected]

Introduction: The main pathophysiologic consequences of overweight and obesity are involved with endocrine abnormalities such as polycystic ovarian syndrome (PCOS) and menstrual disturbance as well as ovulation dysfunction leading to infertility. The present study aimed to evaluate Overweight and obesity disorders amongst infertile couples in Ilam province, western Iran 2010.

Materials and Methods: A descriptive cross sectional study was designed to recruit all 71 women complained from infertility referred to the Gynecology Clinic in Ilam city western Iran. Demographic and clinical characteristics were collected using a valid and reliable questionnaire containing two sections on health history of subjects themselves and their partners. Weight and Height were accurately measured according to the recommended methods. Body mass index (BMI) was calculated and SPSS was used for all analyses.

Results: The mean age and BMI±standard deviations were 27.7±6.1 years and 25.5±3.6 kg/m2 for women. The corresponding rates for their partners were 32.7±7.3 years and 25.3±3.4 kg/m2, respectively. Overall, 56.8% of women and 47.1% of men were either overweight or obese, respectively. BMI was significantly increased by women's age (r=0.275, p=0.02). No significant difference was observed between BMI among men and women. History of abortion was more frequently observed in either overweight or obese women (p=0.02).

Conclusion: Menstrual disturbance and ovulation dysfunction are leading to increased infertility disorder. There is a link between obesity and history of abortion. The appropriate nutrition and nutritional programs and regular daily exercises are recommended for young couples to keep BMI in normal range and to prevent infertility.

Key words: Obesity, Infertility, Infertile couples.

P-4

Relation between thyroid antibodies, APCR, and lupus anticoagulant levels with recurrent spontaneous miscarriage

Haghani L, Ostadkhalil F, Hashemi M, Kargosha A.

Research Committee, Hormozgan University of Medical Sciences, Hormozgan, Iran.

Email: [email protected]

Introduction: recently studies have shown an association between thyroid antibody and spontaneous abortion. The aim of present study was to evaluate the relation between thyroid antibody and thrombophylia and C activated protein c resistance (APCR) with recurrent spontaneous miscarriage.

Materials and Methods: from April 2007 to March 2008 (in a case control study). 74 woman with a history of recurrent abortion and 80 matched woman without previews abortion enrolled in this study. APCR, thyroglobolin (TG), thyroid peroxides antibodies (TPO). Thyroid stimulation hormone (TSH) and free thyroxin (FT) and lupus anticoagulant levels were assessed. The data were analyzed by student t-test. Man Whitney, chi square and fisher exact.

Results: A total 154 patient with mean age ±SD of 33.6±6.4, range=13-52years old) in case and 33.4±5.9 in control group assessed. There is a significant relation between APCR, TG, TPO, TSH, FT and recurrent spontaneous miscarriage (all p<0.05) but not relation with lupus anticoagulant levels.

Conclusion: Based on the currently available evidence, it appears that the presence of thyroid antibodies and APCR is associated with an increased risk for spontaneous miscarriage in subfertile women this index may be considered as a potential diagnostic factor for miscarriage especially spontaneous abortion.

Key words: Thyroid antibodies, Spontaneous abortion, Lupus anticoagulant.

P-5

Seroprevalence of toxoplasmosis in women with recurrent spontaneous abortion

Ebadi P1, Solhjoo K2, Bagheri K1, Eftekhar F2.

1 Faculty of Medicine, Islamic Azad University, Kazerun Branch, Kazerun, Iran.

2 Faculty of Medicine, Department of Microbiology, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Toxoplasmosis, a parasitic infection, varies in its prevalence in various countries. Some studies have suggested its role in the abortion. The aim of this study was to determine the role of anti-Toxoplasma antibody as an etiologic factor in recurrent pregnancy failure.

Materials and Methods: A case-control study was carried out on 120 women who unexplained recurrent pregnancy loss (group I) with 50 women had matched with normal reproductive outcome allocated as control group. Sera from 120 cases and 50 controls were tested for anti-Toxoplasma IgG antibody by ELISA.

Results: The present study revealed a higher percentage of anti-Toxoplasma IgG antibodies positivity in women with repeated abortions (17.5%) than control group (14%), although the difference between them was not statistically significant (p=0.7).

Conclusion: The analysis of these results shows that in spite of proved role of Toxoplasma gondii in fetal abortion, it is still controversial; whatever toxoplasmosis can cause repeated abortion. Thus a study to associate toxoplasmosis with recurrent abortions is difficult because a large cohort of women with toxoplasmosis would be needed to assess the incidence of otherwise unexplained recurrent abortions in them compared with controls.

Key words: Toxoplasma, Recurrent Spontaneous Abortion, Anti-toxoplasma antibody.

P-6

Effectiveness of clomiphene citrate, tamoxifen and letrozole in induction ovulation in women with infertillity due to isolated unovulation

Seyedoshohadaei , F Zandvakily , F Shahgeibi SH.

Department of Obstetrics and Gynecology, Besat Hospital, Gynecology Ward, Kurdistan University of Medical Sciences, Kurdistan, Sanandaj, Iran.

Email: [email protected]

Introduction: Anovulation is the most common cause of infertility. There are many drugs that have been used for induction ovulation among isolated unovulation without polycystic ovarian syndrome (PCOS). The first line oral treatment, since 1962, has been Clomiphene citrate, which is a selective estrogen receptor modulator (SERM). Tamoxifen is another SREM that has been used for induction ovulation. There may be resistance to SREM. Therefore alternative treatments like aromatas inhibitors have been used. This study is designed to compare the effectiveness of clomiphene, tamoxifen and letrozole in ovulation induction outcome: number of mature follicles, endometrial thickness, pregnancy rate, multiple pregnancy rate, live birth and miscarriage in isolated non PCOS unovulatory patient. This study is a prospective randomized clinical trial.

Materials and Methods: 150 infertile women who had isolated non PCOS unovulation, randomized to 3 groups. Group A received clomiphene 50 mg up to 150mg for 5-7days, Group B received tamoxifen 10 mg up to 30mg for 5-7days and Group C received letrozole 2.5 mg up to 7.5mg for 5-7 days. Drugs have been increased in dose and duration to achieve mature follicle. If patients were not responding to treatment with maximum dose for 7 days or failed to concept after six months, treatment was discontinued.

Results: Demographic characteristics illustrate no significant differences in main age ,duration of infertility and FSH and LH level between 3 groups. Overall rate of ovulation was 39 (66, 7%) in group A, 40 (69.7%) in group B and 38 (63.6%) in group C. Pregnancy rate in groups A, B and C were 32 (41.5%), 20 (26%) and 25 (32.5%) and abortion rate in these three groups were 10 (31.3%), 3 (15%), and 4 (16%) respectively. One twin pregnancy was occurred with clomiphene and one with tamoxifen. But all pregnancys with letrozole were singleton.

Conclusion: Clomiphene, tamoxifen and letrozole show similarity in term of ovulation rate. Endometrial thickness is higher, but not significant, with tamoxifen then with clomiphen and letrozol. Letrozole cycles are associated with fewer total follicles and fewer mature follicles but more endometrial thickness compared with clomiphene citrate cycles. Pregnancy rate and miscarriage are higher with clomiphene then tamoxifen and letrozole (p=0.05, X2=9.37), but no significant differences between tamoxifen and letrozole There is no benefit of tamoxifen and letrozole over clomiphene citrate in pregnancy achievement. Patients were in higher risk of multiple births with clomiphene. Abortion rate was lower if patient conceived with tamoxifen or letrozole then clomiphene. Clomiphene citrate (CC) is still the first-line therapy for ovulation induction in these patients tamoxifen or clomiphene citrate resulted in similar ovulation rates [odds ratio (OR) 95%, 0.755, confidence interval (CI) 0.513-1.111]. There was no benefit of tamoxifen over clomiphene citrate in achievement of pregnancy.

Key words: Infertility, Unovulation, Non-polycystic ovarian syndrome.

P-7

Paraoxonase 3 activity and the ratio of antioxidant/peroxidation in the follicular fluid of infertile women

Farzadi L, Gasemzadeh A, Shahnazi V, Khaje E, Rashidi MR, Nouri M.

Infertility Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: According to the recent studies, the paraoxonase 3 (PON3) activities in the follicular fluid is three times more than its activity in the serum. However, the detailed role of PON3 in the ovary function still remains unknown. In the present study, the PON3 activity and the ratio of antioxidant/peroxidation in the follicular fluid in the infertile and fertile women during stimulating cycles in assisted reproductive technique (ART) have been investigated.

Materials and Methods: The follicular fluid was extracted from 50 infertile couples under ART treatment. PON3 activity, ratio of high density lipoprotein, antioxidant capacity and the level of malondialdehyde (MDA), as a marker of lipid peroxidation, were determined using HPLC, sedimentation technique, ELISA method and thio barbitoric acid procedure, respectively.

Results: Of 50 women, there were 20 infertile and the remaining 30 were fertile. The ratio of PON3 activity in follicular fluid of infertile women in comparison with the fertile women was significantly low (p<0.05). The average ratio of PON3 activity/MDA level in the infertile women was achieved lower than the fertile women. Moreover, the concentration of MDA in the follicular fluid of infertile women was significantly higher (p<0.05) than its concentration in the fertile women. Meanwhile, the concentration of high density lipoprotein and total antioxidant capacity of follicular fluid of both groups showed insignificant difference.

Conclusion: The present study showed that PON3 activity and the ratio o of PON3 activity/MDA level in the infertile women are lower than those in the fertile women. Some disorders on the ratio of antioxidant/peroxidation in the follicular fluid could affect the fertility of women.

Key words: Paraoxonase 3, Follicular fluid, Lipidic peroxidation

P-8

The effect of maternal age in ovarian response in IVF cycle

Mostafa Gharabaghi P, Abdollahifard S, Feizinia S.

Infertility Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: There are heterogenous and sometimes confilicting data about possible predictors of ovarian response during IVF cycle.The aim of this study was evaluation the maternal age as a predicting factor of ovarian response during IVF cycle.

Materials and Methods: In an analytic cross-sectional study, 96 female condidates for IVF were recruited at Alzahra infertility center during a 14-month period. Ovarian response was categorized and evaluated in two sections according to the number of retrieved follicles (≤10 and >10) and oocytes (appropriate response: 5-14, inadequate response ≤4, excessive response ?15).

Results: Ninty six women with a mean age of 29.8±5.9 (20-40) years were enrolled. Older age, high BMI, high basal serum FSH and low number of antral follicles were the predictors of inadequate number of retrieved follicles. Significant predictors of inadequate number of retrieved oocytes were older age, high BMI, high basal serum FSH, low ovarian volume and low serum estradiol.

Conclusion: There was a reverse correlation between age, BMI and basal serum FSH with the number of retrieved follicles and oocytes but the correlation between serum estradiol and number of antral follicles with the number of retrieved follicles and oocytes was positive. There was not any independent predictor in this regards.These results can be used for prediction of ovarian response in patients undergoing IVF cycle.

Key words: Invitro fertilization, Oocyte retrieval, Ovarian follicle.

P-9

Investigating the association between second trimester maternal serum, inhibin A and pre-term delivery

Sehat Z, Goshtasbi A.

Department Midwifery and Reproductive Health of Tarbiat Maodares University,Tehran, Iran.

Email: [email protected]

Introduction: To investigate the association between second Trimester Maternal Serum Biomarkers (HCG, MSAFP, UE3, inhibin A) and Pre-term delivery.

Materials and Methods: The Current Study is a historical Cohort Study that have been performed for 700 pregnant women that are the clients of Nilou Patho-biology Lab in the second trimester of pregnancy to do the Quad Marker Screening test in the time interval between March 2008 to September 2008. The information of Mothers that have the required conditions to enter to the study have been registered and after delivery they have been called again to be interviewed (if they want) and some other information for mother and baby have been gathered again. These data set have been entered to the useful computer format using SPSS 16.0 Software and have been analyzed using the statistical and analytical tests like Chi Square Test.

Results: In the presented research, 7.3% (53 persons) of mothers have the preterm delivery and 92.7% (647 persons) have term delivery. The relationships between the biomarkers level in mother's serum have been investigated. There is a direct relationship between the increase AFP and Inhibin A serum level and preterm delivery. Also, there is a inverse relationship between the UE3 serum level and preterm delivery. Moreover, there is not any relationship between the increase HCG serum level and preterm delivery.

Conclusion: The increase in the AFP and Inhibin A and decrease in UE3 serum levels in the second trimester of pregnancy lead to enhance the probability of preterm delivery. It has been concluded that if the current study is done with higher samples and different sampling environment, may be have different results. Considering the fact that the preterm delivery has become a matter of grave concern for mother and fetus health, it is better to perform this study more accurately to investigate more on the preterm delivery outcomes.

Key words: Preterm delivery, Quadruple marker test, AFP, HCG, Inhibin A.

P-10

Comparing intramuscular progesterone, vaginal progesterone and 17 a-hydroxyprogestrone caproate in IVF and ICSI cycle

Moini A1, 2, 3, Zafarani F4, Eslami B2, Sadeghi M1, Kamyabi Z1, Jahangiri N1.

1 Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

2 Department of Obstetrics and Gynecology, Roointan-Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran.

3 Vali-e-Asr Reproduction Health Research, Tehran University of Medical Sciences, Tehran, Iran.

4 Department of Reproductive Imaging, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. The objective of this prospective, randomized study was to compare the efficacy of three types of progesterone on reproductive outcome of patients undergoing IVF/ICSI cycles.

Materials and Methods: A prospective randomized study was performed at Royan Institute. There were 153 patients with age less than 40 who were randomly assigned to three groups. Patients in group one were administered progesterone in oil (100 mg, IM daily), those in group two were given intravaginal progesterone (400 mg, twice daily) and group 3 received 17-a hydroxyprogestrone caproate (375 mg, each three days).

Results: No statistical significances were discovered for biochemical, clinical and ongoing pregnancies in the three groups (p>0.05). However the abortion rate was statistically higher in group 1 when compared with the other groups (35.3%, 5.9%, 5.9%: p=0.025). Meanwhile the live birth rate was not statistically significant between the three groups.

Conclusion: Our study manifested the effect of three types of progesterone were similar on pregnancies rate. We suggest the use of intravaginal progesterone during the luteal phase in patients undergoing an IVF-ET program because the low numbers of abortions, and high ongoing pregnancy rate.

Key words: In vitro fertilization, Luteal phase, Progesterone, Pregnancy.

P-11

Controlled ovarian hyperstimulation and intrauterine insemination cycles in patients with unilateral tubal blockage diagnosed by hysterosalpingography

Ebrahimi M, Akbari Asbagh F, Ghaseminejad A.

Department of Obstetrics and Gynecology, IVF Ward, Mirza Kochak-khan Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Email:[email protected]

Introduction: HSG is widely used as a first-line approach to assess uterine anatomy and tubal patency in routine infertility workup. Management of the patients with unilateral tubal blockage diagnosed by HSG is controversial subject. ).Thus we decided to carry out a prospective study to assess success rate of COH and IUI in these patients.

Materials and Methods: Two groups of patients undergoing stimulated IUI cycles were compared. Sixty-four unfertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the study group, and two hundred couples with unexplained infertility in the control group. The patients underwent 3 consecutive ovarian hyperstimulation (Cl miphen citrate and human Menopausal Gonadotropin) and IUI cycles: CPR for 3 consecutive stimulated IUI cycles was the main outcome measure.

Results: Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in the group ? (26.6%) and the group II (28%) (p=0.87; OR=1.075; 95% CI: 0.57-2.28). The CPR in subgroup with mid-distal tubal blockage (16%) was not statistically lower than subgroup with proximal tubal blockage (33%) (p=0.11; OR= 2.625; 95% CI: 0.745-9.25).The CPR in subgroup with mid-distal tubal blockage (16%) was lower than the patients with unexplained infertility (28%), the difference was not statistically significant (p=0.15, OR=2.042; 95% CI: 0.671-6.213).

Conclusion: Unilateral tubal blockage (diagnosed on HSG) has not effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients.

Key words: Hysterosalpingography, Iintrauterine insemination, Ovarian stimulation, Tubal factor infertility, Unilateral tubal blockage.

P-12

A case report of spontaneous pregnancy during hormonal replacement therapy for premature ovarian failure

Ebrahimi M, Akbari Asbagh F, Poormand N.

Department of Obstetrics and Gynecology, IVF Ward, Mirza Kochak-khan Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Premature ovarian failure (POF) is defined by the association of amenorrhea, hypoestrogenism and elevated (menopausal) levels of serum gonadotropins before age of 40 years-old. This condition affects approximately %1 of women under 40 years of age. Physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. Temporary return of ovarian function, as indicated by elevated estrdiol levels, and follicle development may occur in this condition. Spontaneous Pregnancy is a very rare event in the patient with POF. We report a case of POF who conceived spontaneously during hormone replacement therapy.

Materials and Methods: An infertile 30 years-old woman was presented with confirmed premature ovarian failure after pelvic surgery and sever emotional stress( Serum FSH levels in range of 62-135 IU/L, LH levels in range of 34.8-88IU/L, progesterone level 0.3ng/mL, and those of estrdiol less than 10pg/ mL) on hormone replacement therapy, who conceived. She is currently in second trimester (23 weeks) of an uneventful pregnancy.

Results: Despite having ovarian failure and receiving hormone replacement therapy, the patient spontaneously conceived.

Conclusion: Return of ovarian function and achievement of pregnancy is possible in women with premature ovarian failure. Women who wish to avoid pregnancy should use a barrier method or IUD, because hormonal replacement therapy will not prevent conception.

Key words: Premature menopause, Premature ovarian failure, Transient ovarian failure, Hypergonadotropic hypogonadism, Hypergonadotropic ameno.

P-13

Diagnostic accuracy of 4-hour protein in preeclampsia in pregnant women which refered to Alzahra Hospital of Rasht city in 2009

Asghania M, Mirblouk F, Atrkar Roshan Z, Moslehi M.

Department of Obstetrics and Gynecology, Reproductive Health Research Center, Alzahra Hospital,Guilan University of Medical Sciences, Namjo, Rasht, Iran.

Email: [email protected]

Introduction: Preeclampsia is defined as pregnancy related hypertension together with proteinuria. The gold standard method for proteinuria is defined as excretion of more than 300 mg protein in 24-hour urine .One of the disadvantages of the method is its long duration. Considering controversy of various surveys on less than 24-hour urine collection, we intended to study on diagnostic accuracy of 4-hour urine collection in comparison to 24-hour urine collection in diagnosing preeclampsia.

Materials and Methods: This is a prospective cross-sectional study. Study population consists of 84 pregnant women >20 weeks who had new onset BP?140/90. After data collection on age, pregnancy age, the results of last pregnancies, prenatal care history, result of random urine sample protein for screening, and results of 4-hour and 24-hour urine protein, data were analyzed in SPSS 16.

Results: By using ROC curve, the cut point for 4-hour urine protein was 55.5. Sensitivity and specificity of 4-hour urine protein were respectively 85.1% and 83.7%. 4-hour urine protein showed 7 cases of false positive and 6 cases of false negative. The cut-point of 0.20 for 4-hour Pr/Cr and 0.21 for random Pr/Cr also showed good correlation with 24-hour protein.

Conclusion: Although 24-hour urine protein measurement is the most accurate and gold standard method for measurement of proteinuria, probably 4-hour protein collection and also 4-hour Pr to Cr ratio can be used as acceptable substitutes for measurement of proteinuria in preeclamptic patients whenever 24-hour urine collection is not possible.

Key words: Preeclampsia, Proteinuria, Pregnancy.

P-14

Insitu compared with exteriorized uterine repair at cesarean delivery

Sakhavar N, Teimoori B, Mirteimoori M.

Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran.

Email: [email protected]

Introduction: The cesarean rate is very high in Iran, so it is important to decrease cesarean section complications. So we decided to compare the complications of two method of cesarean section delivery (in-situ uterine repair versus exteriorization repair).

Materials and Methods: This study includes 128 women who underwent cesarean delivery under spinal anesthesia and were randomly assigned to two groups based on the site of uterine repair (64 women in each group). Pain, nausea, vomiting, means operative time, means Hb before and after surgery were assessed. Finally we did descriptive and inferential statistics by using SPSS software.

Results: In this study 64 patients randomized for exteriorized uterine repair group and 64 patients randomized for insitu uterine repair group .The mean time of surgery was shorter in women with insitu repair when compared to those with the uterus exteriorized (p=0.012). The severity of pain after surgery was low in women with insitu repair compared to those with the uterine exteriorization (p=0.000). Also the frequency of nausea and vomiting during surgery was low in women with insitu repair compared to those with the uterus exteriorized (p=0.000). There was no statistical difference between two groups in relation to mean hemoglobin level before and after surgery (p=0.898).

Conclusion: In this study, we found significant differences in complications of two techniques for uterine repair in cesarean delivery. So insitu uterine repair in caesarean section is a valid option.

Key words: Cesarean, Insitu uterine repair, Exteriorization repair.

P-15

Screening for cytomegalovirus, herpes simplex virus and mycoplasma genitalium in human placenta

Borhani M1,2, Hosseini M1, Chamani-Tabriz L2,3.

1 Department of Microbiology, Facuty of Biological Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.

3 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: The placenta represents an important barrier between maternal and fetal circulation. Consequently, the placenta is likely to be infected by various infectious agents. Placental infection indicates risk of vertical transmission, but not always transmission to, or disease of the fetus. The aim of this study was to detection of Cytomegalovirus (CMV), Herpes simplex virus (HSV) and Mycoplasma genitalium placental infection.

Materials and Methods: 30 Fresh frozen placenta tissues collected after normal delivery from volunteered women. DNA was extracted from each sample using QIAamp® DNA mini kit (QIAGEN). A monoplex PCR was applied only for the detection of M. genitalium and a multiplex PCR developed in our laboratory for the detection of CMV and HSV.

Results: The percentage of CMV detection in placentas was 6% (2/30), whereas HSV and M.genitalium DNA were not detected in any placental sample.

Conclusion: In this study CMV infection was found commonly in placenta (6%) which is a good reminder on its importance. However, this can indicate most cases of placental infection are not associated with congenital infection but on the other hand, infants with evidence of viral infection who were asymptomatic at birth, may develop symptoms with age and so further studies on these infants is needed. The negative results due to HSV and M.genitalium may relate to the less frequent prevalence of these pathogens or the number of samples.

Key words: Cytomegalovirus, Herpes Simplex Virus, Mycoplasma genitalium, PCR, Placenta.

P-16

The effects of physiotherapeutic TENS in a woman with unexplained infertility

Berjis K1, Salsabili N2, Nakhostin Ansari N2, Sedighi A2, Salsabili H3.

1 Department of Obstetrics and Gynecology, Mirzakouchak-khan Hospital, Tehran Unversity of Medical Sciences, Tehran, Iran.

2 Faculty of Rehabilitation, Tehran Unversity of Medical Sciences, Tehran, Iran.

3 Faculty of Medical Sciences, Tarbiat Modarres Unversity, Tehran, Iran.

Email: [email protected]

Introduction: Unexplained infertility (UI) is a difficult diagnosis in the field of obstetrics and gynaecology.

Materials and Methods: This report describes TENS treatment as an adjunct therapy for a 30-year- old woman with long standing UI who was scheduled to undergo ovarian stimulation for IVF and embryo transfer (ET). She had 3 unsuccessful IUI treatments. Her last IVF treatment was also failed. The treatment consisted of burst-TENS for 7 sessions which was applied daily from second day of induction of ovulation (I.O) to the hCG administration. The Transvaginal Ultrasonography with pulsed Doppler curves was performed to measure the uterine artery impedance indices of Pulsatility Index (PI) and Resistance Index (RI). Before TENS application, on the first day of I.O, the PI and RI for right side uterine artery were 3.96 and 0.96, respectively. For left uterine artery, the PI and RI were 6.92 and 1, respectively. After treatment with TENS, on the day of hCG administration, the PI and RI for right side.

Results: Uterine artery were 3.39 and 0.90, respectively. On the left side, they were PI=2.62 and RI=0.86. IVF was performed and on the day of oocytes collection, 22 oocytes were collected and inseminated. Fertilization was confirmed 16 hours after insemination by visualization of 2 pronuclei. A singleton pregnancy was achieved by the presence of a fetal sac during an ultrasound examination.

Conclusion: It is concluded that the addition of TENS resulted in remarkable reduction of uterine artery PI and RI and a successful pregnancy after IVF for this woman with UI. Future research is warranted to determine the effect of TENS in IVF successful rates for this population.

Key words: Unexplained infertility, Pregnancy, IVF.

P-17

How can we do prevention of recurrent endometriotic disease in rare sites of body?

Rasekh Athar R.

Jahrom Universiry of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity and uterine musculature. The most common site of endometriosis is pelvis, but endometrotic implants may occur nearly anywhere in the body. Endometriosis is a common and serious gynecologic problem in reproductive age women, who have pelvic pain, dyspareunia, or infertility. The goal of this research was employing a surgical procedure to prevent recurrent endometriosis.

Materials and Methods: This clinical research was done during 8 years on 11174 obstetric patients, 3075 cesarean section (27.5 %), that five of them (0.16 %) were complained of moderate to severe pain, occasionally catastrophic pain from the site of incision around menstruation after 6 months to 2 years of her procedures. These patients had referred to some gynecologic center but some sedative drugs were prescribed which no response to medication. Women aged were, 25-35 years, Gravida 1, 2 and one or two previous cesarean section. Endomtriotic tissues had invaded to deep layers of abdominal wall. Involved endometriotic tissues were resected entirely and electrocauterization of throughout surface was done carefully. The data were analyzed by SPSS.

Results: All patients were recovered from severe pain after operation immediately and discharged from hospital the second day. There isn't any complication during and post operation. The patients were followed up about 8-12 years. Fortunately, none of them have had recurrent pain.

Conclusion: Every gynecologist must be in mind this impression (endometriosis), because, it is mistaken to the other causes of pain. Electrocauterization of throughout surface after resection of endometriotic tissues will be suggested for prevention of recurrent disease.

Key words: Recurrent endometriosis, Pain, Elecrocauterization.

P-18

Effect of zinc supplementation on inflammatory markers in women with polycystic ovary syndrome

Sadaghiani M1, Pourteymour fard Tabrizi F2.

1 Infertility Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Nutrition Research Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: The present study was designed to examine the effect of Zinc on inflammatory markers in women with polycystic ovary syndrome (PCOS).

Materials and Methods: In a randomized, double-blind, placebo controlled clinical trial, Sixty patients with Polycystic ovary syndrome were randomly divided into two groups, each group received one of the following daily supplement for eight weeks; group Zn: 50 mg Zn (n=30), group P: Placebo (n=30). Fasting serum zinc levels, inflammatory markers, systolic-and diastolic blood pressure, Anthropometric indices and Nutritional intake were measured at the baseline and the end of 8th week.

Results: Results indicate that after eight weeks of supplementation, Mean of nutritional intake, anthropometric indices, systolic-and diastolic blood pressure did not change in two groups significantly. Also zinc supplementation had significantly effects in increasing serum zinc (p<0.05) and in decreasing serum C-reactive protein (CRP) and Interleukin6 (IL-6) levels (p<0.05). There was no significant change in the levels of these parameters in the placebo group.

Conclusion: The findings of the present study indicated that Zinc supplementation might be concerned as an inexpensive adjunct to treatments in patients with Polycystic ovary syndrome in the hope of reducing cardiovascular disease risk factors, particular inflammation.

Key words: Polycystic ovary syndrome, Zinc, Inflammation.

P-19

Accuracy of urine dipslide to detect asymptomatic bacteriuria in pregnancy

Azhari S1, Moosavi Yazd M2, Sojudi Moghaddam MH3, Ebrahimzade S4.

1 Department of Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.

3 Department of Microbiology, Sabzevar University of Medical Sciences, Sabzevar, Iran.

4 Mashhad University of Medical Sciences, Mashhad, Iran.

Email: [email protected]

Introduction: Asymptomatic bacteriuria is the most common infectious complication of pregnancy. Because of severe maternal and fetal side effects, screening and treatment of infected womens is a part of standard caring in pregnancy. Urine culture was rendered difficult because of needing to laboratory facilities, experienced technicians and expenciveness. There fore, the present research entiteled "accuracy of urine dipslide to detecting asymptomatic bacteriuria in pregnancy" was performed for initiation an accurate, rapid and simple and inexpencive method.

Materials and Methods: This research is an analysis of the laboratory methods. Urine specimen was collected of 1100 pregnant women with gestational age 6 to 35 weeks, without any UTI symptoms or any previous antibiotic supplementation and who refered to shahid Aldaghi health care center in Sabzevar and concurrently urine culture by microbiologist and dipslide by researcher was performed.Dipslides was saving in room temperature for 72 hours and bacterial growth was analyzed every 24 hours. Dipslide results were compared with urine culture every 24 hours. Results via SPSS 11.5 were presented to sensitivity, specificity, positive predictive value and negative predictive value.

Results: Dipslides after 48 hours showed sensitivity 100%, specificity 99/9%, PPV 97/5% and NPV 100%.

Conclusion: Dipslide can be a suitable alternative for standard urine culture for screening asymptomatic bacteriuria.

Key words: Dipslide, Asymptomatic bacteriuria, Pregnancy.

P-20

Laparoscopic hysterectomy

Bina I.

Dena Hospital, Shiraz, Iran.

Email: [email protected]

Introduction: Laparoscopic Hysterectomy (L.H) is a relatively new procedure and an alternative to abdominal hysterectomy (TAH), and can be run in different techniques more over; adhesionolysis, removal of myoma and other pelvic masses can be performed by new techniques and instruments.

Materials and Methods: Since Feb.2007 till Dec. 2010 we scheduled 81 patients for LH, one of them refused for LH and she preferred TAH. 72 patients (42 to 53 years old) were operated. Eight patients had big myoma and one of them had a huge pare ovarian cyst. All of them suffered from A.U.B.

Surgical techniques: By four puncture technique, uterine pedicles were coagulated and cut by bipolar and ligasure. After dissection of bladder and ureters, uterine vessels and vaginal vault were sutured intra corporeally or cut and coagulated with ligasure. In four cases we had to use morcelltor to decrease size of uterus so that it could be delivered vaginally.

Results: There was one case of bladder perforation (0.013%), which repaired laparoscopically and cystoscopy carried out to check ureteral orifices and bladder integrity. Five cases (0.06%) had post op fever which subsided with medications. There was no blood transfusion or other complications. Mean blood loss was 300±200 ml. and mean duration of operation was 1.30±20 minutes.

Pathologic findings:

* Adenomyosis: 27 cases (33%)

* Myoma 41 case (50%)

* Myoma and Adenomyosis 13 cases (17%)

Conclusion: Laparoscopic Hysterectomy is a safe and appropriate route of surgery with good outcomes, if there is no limitation or contraindication, and it encompasses variety of procedures that can be performed by an expert team and good and perfect instruments.

Key words: Hysterectomy, Laparoscopic, Cystoscopy.

P-21

Heterotopic pregnancy following induction of ovulation with clomiphene citrate: A case report

Ghandi S1, Fazel M2.

1 Department of Obstetrics and Gynecology, Sabzevar University of Medical Sciences, Sabzevar, Iran.

2 Sabzevar University of Medical Sciences, Sabzevar, Iran.

Email: [email protected]

Introduction: Altough heterotopic gestation is common in assisted reproductive techniques, it is very rare in natural conception and clomiphene induced pregnancy. Diagnosis and appropriate intervention of heterotopic pregnancy requires a high index of suspicious.

Materials and Methods: A 30 years old woman with a history of early spontaneous abortion conceived after two cycles of ovulation induction with clomiphene citrate. (100mg/day starting on day 5 of the cycle). Her next presentation to the clinic was at 6 weeks of gestation, when abdominal ultrasound scan examination revealed an intrauterine pregnancy of corresponding period of gestation and bilateral cystic lesion measuring 35 mm in both ovaries. She has no history of pelvic inflammatory disease and was asymptomatic except for nausea and vomiting (hyperemesis gravidarum). Eighteen days later she was presented in emergency room with severe acute lower abdominal pain followed by a syncopal attack. On examination she was pallor and there was a generalized abdominal distention and tenderness.

Results: Ultrasound by a sonologist showed a large amount of free fluid in the peritoneal cavity, a viable intrauterine pregnancy with gestational age of 9 w +3d, a 40mm cystic lesion in left ovary, a 38mm cystic lesion in right ovary and a 33 mm heterogenous mass in relation to the left adnexae . Her hemoglobin was 10 gm/dl, and coagulation parameters were normal. On expolatory laparotomy there were approximately 1.5 liter of hemoperitoneum and a ruptured left tubal pregnancy. The uterus was of 8-9weeks size. Left salpingectomy was performed. Pathological examination confirmed a ruptured left tubal pregnancy. A repeat ultrasound scan on the third postoperative day showed a viable intrauterine pregnancy. The pregnancy was followed up till term and ended by cesarean delivery with a healthy baby girl.

Conclusion: Physicians should have a high suspicion of heterotopic pregnancy in women conceive after using ovulation inducing agents.

Key words: Pregnancy, Clomiphene citrate, Ovulation.

P-22

Evaluation of soluble gp130 and its relationship with autoantibodies, individual, psychological, environmental, laboratory and lifestyle parameters in recurrent miscarriage patients

Bagheri K.

Department of Immunology, Faculty of Medicine, Islamic Azad University, Kazerun Branch, Kazerun, Iran.

Email: [email protected]

Introduction: This study was performed to evaluate soluble glyeoprotein-130 (sgp130) concentration and its relationship with other parameters which might have a role in some abortions.

Materials and Methods: Sgp130 level along with 50 variables was evaluated in women with at least three previous abortions and women with natural childbirth.

Results: Although there were no significant differences in sociodemographics, routine blood parameters, physical activity, educational level, dietary habits, smoking or alcohol consumption between miscarriage-patients and control women, but higher post-abortion antinuclear-antibody (ANA) and depression level, lower post-abortion level of sgp130 together with higher gestational glucose-challenge-test (GCT) value was observed in patients. A positive significant correlation was found between the number of abortions and parameters such as age, partial-thromboplastin-time (PTT), C-reactive-protein (CRP) and rheumatoid-factor (RF) in patient groups. Surprising that, the association between abortion histories and depression in miscarriage-patients become not significant after controlling for age. Further investigation showed that only in patients, sgp130 level had an independent inverse correlation with level of anti-annexin-V antibodies (Anti-AV) and depression score. There was also a significant association between anti-double-stranded-DNA-antibody (anti-dsDNA) or RF level and depression in miscarriage-patients. Our results do not support any association between patient's sgp130 level and sociodemographic parameters, health-related habits (like tobacco-alcohol consumption, physical activity, dietary habits, hair products, deodorant or air-freshener, pesticide or insecticide poisons, contraceptive pills) and the number of abortions. None of studied blood parameters in miscarriage-patients such as the level of autoantibodies (ANA, anti-dsDNA, Anti-laminin, anti-Cardiolipin-antibody and lupus-anticoagulants), coagulation parameters (Protein-S, Protein-C, antithrombin-activity, PTT, activated-protein-C-resistance prothrombin-time-INR), homocysteine level, GCT, FBS, CRP and RF was correlated with sgp130 level.

Conclusion: We conclude that after several miscarriages, post-gestational level of sgp130 or ANA along with depression status may be different with control women. Further studies are required to justify inverse correlation between sgp130 and anti-AV or depression in miscarriage-patients.

Key words: Soluble gp130, ANA, Recurrent miscarriage, Depression, Anti-annexin-V antibodies.

P-23

Comparing outcome of recombinant human chorionic gonadotropin (rhCG) and urinary hCG for oocyte maturation of poor responders undergoing IVF/ICSI

Madani T, Jahangiri N, khodabakhshi SH.

1 Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: In this study, we compare the effect of 250 mg and 500 mg of recombinant hCG with 10,000 IU of urinary hCG on IVF/ICSI outcome of patients with poor ovarian response.

Materials and Methods: In this retrospective study, the data of 507 poor ovarian response patients referred to Royan Institute during 2008 -2009 were analyzed. Women who received 250 mg of recombinant hCG SC, 500 mg of recombinant hCG SC, or 10,000U urinary hCG IM after completing gonadotropin stimulation were compared. Numbers of retrieved and MII oocytes, number of embryos transferred, implantation and pregnancy rates were the main outcome measures.

Results: There were no statistical differences in mean numbers of retrieved oocytes, MII oocytes and embryos transferred between three groups. Chemical pregnancy, clinical pregnancy and implantation rates were significantly higher with 500 mg of recombinant hCG than with the lower dose and urinary hCG.

Conclusion: Recombinant hCG (500 µg) seems to be better than Recombinant hCG (250 µg) or urinary hCG (1000 IU) for inhancing the pregnancy and implantation rates in poor responders undergoing IVF/ICSI.

Key words: Recombinant human chorionic gonadotropin, Urinary human chorionic gonadotropin, Assisted reproduction technology, Oocyte maturation, IVF/ICSI.

P-24

High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome

Davari-Tanha F1, Hemati T1, Moghadami-Tabrizi N1, Salmanian B2, Javadian P2.

1 Department of Obstetrics and Gynecology, Mirza Kouchak-Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Polycystic ovarian syndrome (PCOS) is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome. This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients.

Materials and Methods: This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normoovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) plasma levels in the blood sample of the 3rd day of their menstrual cycle. Insulin resistance was determined with the fasting glucose (mmol/L) to insulin (mIU/L) ratio and HOMA-IR. Independent-samples T test and linear regression test were utilized to analyze the obtained data.

Results: Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant (IR) (LogHOMA-IR?0.57) and non insulin resistant (NIR) patients. The IR group had significantly higher homocysteine (p value=0.02), fasting insulin and glucose levels (p-value<0.001) rather than NIR group.

Conclusion: PCOS patients have a leaning toward hyperhomocysteinaemia regardless of insulin resistance. Regarding resistance indices, insulin resistance is also common in them. There is an association found between insulin resistance and hyperhomocysteinaemia in PCOS patients.

Key words: PCOS, Homocysteine, Insulin resistance, PCOS, Insulin resistance (IR).

P-25

Role of anti-mullerian hormone in prediction of assisted reproductive technology outcomes

Safdarian L, Khosravi KH, Agha Hosseini M, Aleyasin A, Sarvi F, Fallahi P.

Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Anti-Mullerian hormone (AMH) has been suggested as a marker of ovarian reserve and predictor of ovarian response to controlled ovarian hyper stimulation. The aim of this study is to determine the role of AMH in prediction of success ART cycles in patients with normal FSH serum levels.

Materials and Methods: This prospective cohort study included 80 infertile women under 4o years, who candidates for assisted reproductive technique during October 2009 to September 2010. Serum AMH levels on cycle day 3 were measured and all the patients underwent controlled ovarian hyper stimulation and ART. The relationship between serum AMH and ART outcomes, including oocytes number, matured oocytes, fertilization rate, implantation rate, high quality embryo, free zed embryo and biochemical and clinical pregnancy rates were evaluated. Cut-off for level of AMH in this level pregnancy is high, determined.

Results: Serum basal AMH levels showed positive correlation with number of oocytes retrieved, mature oocytes, number of embryos transferred and biochemical and clinical pregnancy. Cut-off for serum AMH with and without clinical pregnancy was 3.9.

Conclusion: This study showed that in pregnant women undergoing ART, AMH serum levels were higher than non pregnant women.

Key words: Anti-Mullerian hormone, Assisted reproductive technology, Outcomes, Follicle stimulating factor.

P-26

Evaluation of 17 alpha hydroxy progesterone prevention of preterm labor

Nanbakhsh F, Broomand F, Afsoon Y, Hosseini Z, Aghlmand S, Mazloomi P.

Department of Obstetrics and Gynecology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

Email: [email protected]

Introduction: Preterm labor is defined to delivery before 37 weeks of pregnancy. Diagnostic signs and symptoms include crampy pain dilatation higher than 2 cm and efasman higher than 80%. Despite interventions such as administration of antibiotic and Tocolytic agents and severe repeated care before of delivery, preterm labor has remained inconclusive. Recently, some studies have shown that progesterone and its derivatives play an important role in prevention of preterm labor.

Materials and Methods: In this study, only pregnant women by the age between 26-35 weeks of their pregnancy and labor (preterm labor) to look to Kosar Women's Center and Tocolytic therapy for 36-48 hours is began and labor in this group be inhibit . After 48 hours for patients intervention group, 250 mg 17 alpha hydroxy progesterone and for control group distilled water are injected intramuscular weekly. Weekly intramuscular injection until 35 weeks of pregnancy is done. This study is double blind. Patients in both groups are received progesterone and distilled water weekly. Injection by clinics midwives or is done by gynecology residents.

Results: Intervention period until the start of labor groups treated with 17 alpha hydroxy progesterone longer than the placebo group was treated, this association was statistically significant (P value = 0.0001(. Beginning of the intervention period compared to delivery based on cervical dilatation and efasman group treated with 17 alpha hydroxy progesterone as active treatment groups of placebo was statistically significant (p-value = 0.001) and (p-value=0.000 . ( Comparison of neonatal outcomes between the intervention group and placebo group from 5 minute Apgar score was significant (p-value=0.03 (. Comparison of birth weight between the two groups was not statistically significant (p-value=0.07). Comparison of length of hospitalization in the N ICU was not statistically significant. (p-value = 0.46).

Conclusion: Treatmen of the pregnant patients with 17 alpha hydroxy progesterone can cause delays to the progress of labor .

Key words: 17 Alpha hydroxy progesterone, Preterm labor, Threatened preterm labor, Delivery development, Preventive effect of labor progress.

P-27

Predicting factors for success of oocyte donation

Nikpuri Z1, Mehrafza M1, Vojudi E1, Asgharnia M2, Abdollahiyan P1, Mohammad Tabar Z1, Shademani K1, Shakiba M1, Malmasi S1.

1 Mehr Research and Medical Institute, Rasht, Iran.

2 Azad Islamic University, Rasht, Iran.

Email: [email protected]

Introduction: There are many factors related to the successful embryo implantation. This study investigated factors that may affect the clinical outcome of oocyte donation cycles.

Materials and Methods: In this cross sectional study, Outcome parameters including age of oocyte recipient and donor, infertility duration, BMI, gravidity, abortion, endometrial thickness, hormonal profile of the recipients, the number of oocytes and clinical pregnancy were retrieved from 131 patient's records referring to Mehr infertility institute.

Results: In this study, clinical pregnancy rate was 36.6% per cycle and 41.4% per patient. The mean age of recipients with successful pregnancy was significantly lower than those without pregnancy (40.27 versus 43.25). There was also a significant difference in pregnancy rate between the group with <15 years infertility duration and >15 years (46.6% versus 24.6%). Using logistic regression analysis the number of transferred embryo was significantly associated with success of pregnancy adjusted for age, LH and FSH level, gravidity history of donor and recipient, endometrial thickness, BMI and infertility duration of recipients.

Conclusion: This study revealed that the number of embryos transferred is the most important predictive factor for success of pregnancy. Identifying the predictive factors for successful pregnancy is helpful for physician to choose better approach for oocyte donation cycles so further study with larger sample size in a prospective methodology is recommended.

Key words: Oocyte donation, Pregnancy, Predicting factors.

P-28

A successful pregnancy in a patient with advanced chronic renal insufficiency

Saghafi H1, Abbasi M2, Mehran N2.

1 Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.

2 Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran.

Email: [email protected]

Introduction: In the women with chronic renal insufficiency, ovulation is suppressed, so they rarely become pregnant. If pregnancy occures, they will encounter with many dangers, even death of fetus or mother .The aim of this study is reporting of a successful pregnancy in a patient with advanced chronic renal insufficiency.

Materials and Methods: The patient was a 32 years old woman with 8 years of infertility.The first chief complaint was abdominal pain especially in hypogastric area and azothemia. Sonography findings showed asymmetrical small kidneys. In laboratory testes; the plasma Creatinin was 2.9 mg/dl, mild proteinuria and hematuria. The urine specific gravity was 1010. Other compliants were pruritus and flank pain during voiding. The patient was evaluated and fallowed with diagnosis of chronic renal failure due to probable chronic pyelonephritis.

Results: At once, she referred with positive pregnancy test. After explaining of hazards and also probability of having a successful pregnancy for her and her husband, they decided to continue to pregnancy, in despite of her obstetrician and urologist suggestion for aborting. During pregnancy, proteinuria reach to ++ occasionally. Her hemoglobin fell to 9.7 and blood pressure fluctuated between 110/80 and 130/85 mm hg. Her creatinin reach 3.7 mg/dl in this period. She admitted in hospital at 7th month because of preterm labor. But with beginning of magnesium sulfate infusion, her pain was suppressed. Finally, in 35th week of pregnancy, while plasma creatinin reach 3/2 mg/dl and dexamethasone was begun, she refered to obstetrician for termination of pregnancy as cesarean delivery. Fortunately, both of the mother and newborn were healthy and well and pregnancy was terminated succesfully.

Conclusion: With the point of impossibility of pregnancy and or poor outcomes of pregnancy in these patients, it is possible to have a safe and good pregnancy if the pregnant woman be under supervision of a nephrologist and obstetrician throughout the pregnancy.

Key words: Chronic renal insufficiency, Successful pregnancy.

P-29

Frequency of uterine fibroma and associated factors in women undergone hysterectomy in Alzahra Hospital, Rasht, 2008-2009

Asgharnia M, Faraji R, Karimi M.

Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran.

Email: [email protected]

Introduction: Liomyoma is the most frequent benign tumors of pelvic and it is the most common cause of women's major surgery after C/S, hysterectomy and uterine surgery. The aim of this investigation is evaluation of frequency of fibroma and associated risk factors in patients undergoing hysterectomy.

Materials and Methods: In this consecuative descriptive study all hysterectomy except cesarean section patients in 2008 to 2009 was included. According to types of variables all data collected and analyzed with T. test, chi- square and spss ver.17.

Results: 266 patients with hysterectomy rolled in this study. 152 cases (56.9%) had fibroma. The mean age of patients with fibroma was less than patients without fibroma (p=0.002); from 32 patients with positive history of infertility, 29 cases (90.6%) had fibroma and 3 cases (9.4%) had no fibroma, which was statistically significant (p=0.0001). 69 patients had positive history of HTN, 68.1% had fibroma and 31.9% had no fibroma, this difference was statistically significant (p=0.034). 23 cases used OCP in that 4 cases (17.4%) had fibroma, this difference was statistically significant (p=0.0001). Sonograghy reported fibroma in 156 cases, in 144 cases it was confirmed by pathologic samples. As statistically analysis showed sensitivity of sonography in finding fibroma was 94.7% and specificity was 87.7%.

Conclusion: Regarding to our finding, with increasing age prevalence of fibroma declines and OCP has a protective effect. Moreover, HTN and low parity have a positive impact on fibroma formation.

Key words: Hysterectomy, Fibroma, HTN, OCP, Infertility history.

P-30

The effect of local injury to endometrium on pregnancy rate in ICSI: a randomized controlled trial

Mehrafza M1, Asgharnia M2, Abdollahiyan P1, Oudi M1, Nikpuri Z1, Mohammad Tabar Z1, Shademani K1, Hossieni A1,3, Shakiba M1, Vojudi E1.

1 Mehr Infertility Institute, Rasht, Iran.

2 Azad Islamic University, Rasht, Iran.

3 Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Local injury to the endometrium prior to controlled ovarian stimulation may considerably improve implantation and pregnancy rate in intracytoplasmic sperm injection patients. This study aimed to determine the effect of endometrial injury on uterine receptivity.

Materials and Methods: In this randomized clinical trial study, all women undergoing ICSI cycle in Mehr infertility institute were randomly assigned to either case or control group. Local injury to the endometrium by endometrial biopsies was performed for case group on days 20-21 of menstrual cycle before the ICSI cycle and then implantation and pregnancy rate were compared in the two groups.

Results: During this period, 110 patients (55 cases per groups) were analyzed. Overall pregnancy rate reported in 41/110 cycles (37.3%). There were not statistically significant difference between case and control group regarding the mean age of women, duration and cause of infertility, sperm parameters, FSH and estradiol on the 3rd day of menstrual cycle, mean number of oocyte retrieval, MII, cleaved, ET and PR (p>0.05). Multiple logistic regressions showed significant effect of LH levels on the outcome of ICSI (p>0.05).

Conclusion: One time Local injury to endometrium of ICSI patients doesn't increase the incidence of pregnancy rate. Further studies with multiple local injuries at different times are recommended.

Key words: Pregnancy rate, ICSI, Local injury, Endometrial biopsy.

P-31

Muslim infertile couple's acceptability of donation programs: a qualitative study

Ezabadi Z, Alizadeh L, Omani Samani R.

Department of Epidemiology and Reproductive Health, Reproductive Medicine Research Center, Royan Institute, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: Iran is the only Muslim country in which gamete and embryo donation is practiced. Although embryo donation is accepted by law and gamete donation by clergy leaders, there are difficulties in acceptability of these procedures by this nation. As the culture changes by the time, this study was done to determine opinions and attitudes of infertile couples undergoing assisted reproductive techniques.

Materials and Methods: It was a qualitative study on 10 infertile couples that referred to assisted reproduction clinic for the first time. Deep interviews were done with husband and wife separately. First an explanation of treatment methods and donation programs were presented and they were assured that this is not related to their treatment and no personal data will be published. The questions were open and general preventing any bias in gathering the ideas. Our focus was their idea about donation, acceptability plus their reasons, their information about law or religious acceptability, their idea about parent-child relation and children rights and welfare.

Results: Sperm donation: 4 couples totally against (con), 3 agreeing (pro) and in 2 couples there were difference between husband and wife (pro and con) and one couple couldn't give a certain idea. 3 of 4 con couples had male factor infertility. From 10 women, 5 were con mostly because they only accept children from their husbands or had doubt about religious acceptability. Among other 5 women, 3 of them agreed if there is no other way to have a child, one accepted just to prevent breaking up the family and just one of them was totally pro. Among the men, 5 were con due to religious reasons (2), bad feeling (1) and remaining two had concern about the resulting child feeling and lineage. All of the men were pessimistic to sperm donation and their acceptations were reluctance.

Egg donation: only 3 couples were pro and in remaining 7 couples there were difference between husband and wife. In women, 8 were pro from which 6 accept when there is no other way, one preferred egg from close relatives and one freely accepted. No one of two con women presented a reason for their opposition. Among males 3 were con from which two didn't have any reason and one had religious concern. From 7 pro, 3 men freely accepted which one of them pointed to polygamy which is permited in Islam, and remaining 4 accepted in necessity.

Embryo donation: 3 couples were pro and in remaining 7 there were difference between man and wife. Among women, 3 were pro from which one preferred adoption and other two had bad feeling about it. 5 pro women accepted if there is no other way, one accepted but had concern about future claims from the parents of the embryo and the last one could accept if she knew the donors perfectly. Among men 3 were con with religious and future claims concerns. From 7 pro, 4 men accepted freely but among them one preferred gamete 50% of child's genes comes from one parent. Remaining 3 accepted as the last way to have a child.

Conclusion: Acceptability of gamete and embryo donation among Muslim people of Iran is significant mostly when necessary with no relation to the cause of infertility.

Key words: Attitude, Infertile, Donation, Egg, Sperm, Embryo.

P-32

GnRH agonist versus HCG to trigger ovulation in PCOS women: a retrospective comparison of two different protocols in assisted reproductive technique cycles

Nasiri R1, Mansuri Turshiz M2, Oskuian H1, Khalilifar H2, Fadavi Eslam M2, Mahbub S2.

1 Department of Obstetrics and Gynecology, Aria Hospital, Islamic Azad University of Medical Sciences, Mashhad Brunch, Mashhad, Iran.

2 Novin Fertility and Infertility Center, Mashhad, Iran.

Email: [email protected]

Introduction: Ovarian hyperstimulation syndrome (OHSS) remains a major complication of IVF. Triggering of final oocyte maturation with gonadotrophin-releasing hormone agonist (GnRH) in GnRH antagonist protocols has previously been shown to prevent (OHSS), but at the same time a detrimental effect on clinical outcome parameters was usually reported. In this study, we compared OHSS, fertilization, implantation and pregnancy rates in cycles triggered for final oocyte maturation with either human chorionic gonadotropin (hCG) or gonadotropin releasing hormone (GnRH) agonist in PCOS women undergoing two different protocols.

Materials and Methods: this study was a retrospective study. One hundred and ninety eight consecutive PCOS women admitted to the IVF unit during a 3-year period. GnRH-antagonist protocol triggered with GnRH agonist (Buserelin 2 mg) in 93 patients (antagonist-agonist group) compared with long GnRH-agonist protocol (agonist-HCG group) in 105 patients. The primary outcome measure was incidence of (OHSS). Secondary outcome measures were fertilization, implantation, and pregnancy rates in both groups.

Results: There was no statistically significant difference in the number of oocytes retrieved (21 vs 19), proportion of M2 oocytes, number of embryos (13 vs. 10), fertilization and implantation rate between antagonist-agonist group compared with agonist-HCG group respectively. None of the patients in the antagonist-agonist group developed moderate and severe (OHSS) compared with 16% of patients in the agonist-HCG group. Total duration of stimulation (9.44 vs. 10.13 p=0.000) and the number of FSH ampoules used (14.22 vs 17.74 p=0.000) were significantly lower in the antagonist-agonist group. Endometrial thickness, chemical pregnancy rate (33.8% vs. 50.6% p=0.036) and clinical pregnancy rate (21.8% vs. 48% p=0.00.1) were significantly lower in antagonist-agonist group.

Conclusion: The use of flexible multidose GnRHantagonist protocol with GnRH-agonist for final oocyte maturation, in PCOS patients, eliminates the risk of OHSS but results in decreased pregnancy rates in fresh embryo ART cycles. Before confirming this conclusion more research about luteal phase rescue after GnRH agonist triggering is needed.

Key words: OHSS, Fertilization, Implantation.

P-33

Induction ovulation in polycystic ovary patient with clomiphene citrate and letrozole

Keikha F, Shahraki Mojahed B.

Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran.

Email: [email protected]

Introduction: Chomiphene citrate (clomid, serophene) has been the first line intervention for medical induction of ovulation in PCOS patients. Unfortunately, the antiestrogenic effects of clomiphene citrate at the level of endometrium or the cervix (decrease mucous of cervix and decrease in endometerial layer) and increase multiform gestation may have adverse effects on fertility in a minority of individuals. Letrozole has the effects of increase cervical mucous, increase endometerial layer and decrease multifetal gestation.

Materials and Methods: In this clinical trial 116 infertile patients with PCOS received either 100mg clomiphene citrate (n=58) or 5mg letrozole (n=58) daily since day 3-7 of their menstrual cycle. Then the size, number and growth rate of follicles, endometrial thickness and pregnancy rate were measured in both groups and analyzed with t-test and fisher test and k square test.

Results: In clomiphene group: 49 women showed negative β hCG and 3 women showed positive β hCG and in leterozole group: 34 women showed negative β hCG and 11 women showed positive β hcG (p=0.018). Endometrial thickness in the letrozole group was 8.60 mm and in the clomiphene group it was 7.96 mm (p=0.196). The follicle diameter > 35 mm in the clomiphene group was seen in 7 women and in the leterozole group in none (p=0.014). The follicle diameter > 18mm in the clomiphene group was seen in 18 women and in the leterozole group in 22 women (p=0.154).

Conclusion: The number and the size of mature follicles were significantly more in the clomiphene group. The pregnancy rate in letrozole group was higher than that in the clomiphene group and the difference was significant statistically. Nonsignificant difference was detected in endometrial thickness between two groups. This Study found superiority in letrozole for inducing pregnancy in women. Letrozole might be an acceptable alternative to clomiphene citrate to induce ovulation and pregnancy in PCOS patients.

Key words: Clomiphen, Letrozole, Polycystic Ovary.

P-34

A successful intrauterine pregnancy in a patient with bilateral fallopian tubes occlusion, a case report

Moradan S.

Department of Obstetrics and Gynecology, Amir University Hospital, Semnan University of Medical Sciences, Semnan, Iran.

Email: [email protected]

Introduction: A 23 years old woman with history of infertility for 4 years duration was referred.

Materials and Methods: Infertility workup consists of hormonal evaluation, sonography, sperm analysis and hysterosalpingography were performed.

Results: Sonography and bilateral uterine tubes occlusion in hysterosalpingography were present. The patient undergone ovulation induction with clomiphene citrate, letrozole and HMG about 8 cycles before but pregnancy did not happen. Diagnostic laparoscopy for infertility evaluation was done. In laparoscopy the uterus was normal; there was no adhesion or endometrioses lesion in pelvic cavity. Ovaries had PCOD pattern. So, cauterizations of every ovary in 4 points were done. Then the patency of both tubes was evaluated by methylene blue dye injection. But even with several times try and more dye there was no spillage of dye from any tubes. So, the operation was finished and use of assisted reproductive technology for pregnancy was recommended to the patient. One month later, the patient referred with history of 3 days retard in her menstruation date and the pregnancy test was positive .ten days later there was normal 7 week gestational sac inside the uterine cavity with fetal heart beat. She had an uneventful pregnancy and cesarean section was performed in 40w+3d and a boy newborn with Apgar score 9 was delivered.

Conclusion: This case is noticeable because in both hysterosalpingography and laparoscopy there was bilateral uterine tubes occlusion but the patient had normal pregnancy.

Key words: Uterine tubes occlusion, Laparoscopy, Hysterosalpingography.

P-35

Comparison study on effect of intra muscular petidin injection against intra venues patient control analgesia (PCA) on women who had elective cesarean in Sepahan shahr Hospital, Isfahan, 1389

Ghahiri A1, Ghasemi M2, Fereidoni F1.

1 Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Midwife Ward, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Email: [email protected]

Introduction: Cesarean is one of the most common surgeries. Pain is one of it`s side effect which bothers mothers. Opioids are the most common pain relief which used as intra muscular, intra venues, sub cotaneous or new methods such as patient control analgesia (PCA). As it is new method, research decided to compare efficacy of these 2 methods.

Materials and Methods: This is a prospective clinical trial study which has done on primi parous with full term, single pregnancy who was candidate for elective cesarean in Sepahan shahr hospital of Isfahan in 2010. Excluding criteria was using another drugs, essential disease, not to permit, dizziness; coma .number of cases was 44 in each group which had been selected simple. In recovery and surgery ward patients were evaluated about vital signs- drugs side effects. Pain score evaluated by visual analog scale (VAS) by patients. Satisfaction of pain relief asked from patients.

Results: Petidin was significantly more effective for pain relief than PCA in 1, 8, 12 hours after surgery (p<0.05). Mean of pain was less in 2, 4 hours after surgery in petidin group than PCA but not significant. Total petidin was more effective than PCA for pain relief (p<0.02).

Conclusion: This study showed although PCA is new method for pain relief but it doesn't have efficacy such as old methods like intra muscular petidine. Also patient`s satisfaction was less in PCA method, because of expensive and it`s side effect such as nausea and vomiting.

Key words: Cesarean- PCA-IM petidine.

P-36

Peritoneal tuberclosis mimicking ovarian cancer in three patients

Karimi Zarchi M1, Taghipor SH2, Teimuri S3, Nemati A3.

1 Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2 Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

3 Faculty of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran.

Email: [email protected]

Introduction: Pritoneal toberclusis is a rare disease that mimik ovarian malignancy and consist of 3.3% of cases of exterapolmonary tuberclosis (TB). Clinical mainifastion of pritoneal TB resemble ovarian cancer and may cause gynecologist mistaked and performance of unnesessary extend surgery.

Materials and Methods: We describe three patients with complete physical examination, medical and family history, routin biochemical test and level of CA-125, chest X-rey and abdominal ultrasonography with symptoms of abdominal pain, ascitis, weith loss who reffred to Shahid Sadoghy Hospital.

Results: Three patiente with peritoneal tuberclusis mimicking ovarian cancer were encountered. All of the patiente had abdominal pain, elevated serum CA125 higher than 1000 u/ml and one of them had fever and severe ascitis. Laparoscopy in one patient and laparotomy in two patients revealed peritoneal TB and no malignancy. All of the patients treated with quadruple anti -TB drugs and were followed up for 6 month.

Conclusion: Ascitis, high level of Ca125 without large ovarian masses help us to diagnosis peritoneal TB. The diagnosis of TB and ovarian carcinoma is very difficult.

Key words: Pritoneal toberclusis, Ovarian, Cancer.

P-37

Fertility preservation in young women with malignant endometrial disorders

Karimi Zarchi M, Mousavi A, Behtash N, Chiti A.

Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Email:[email protected]

Introduction: Although endometrial cancer is primarily a postmenopausal disease, 25% of patients are at pre menopausal age with 3-5% of them being 40 years old or younger. The younger groups of women with endometrial carcinoma are frequently nulligravid with a history of infertility and strong desire to preserve fertility, which may pose a therapeutic dilemma for both patients and physicians. We reported three young women with atypical complex hyperplasia or early stage endometrial cancer that treated with conservative hormonal therapy.

Materials and Methods: The medical therapy has been proposed for young women with endometrial cancer (grade I) who wish to preserve their fertility. However, detailed evaluation including: physical examination, history taking, performing D and C, and examining the specimen by a skilled pathologist.

Results: Also in patients at stage I grade I, advisory sessions on benefits and side effects of the high dose of progesterone with evaluation of the endometrium every three months until the total regression is recommended.

Conclusion: Using imaging techniques especially Contrast Enhanced MRI and for some patients explorative laparoscopy with sampling of peritoneal and lymph nodes and evaluation of adenexa is necessary.

Key words: Endometrial cancer, Conservative management, Infertility.

P-38

The preliminary report on comparison of 1/2 and 1/3 dose GnRH-a on fertility outcomes in patient with ICSI

Mehrafza M, Vojudi E, Rahimian T, Asgharnia M, Abdollahiyan Z, Nikpuri P, Mohammad Tabar Z, Shademani K, Nasrollazadeh M, Malmasi S.

Mehr Research and Medical Institute, Rasht, Guilan, Iran.

Email: [email protected]

Introduction: Using GnRH agonist prevents premature luteinizing hormone surge but can also be accompanied with lack of ovarian response. In this double-blind, randomized clinical trial we compared the result of using half-dose (1.875 µg/ml) against 1/3 dose (1.25 µg/ml) of GnRH-a on outcomes in infertile patients undergoing ICSI-ET.

Materials and Methods: A total of 300 patients randomly allocated to two groups receiving 1/2 dose (group A, n=150) or 1/3 dose (group B, n=150) of CnRH-a. Down regulation by GnRH-a was done on day 20 of cycles and HMG was administered on the 3rd day of next cycle. Two to four embryos were transferred and the outcomes were compared.

Results: Up to now, 167 embryo transfer was down (group A=90, group B=77). The mean (standard deviation) of mature oocyte were 10.07 (6.15) and 8.59 (5.69) in group A and B, respectively. There were 4 cases of OHSS in each group and two cases of no egg in group B, whom their cycles were canceled. The chemical pregnancy rate were 55.8% (48 out of 86) in group A and 57.7% (41 out of 71) in group B (p=0.81). Forty one percent in group A and 51.4% in group B had clinical pregnancy that was not statistically significant. The preliminary report of current study revealed that there are no differences in clinical or chemical pregnancy rate, endometrial thickness, number of injected HMG, number of oocyte and OHSS in patients receiving 1/2 and 1/3 GnRH agonist.

Conclusion: Using low dose of GnRH-a for ovarian stimulation are suggested. This research need to be completed to confirm the findings.

Key words: GnRH agonist, Human Menopausal Gonadotrophin, OHSS.

2- Embryology, Genetic, Stem cell

P-39

Does maternal age have any effect on the rates of fertilization and embryo development in ICSI cycles?

Halvaei I, Khalili MA, Soleimani M, Razi MH.

Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Email: [email protected]

Introduction: Many factors may affect ICSI outcome, and one of the interesting and important issue for research is to predict this achievement. Besides, it is worthwhile to do this prognosis with invasive tools and one of these invasive tools is maternal age. So, this study was designed to evaluate the role of women's age on rates of fertilization and embryo development in ICSI cycles.

Materials and Methods: In this prospective study, we evaluated the age of 80 patients on the rates of fertilization and embryo development in ICSI cycles. The women aged between 21-42 years old (mean 32.6±5.3). After ICSI, we divided the oocytes into two groups of fertilized and unfertilized, and the maternal age was compared between two groups. Also, female age was compared between groups of good and bad quality embryos and early and late cleaved embryos.

Results: There was no significant difference for women age between fertilized and unfertilized groups, 32.3±0.3 and 32.9±0.4, respectively. Also, no significant difference was noticed for maternal age between groups of early and late cleaved embryos (32.2±0.3 and 32.8±0.6, respectively). But, we found significant differences between maternal age in groups of good and bad quality embryos (31.8±0.3 and 33.3±0.5, respectively, p= 0.016).

Conclusion: Maternal age may be effective on formation of good embryo development, but has no effect on rates of fertilization and embryo cleavage.

Key words: Fertilization, ICSI, Embryo.

P-40

The effect of hydroalcoholic extract of phoenix dactylifera meristem on serum hormones testosterone, estradiol and gonadotropin in male rat

Dokhanchi M1, Karimi Jashni H2.

1 Development of Biology, Islamic Azad University, Jahrom Branch, Jahrom, Iran.

2 Department of Anatomy, Medical University of Jahrom, Jahrom Branch, Jahrom, Iran.

Email: [email protected]

Introduction: Meristem of phoenix dectylifera has been considered as a nutritional resource to strength the sexual ability among people who lives south of country. This study investigated the effect of phoenix dactylifera extract on serum level testosterone, estradiol and gonadotropin hormones in the male rat .

Materials and Methods: In this research, 96 wistar male rats were divided into 8 groups that including 12 rats. Control group received no treatment, the distilled water group received 1cc. distilled water (extract dissolvent) and experimental groups received respectively 25, 50, 100, 150, 200, 250 mg/kg of phoenix dactylifera orally for 28 days. The results were analysed by using SPSS software and one-way analysis-test.

Results: The results showed that serum level of testosterone and estradiol in the experimental groups receiving the phoenix dactylifera extract, compared to the control and distilled water groups decreased significantly (p<0.05). Serum level of gonadotropin hormones (LH, FSH) in experimental groups compared to the control group is not significant .

Conclusion: The results showed that the phoenix dactylifera extract phytosterol, probably due to reducing cholesterol and its anti-androgen effect, is reducing the testosterone and estradiol hormones but has no effect on gonadotropin .

Key words: Phoenix dactylifera, Meristem, Testosterone, Estradiol, Gonadotropin.

P-41

Effect of plant tribulus terrestris extract on sperm parameter of male rats.

Malekzade Shiravani S1, Karimi Jashni H2, Hoshmand F3, Haghshenas Emami R1, Baghery M4.

1 Department of Biology, Islamic Azad University, Jahrom Branch, Jahrom, Iran.

2 Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

3 Department of Pathology, Jahrom University of Medical Science, Jahrom, Iran.

4 Stem Cell and Transgenic Technology Research Center, Jahrom, Iran.

Email: [email protected]

Introduction: The aim of the current study is to investigate the influence of Tribulus terrestris extract on sexual hormone in male rats.

Materials and Methods: Thirty-five sexually mature male wistar rats were randomly divided into five groups of seven each. Group I served as a control group and group II as a vehicle group (saline normal, 2.5 ml) and groups III, IV and V were treated with three different doses of TT extract (2.5, 5 and 10 mg/kg body weight, respectively), orally, once daily for 8 weeks.The experimental groups were named TT2.5 and TT5and TT10, respectively.

Results: There was significant difference between Tribulus terrestris and controls in the sperm count, morghology and motility at P≤0.05 level.

Conclusion: These results indicate that the Tribulus terrestris influence on above parameter sperm then could the positive effect on treatment of male infertility.

Key words: Tribulus terrestris, Sperm count, Morphology, motility, Male rat.

P-42

Paraoxonase 3 activity and the ratio of antioxidant/peroxidation in the follicular fluid of infertile women

Farzadi L, Gasemzadeh A, Shahnazi V, Khaje E, Rashidi MR, Nouri M.

Infertility Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: According to the recent studies, the paraoxonase 3 (PON3) activities in the follicular fluid is three times more than its activity in the serum. However, the detailed role of PON3 in the ovary function still remains unknown. In the present study, the PON3 activity and the ratio of antioxidant/peroxidation in the follicular fluid in the infertile and fertile women during stimulating cycles in assisted reproductive technique (ART) have been investigated.

Materials and Methods: The follicular fluid was extracted from 50 infertile couples under ART treatment. PON3 activity, ratio of high density lipoprotein, antioxidant capacity and the level of malondialdehyde (MDA), as a marker of lipid peroxidation, were determined using HPLC, sedimentation technique, ELISA method and thio barbitoric acid procedure, respectively.

Results: Of 50 women, there were 20 infertile and the remaining 30 were fertile. The ratio of PON3 activity in follicular fluid of infertile women in comparison with the fertile women was significantly low (p<0.05). The average ratio of PON3 activity/MDA level in the infertile women was achieved lower than the fertile women. Moreover, the concentration of MDA in the follicular fluid of infertile women was significantly higher (p<0.05) than its concentration in the fertile women. Meanwhile, the concentration of high density lipoprotein and total antioxidant capacity of follicular fluid of both groups showed insignificant difference.

Conclusion: The present study showed that PON3 activity and the ratio o of PON3 activity/MDA level in the infertile women are lower than those in the fertile women. Some disorders on the ratio of antioxidant/peroxidation in the follicular fluid could affect the fertility of women.

Key words: Paraoxonase 3, Follicular fluid, Lipidic peroxidation.

P-43

Investigating the effect of tribulus terrestris on testis tissue

Malekzade Shiravani S1, Karimi Jashni H2, Hoshmand F3.

1 Department of Biology, Islamic Azad University, Jahrom Branch, Jahrom, Iran.

2 Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

3 Department of Pathology, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: The previouse believed that Tribulus terrestris increase sexual function and libido in men, more than have other pharmacological properties. Benefitical of herbal drug have to evidenced with clinical and bodily measure.The aim of the current study was to investigate the influence of Tribulus terrestris extract on primary spermatocyte and rat weight.

Materials and Methods: In this experimental study used Thirty-five mature male wistar rats were randomly divided into five groups of seven each. Group I served as a control and group II as a vehicle group (normal saline, 2.5 ml) and groups III, IV and V were treated with three different doses of TT extract (2.5, 5 and 10 mg/kg body weight, respectively), orally, once daily for 8 weeks. Tissue section investigation with light microscope was performed. The results were analyzed by SPSS software.

Results: Tissue section histological investigation determined that only significant difference was between experimental group 3 and control group (p≤0.01).

Conclusion: Above result showed that tribulus terrestris could balance action of male reproductive system and maybe used up for treatment of male infertility, with effect on the testis spermatocyte.

Key words: Tribulus terrestris, Reproductive system, Testis tissue, Rat.

P-44

Effect of aqueous extract of saffron stigma on spermatogenesis in rat

Karimi Jashni H1, Davoodi A2.

1 Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

2 Development of Biology Graduate Student, Department of Anatomy, Azad Medical University of Jahrom, Jahrom, Iran.

Email: [email protected]

Introduction: Crocus sativus L, commonly known as saffron is used in folk medicine for various purposes the aim of this study was assessment effect of saffron extract on rat spermatogenesis.

Materials and Methods: A total of 35 adult male rats with average weight 200±20 gr were randomly divided into 5 groups, including control, sham and experimental groups (1, 2, 3) which received 25, 50, 100 mg/ kg/bw of saffron extract intraperitoneally for 21 days. After the last treatment, rats were sacrificed and their testis were removed, fixed and studied with stereological methods. The data analyzed based on ANOVA test.

Results: The results showed that the mean number of seminiferous tubules in all experimental groups compared with control group increased significantly (p<0.05) .Also the mean number of spermatogonia, spermatocyte and sertoli cells in all experimental groups compared with control group , increased significantly (p<0.05) but extract of saffron did not effect on spermatid number and leydig cell.

Conclusion: These results show that saffron extract improved spermatogenesis process in rat and probably it could be used for infertility male treatment.

Key words: Saffron, Spermatogenesis, Rat.

P-45

Effect of alcoholic extract of aloe vera on spermatogenesis in rats

Karimi Jashni H, Najmadini N.

Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Studies have shown that aloe vera plant is useful for treatment of constipation, warts, viral and bacterial infections, colon ulcers, inflammation and cancer. The aim of this study was to evaluate the effect of aloe vera plant extract on spermatogenesis process in rats.

Materials and Methods: In this study 35 adult male rats with average weight 200 ± 20 g were randomly divided into 5 groups, including control, sham and experimental groups (1, 2, 3) which received orally 50, 100 , 200 mg /kg/bw aloe vera extract respectively for 30 days. After the last treatment, rats were sacrificed and their testis were removed, fixed and studied with stereological methods. The data analyzed based on ANOVA test.

Results: The results showed that the mean number of spermatogonia cells in all experimental groups and sertoli cells in experimental group 2 and 3 (100, 2 00 mg) and leydig cells in the experimental group 3 (200mg) compared with the control group decreased significantly (p<0.05). The number of primary spermatocyte and spermatid cells in all experimental groups compared with the control group decreased. But this reduced is not significantly. Also the aloe vera plant extract did not effect on mean umber of seminiferous tubules.

Conclusion: According to the results aloe vera extract probably having compounds such as phytosterols that can inhibit the spermatogenesis process in rat.

Key words: Aloe vera plant, Spermatogenesis, Rat.

P-46

Effect of hydroalcoholic extract of phoenix dactylifera on spermatogenesis in rat

Karimi Jashni H, Dkhanchy M.

Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: In traditional medicine medicinal plants are used fore infertility treatment .The aim of this study was assessment effect of phoenix dactylifera extract on rat spermatogenesis.

Materials and Methods: In total 84 adult male wistar rats with average weight of 300±20 grams s were randomly divided into 8 groups, including control, sham and experimental groups (1 to 6) which orally received 25, 50, 100, 150, 200, 250 mg/kg/bw phoenix dactylifera extract for 28 days respectively . After the last treatment, rats were sacrificed and their testis were removed, fixed and studied with stereological methods. The data analyzed based on ANOVA test.

Results: The results showed the mean number of seminiferous tubules in experimental groups compared to the control group increased significantly (p<0.05) but the mean diameter of seminiferous tubules decreased significantly (p<0.05) .The mean number of spermatogonia cell, spermatocyte, spermatozoa in the first experimental group (25mg) compared to the control group increased significantly (p<0.05) but in other experimental groups decreased. Extract of Phoenix dactylifera no effect on number of leydig and sertoli cells.

Conclusion: The results showed that low doses of phoenix dactylifera extract improved spermatogenesis process, but high doses decreased spermatogenesis.

Key words: Phoenix dactylifera, Spermatogenesis, Rat.

P-47

Effects of GnRH agonist on epididymis tissue in preburtal rat

Peirouvi T1, Haidary A2, Solati M3.

1 Department of Histology, Urmia University of Medical Sciences, Urmia, Iran.

2 Department of Pharmacology, Urmia University of Medical Sciences, Urmia, Iran.

3 Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

Email: [email protected]

Introduction: The epididymis is a tubule that processes the maturation, storing and transferring of sperms. Growth and maintenance of epididymis structures is depending on testosterone hormone release, that respectively the release of testosterone hormone directly controlled by hypophysis gonadotropin hormones. And also gonadotropins controlled by the hypothalamus releasing hormones. Using the GnRH analogs can stop the gonado-hypophysis axis. This study aimed at determining the effect of GnRH agonist on the immature rat's epididymal tissue.

Materials and Methods: In these study 20 rats in 25th of birth day divided into 2 groups (n=10). The study group received 0.1 mg/ml gonadotropin releasing hormone agonist and control group received physiologic serum 0.1 mg/ml for 5 days and then rats were dissected in 30th of birth day. Their epididymis were isolated and processed for histological study.

Results: Finding reveals that epithelium height and lumen diameter, in control and study groups differ significantly (p≤0.05). But no significant difference is seen in muscular thickness.

Conclusion: This study shows that short term prescription of GnRH, increase the growth of epithelium and diameter of lumen in epididymis. And no affect muscle.

Key words: Epithelium, Muscle, Lumen, GnRH agonist, Prepubertal rat.

P-48

Saffron extract improves maturation and fertilization rate of immature mouse oocytes

Tavana S1, 2, Eimani H2, 3, Azarnia M1, Shahverdi A2.

1 Department of Biology, Faculty of Sciences, Kharazmi (Tarbiat Moallem) University, Tehran, Iran.

2 Department of Embryology, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

3 Department of Anatomy, Faculty of Medicine, Baqiyatallah University, Tehran, Iran.

Email: [email protected]

Introduction: Lower pregnancy rates of in-vitro matured oocytes compared to much lower than those of in vivo stimulated cycles, indicate that optimization of in-vitro maturation (IVM) procedure is remained a challenge. Reduced developmental competence of in-vitro matured oocytes shows that current culture systems for oocytes maturation do not adequately support nuclear and/or cytoplasmic maturation. Therefore in this study, it was evaluated the effect of different concentrations of Crocus sativus L. (saffron) extract as an antioxidant agent on IVM of immature mouse oocytes.

Materials and Methods: Cumulus-Oocyte Complexes (COCs) were collected from 6-8 weeks old NMRI female mice ovary. COCs were cultured in IVM medium supplemented with 0 (control), 5, 10, 20 and 40 µg/ml of saffron extract for 16-18 hrs in 5% CO2 and 37?C. Then, the rates of maturation and fertilization were recorded.

Results: Our data showed that addition of 40 µg/ml saffron extract to maturation medium significantly increased maturation rate compared to control group. However lower concentrations such as 10 µg/ml of saffron extract in maturation medium significantly (p<0.05) increased the fertilization rate of oocytes in comparison with control group.

Conclusion: The results of this study indicated that lower concentrations are more appropriate to be added to maturation medium compared to other experimental and control groups. Generally it was cocluded that addition of appropriate amounts of the natural extracts such as saffron extract to maturation medium may increase quality of MII oocytes and subsequently rate of In-Vitro Fertilization.

Key words: In- vitro Maturation, Crocus sativus L., In-vitro Fertilization, Antioxidant.

P-49

Relation between thyroid antibodies, APCR, and lupus anticoagulant levels with recurrent spontaneous miscarriage

Haghani L, Ostadkhalil F, Hashemi M, Kargosha A.

Student Research Committee of Hormozgan University of Medical Science, Hormozgan, Iran.

Email: [email protected]

Introduction: Recently studies have shown an association between thyroid antibody and spontaneous abortion. The aim of present study was to evaluate the relation between thyroid antibody and thrombophylia and C activated protein c resistance (APCR) with recurrent spontaneous miscarriage.

Matherials and Methods: From April 2007 to March 2008 in a case control study, 74 woman with a history of recurrent abortion and 80 matched woman without previews abortion enrolled in this study. APCR, Thyroglobolin (TG), thyroid peroxides antibodies (TPO). Thyroid stimulation hormone (TSH) and free thyroxin (FT) and lupus anticoagulant levels were assessed. The data were analyzed by student t test. Man Whitney, chi2 square and fisher exact.

Results: A total 154 patient with mean age ±SD=33.6±6.4 range =13-52years old) in case and 33.4±5.9 in control group assessed. There is a significant relation between APCR, TG, TPO, TSH, FT and recurrent spontaneous miscarriage (all p<0.05) but not relation with lupus anticoagulant levels.

Conclusion: Based on the currently available evidence, it appears that the presence of thyroid antibodies and APCR is associated with an increased risk for spontaneous miscarriage in subfertile women this index may be considered as a potential diagnostic factor for miscarriage especially spontaneous abortion.

Key words: Thyroid antibodies, Spontaneous abortion, Lupus anticoagulant.

P-50

The effect of hydroalcoholic extract of phoenix dactylifera meristem on serum hormones testosterone, estradiol and gonadotropin in male rat

Dokhanchi M, Karimi Jashni H.

Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Meristem of phoenix dectylifera has been considered as a nutritional resource to strength the sexual ability among people who lives south of country. This study investigated the effect of phoenix dactylifera extract on serum level testosterone, estradiol and gonadotropin hormones in the male rat .

Materials and Methods: In this research, 96 wistar male rats were divided into 8 groups that including 12 rats. Control group received no treatment, the distilled water group received 1cc. distilled water (extract dissolvent) and experimental groups received respectively 25, 50, 100, 150, 200, 250 mg/kg of phoenix dactylifera orally for 28 days. The results were analysed by using SPSS software and one-way analysis-test.

Results: The results showed that serum level of testosterone and estradiol in the experimental groups receiving the phoenix dactylifera extract, compared to the control and distilled water groups decreased significantly (p<0.05). Serum level of gonadotropin hormones (LH, FSH) in experimental groups compared to the control group is not significant .

Conclusion: The results showed that the phoenix dactylifera extract phytosterol, probably due to reducing cholesterol and its anti-androgen effect, is reducing the testosterone and estradiol hormones but has no effect on gonadotropin .

Key words: Phoenix dactylifera, Meristem, Testosterone, Estradiol, Gonadotropin.

P-51

In vitro maturation, fertilization and embryo developmental capacity of mouse germinal vesicle oocytes after vitrification

Mayahi O1, Mahmoudi R2.

1 Student Research Committee, Yasouj University of Medical Sciences, Yasouj, Iran.

2 Cellular and Molecullar Research Center, Yasouj University of Medical Sciences, Yasouj, Iran.

Email: [email protected]

Introduction: Cryopreservation of oocytes has become an essential service for infertility treatment. Research in this area focuses on the possibility of restoring fertility in women with reproductive problems or after cancer treatments. Another goal is to establish a genetic resource bank for endangered or commercially important animal species. The aim of this study was to evaluate viability, fertilization and subsequent developmental to blasetocyts of mouse germinal vesicle oocytes after single and stepwise vitrification procedure.

Materials and Methods: Oocytes were obtained from 4 week old female mice 48hr after i.p. injection of 7.5 IU pregnant mare serum gonadotropin (PMSG). Collected oocytes before vitrification were exposed to cryoprotectant, which was composed of 30% (v/v) ethylene glycol, 18% (w/v) Ficoll-70, and 0.3 M sucrose, either by single step or in a step-wise way. After vitrification and storage in liquid nitrogen, the oocytes were thawed and washed two times in medium TCM199 and then subjected to in vitro maturation, fertilization and culture for blasetocysts.

Results: The oocytes survival rates after vitrifying-warming, maturation rate, the capacity of fertilization and embryonic development to blasetocyst were examined in vitro. The oocytes surviving, maturing to MII, fertilization, cleavage and blastocyst rate in the step-wise exposure were significantly higher (p<0.05) compared with corresponding rate in the single step procedure.

Conclusion: The results of present study indicated that germinal vesicle oocytes vitrified stepwise procedure had positive effect on survival, maturation, fertilization cleavage and blasetocysts rate than single step procedure.

Key words: Cryopreservation, Germinal Vesicle Oocyte, Vitrification, Mouse, Ethylene glycol, Blasetocyst.

P-52

Correlation between sperm DNA fragmentation index, apoptosis and mitochondrial membrane potential with routine sperm parameters and laboratory outcome

Sharbatoghli M1, Rezazadeh Valojerdi M1, 2, Amanlou M3.

1 Department of Emberyology, Cell Sciences Research Center, Royan Institute, ACECR, Tehran, Iran.

2 Department of Anatomy, Tarbiat Modares University, Tehran, Iran.

3 Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Conventional semen analysis is a common test for evaluation of routine sperm parameters, but these tests don't provide any information about DNA damage, mitochondrial dysfunction, sperm apoptosis and oxidative stress. However finding any relationship could be very useful in foreseeing the result of the treatments. The purpose of this study was to assess the relationship between DNA damage, apoptosis and mitochondrial membrane potential (??m) in ejaculated spermatozoa with semen variables and also evaluate their effects on the laboratory ICSI outcome after intracytoplasmic sperm injection (ICSI).

Materials and Methods: The semen parameters in 120 infertile couples undergoing ICSI treatment were routinely analyzed and then examined for incidence of sperm DNA fragmentation (sperm chromatin dispersion test), apoptosis (annexin v binding staining) and mitochondrial membrane potential (JC-1 binding staining) were by flow cytometry.

Results: There was no correlation between DNA fragmentation index (% DFI), apoptosis and mitochondrial membrane potential (MMP) with the ICSI lab outcome. Sperm variables were related to %DFI (motility and abnormal morphology), apoptosis (concentration and motility) and low MMP (concentration, motility and abnormal morphology) (p<0.01 and p<0.05, respectively). The sperm %DFI also showed significant correlation with apoptosis and low MMP (p<0.01).

Conclusion: In spite of positive correlation between % DFI, apoptosis and MMP with semen parameters, there was not significant correlation with ICSI outcome. Therefore, the lack of the mentioned correlation could not be considered as a cause for refraining unfertile men from ART techniques.

Key words: Sperm parameters, DNA damage, Mitochondrial, Apoptosis.

P-53

Effect of hydroalcoholic phoenix dactylifera extract on serum hormone testosterone, estradiol and gonadotropin in male rat

Dkhanchy F1, Karimi jashni H1, Hooshmand F2.

1 Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

2 Department of Pathology, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: Infertility is one of the problems in human society. In traditional medicine, medicinal plants are used for infertility treatment. One of the plants that different parts of it are used is palm. This study investigated the effect of phoenix dactylifera extract on serum level testosterone, estradiol and gonadotropin hormones in the male rat.

Materials and Methods: In this study, we used 96 adult male westar rats, weight range 280-300 g and age 2.5 to 3 months. The rats were randomly divided into eight groups. Control group received standard food and water and experimental groups received respectively 25, 50, 100, 150, 200, 250 mg doses of phoenix dactylifera orally for 28 days. Blood samples were obtained from all groups. Hormones were measured by RIA. The results were analysed by using SPSS software and one-way analysis - test.

Results: The results showed that serum level of testosterone in the experimental groups receiving the phoenix dactylifera extract, compared to the control and shame groups decreased significantly (p<0/05), the hormone level of estradiol in the experimental groups receiving the high doses of phoenix dactylifera extract, compared to the control and shame groups decreased significantly (p<0.05). Serum level of gonadotropin hormones (LH, FSH) in experimental groups compared to the control group is not significant.

Conclusion: The results showed that the phoenix dactylifera extract fetoestrol, probably due to reducing cholesterol and its anti-androgen effect, is reducing the testosterone and estradiol hormones but has no effect on gonadotropin.

Key words: Phoenix dactylifera, Estradiol, Gonadotropin.

P-54

The efficacy of melatonin on in-vitro cleavage and developmental rate of mouse two-cell embryos during preimplantation stages

Ramezani M1, Asgari Z1, Bahadori MH2, Nasri S2, Jabari F2.

1 Payam e noor University, Tehran, Iran.

2 Department of Anatomy, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Email: [email protected]

Introduction: Melatonin promotes in-vitro embryo development in different species. This study determined the effects of melatonin on in-vitro mouse embryo development, in particular, cleavage rate and blastocyst rate.

Materials and Methods: Two-cell embryos were obtained from oviduct of female NMRI mice 48 hours after administration of an intra-peritoneal injection of 5 IU pregnant mares' serum gonadotrophin and subsequent human chorionic gonadotrophin (ip). Embryos were cultured in T6 supplemented with different dosages of melatonin {0 (control group), 100 µM/ml, 10 µM/ml, 1 µM/ml, 100 nM/ml and 10nM/ml}. The rate of embryos cleavage was assessed in the T6 medium until blastocyst stage using of invert microscope.

Results: The results showed that the rate of cleavage and development of mouse embryos increase significantly in the development culture medium supplemented with 10 and 100 nM/mg of melatonin in comparison to control group (p< 0.001).

Conclusion: The results of this study demonstrate that, enriching the culture medium with melatonin, increases in-vitro blastocysts production in mice.

Key words: Melatonin, Embryo Development, Blastocyst, Cleavage

P-55

Spermatogenesis and the level of blood testosterone hormone in male infertility

Jahanpour NS1, Jahanpour F2, Azodi P2.

1 Department of Fars Province Educational, Shiraz, Iran.

2 Faculty of Nursing & Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.

Email: [email protected]

Introduction: Spermatogenesis and the level of blood testosterone hormone affected by Non-steroidal anti-inflammatory drugs. Celecoxib is a Non-steroidal anti-inflammatory drugs and the selectiveCox-2 inhibitor. Nowadays this drug uses as an analgesic, antipyretic and anti-inflammatory agent frequently. In some patients that used celecoxib for a long time, unusual effect of this drug may be seen. The goal of this survey is assess the effect of this drug on male-reproductive system functions.

Materials and Methods: This survey done for study of effect of celecoxib on rat reproductive system, especially on spermatogenesis and the level of blood testosterone hormone. In this manner histologic studies and measuring of weight (testis, prostate, seminal vesicle and epidydimis) and the level of blood testestron are done. 50 rats with 200-230 gr. weight selected and compared in 5 groups. Control group (no drug given), sham group (solvent drug: Di- methyl sulfoxide), 3 cases group (orally celecoxib 10, 20 and 40mg/kg given daily) for 15 days. In the end of 15 days heart blood sampling for measuring serum testestron level accomplished after that reproductive systems separated and prepared for histologic study.

Results: Result showed no significant differences in mean weight of body testis, epidydimis and seminal vesicle in control and case groups. But significant differences are seen in the mean weight of prostate per body weight in case group (40 mg/kg) in compared with control group. That is due to ant malignant effect of celecoxib on prostate. No differences seem between control and case groups in arrangement mode, nuclei shape and cytoplasm in histological examination in spermatogonia and primary spermatocytes in transverse section of somniferous tubules celecoxib in case group (40 mg/kg) can decrease lydige cells number, that is due to inhibited prostaglandin synthesize, for the result of cox-2 inhibitor and decreased level of testosterone hormone.

Conclusion: It looks that number of sertoli cells in control and case groups are differences. So that in case group (40 mg/kg) number of sertoli cells decreased due to decrease testestron level. This can cause production of abnormal sperms. In the survey can conclude that use of high doses of celecoxib can decreased size and number of lydig cells and this is cause of decreased testosterone hormone.

Key words: Celecoxib, Infertility, Testosterone hormone.

P-56

Therapeutic effects of Arthemisia Herba Alba extract on testis and spermatogenesis in diabetic rats

Parkami MA1, Zahiri SH2, Sadeghi H1, Karrgarjahromy H1, Yazdanpanah S1, Koohpeyma F1.

1 Islamic Azad University, Jahrom Branch, Jahrom, Iran.

2 Department of Anatomy, Shiraz University of Medical Scaines, Shiraz, Iran.

Email: [email protected]

Introduction: Arthemisia is one of the important traditional herbal plants that has therapeutic effects in some diseases include diabetes type II.One of the side effects of diabetes is disorder in testis tissue &spermatogenesis.In this work we studied the effects of this herbal drug on male reproductive system in diabetic rats.

Materials and Methods: 40 adult male wistar rat classified in 5 groups as fallows: control & 4 experimental groups that include: streptozocin (55 mg/kg: IP) metphormin (250 mg/kg: PO) and two diabetic groups were treated with extract doses of (200 and 300 mg/kg PO). Duration time of treatment was 56 days. Assessing parameters were blood sugar, testosterone, FSH, LH, weight (animals and testis), testis volume and histological indexes. Data analyzed by SPSS 15 software and ANOVA and Duncan Tests.

Results: Finding indicates that arthemisia extract (300 mg/kg) causes reduction in glucose level and increases in testosterone, LH, FSH, spermatogenic indexes (TDI, SI, RI) and wellness in testis volume and histological damages due to diabetes.

Conclusion: Hypoglycemic effect of Arthemisia extract can be effective in reduction of many adverse effects due to diabete injury in male reproductive system such as infertility problem probably.

Key words: Arthemisia, Infertility, Spermatogenesis, Testis, Rat.

P-57

Effects of sperm parameters and number of MII oocytes on the success rate of embryo formation and implantation in ICSI candidates

Ghoraeian P1, Mozdarani H1, Fallahi P2, Rezaeian Z2, Aleyasin A2.

1 Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Department of Infertility, Shariati Hospital, Tehran, Iran.

Email: [email protected]

Introduction: Various factors are involved in infertility. Sperm parameters as well as quality of MII oocytes are important factors involved in successful fertilization and implantation rate in ICSI candidates. In this study we have tested the involvement of either factor in two distinct groups. The aim of this study was to investigate the success rate of embryo formation and implantation in ICSI candidates regarding to the oocytes number and sperm parameters.

Materials and Methods: Sixty couples candidate for ICSI were divided into two groups of normospermia and severe oligo/azoospermia. The sperm parameters, the number of injected MII oocytes, embryo formation and embryo transfer and the result of pregnancy test about 16 days after oocyte collection were considered for analyses. Unpaired t-test analysis was used to compare the difference between various parameters in two groups.

Results: Results show that there was a significant difference between sperm count (p<0.0001), number of embryos (p<0.001) and number of transferred embryos (p<0.038), in normospermia group compared with severe oligo/azoo spermia group. However there was no significant difference for retrieved and MII oocytes between either groups (p>0.1). Also, there was no significance difference in success rate of pregnancy after 16 weeks of embryo transfer between two groups (p>0.11).

Conclusion: The sperm parameters significantly affected the embryo formation and transfer. However, the pregnancy rate in two study groups was not significantly different, although, the numbers of MII oocyte were similar. The reason might reside in the postzygotic chromosomal abnormalities, showing up in preimplantation stage embryos.

Key words: Infertility, Sperm parameters, Oocytes, Fertilization rate, Implantation rate.

P-58

Effect of plant tribulus terrestris extract on sexual hormones (FSH, LH and Testosterone) of male rats

Karimi Jashni H1, Malekzade Shiravani S2, Hoshmand F3.

1 Department of Biology, Islamic Azad University, Jahrom Branch, Jahrom, Iran.

2 Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

3 Department of Pathology, Jahrom University of Medical Sciences, Jahrom, Iran.

Email: [email protected]

Introduction: The aim of the current study is to investigate the influence of Tribulus terrestris extract on sexual hormones in male rats.

Materials and Methods: Thirty-five mature male wistar rats were randomly divided into five groups of seven each. Group I served as a control and group II as a vehicle group (normal saline, 2.5 ml) and groups III, IV and V were treated with three different doses of TT extract (2.5, 5 and 10 mg/kg body weight, respectively), orally, once daily for 8 weeks.The experimental groups were named TT1, TT2 and TT3, respectively.

Results: There was significant difference between TT1 (mean±SD: 1.70±0.67 ng/ml) (p≤0.05) and control group in the serum testosterone. There was no significant difference between Tribulus terrestris treatmented groups and control group in the serum luteinizing hormone levels. There was only significant difference between TT3 (mean±SD: 28.02±2.65 IU/L) (p£0.05) and control group in the serum Follicle stimulating hormone levels.

Conclusion: These results indicate that the Tribulus terrestris influence on sexual hormones of rats.

Key words: Tribulus terrestris, Testosterone, Follicle stimulating hormone, Luteinizing hormone, Male rat.

P-59

The effect of in vivo administration of amlodipine and pentoxifylline on acrosomal reaction in mouse

Sadeghzadeh Oskouei B, Ghanbar AA, Roshangar L, Khaki AA, Soleimani Rad J.

Department of Anatomy, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: multipotent62@gmail

Introduction: Calcium channels are present in the plasma membrane of many cells including sperm. The present study was aimed to examine the effects of Amlodipine (a calcium-channels inhibitor) and Pentoxifylline on acrosomal reaction.

Materials and Methods: Syrian male mice were recieved 2.5 mg/kg/day Amlodipine and Pentoxifylline (0.6 mg/kg) orally for 3 months. After epididimal biopsy, acrosome reaction was studied by a light microscope.

Results: Number of sperms with acrosoaml reaction showed a significant increased in Amlodipine and Pentoxifylline group (p<0.001) but Pentoxifylline groups were greater.

Conclusion: Amlodipine and Pentoxifylline oral administration enhances acrosomal rection.

Key words: Amlodipine, Pentoxifylline, Calcium channels, Acrosomal reaction, Sperm, Fertility, Mouse.

P-60

Patient attitudes toward the fate of their frozen embryos after the end of cryopreservation time

Alizadeh L, Hassani F, Mozafari S, Omani Samani R.

Department of Epidemiology and Reproductive Health, Reproductive Medicine Research Center, Royan Institute, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: Cryopreservation is a routine procedure in almost all of assisted reproduction clinics and can be used for embryos, sperms, oocytes and to some extent for reproductive tissues. This study was designed to investigate the decisions that couples made regarding the fate of their frozen embryos after finishing the preservation period and the underlying reasons for their decisions.

Materials and Methods: A list of the infertile couples who had frozen embryos in the Nitrogen Tanks of Royan Institute was made. All of them have passed the five-year period of cryopreservation according to the institute legislation. A semi structured questionnaire was designed to get their ideas freely in response to our questions. Data were gathered through telephone calls by an expert staff well trained for preventing any bias in the interviews. Ethical considerations such as freedom of the patients to participate or withdraw at any time of the interview, prevent of put psychological pressure to get the answers and the permission of using the data assuring them about not publishing any personal information was followed and data were analyzed using SPSS 16.

Results: From all our cases 78% chose donation to other infertile couples, 12% to research, 5% discard and remaining 5% couldn't choose any of the proposed fates for their embryo even after enough time for thinking and at the end they left the decision to us. Most of the people had altruistic incentives for donating the embryos and on the contrary for not donating, the main concern was the destiny of the resulting child. Among the possible influencing factors like age, education, duration of infertility, previous failure(s) in treatment, abortion history, job and current live child, the only factor was to have a child (P=0.009) that was associated with higher choice of donation to the other infertile. Among these cases 70% believed that the recipient is the mother, 11% step mother, 1% not related and remaining 15% could not specify any relation between the child and the recipient, but regarding relation between the child and the donor 41% believed in no relation followed by 19% don't know, 19% mother, 16% genetic relation and 4% step mother. Also among them, 54% were interested to know the child, 43% know the recipients and 61% had considered some characteristics among the recipients to donate them their embryos. Also, in the group of cases who decided to donate for research, the type of preferred research or education usage of their embryos was decided as follows: 88% chose embryology, 91% stem cells and 81% educational usage. All the people who decided to discard the embryos were worrying about the destiny of the resulting child and the consequences of the researches.

Conclusion: Unlike other parts of the world, infertile people in Iran mostly like to donate their surplus embryos to other couple rather than donating to the research or discarding them.

Key words: Embryo, Fate, Donation, Cryopreservation, Infertility.

P-61

Stereological and histopathological study of ovary after administration of hydroalchoholic extract of Artemisia herba Alba in diabetic rats

Koohpeyma F1, Zahiri SH2, Sadeghi H3, Kargar Jahromy Ho1, Parkami MR3, Koohpeyma R2.

1 Young Clup Research, Azad University of Jahrom, Jahrom, Iran.

2 Department of Anatomy, Shiraz University of Medical Scainces, Shiraz, Iran.

3 Azad University of Jahrom, Jahrom, Iran.

Email: [email protected]

Introduction: Since previous studies had been noted to hypoglycemic effects of Artemisa, in this study, we examine the effectiveness of hydroalchoholic extract of this traditional herbal plant on female reproductive system damages due to diabetes.

Materials and Methods: 50 adult female wistar rats classified in 5 groups as fallows: control and 4 Experimental groups included: streotozocin (50mg/kg: IP), metformin (250 mg/kg: PO) and two diabetic groups treated with extract (200, 300 mg/kg: PO). After 8 weeks animals were dissected and their right ovaries were processed for histological and stereological assessment Staining was done by 3 techniques: H&E, PAS, and Trichrome. All data of considerable variables were analyzed by SPSS 15 software and ANOVA and Duncan Tests.

Results: Our finding indicates that in Diabetic groups adverse effects of disease such as: high blood glucose, increase of ovary volume and percentage of atretic follicles besides congestion ,thickening of zona and fibrosis in stroma of ovary were seen but these signs were been moderate and low in groups had been treated with extract (300 mg/kg).

Conclusion: Since the artemisia extract has a potent hypoglycemic effect, we suggest this herbal medial traditionah plant as a suitable drug for reduction of side effect of diabetes on female reproductive system especially infertility problems due to diabetes.

Key words: Diabete, Infertility, Ovary, Artemisia, Rat.

P-62

Effects of aqueous saffron extract on concentrations of FSH, LH and testosterone in adult male rat blood serum

Karimi Jashni H1, Johari H2, Davoodi A3, Roodi M4.

1 Department of Anatomy, Jahrom University of Medical Sciences, Jahrom, Iran.

2 Department of Physiology, Islamic Azad University, Kazerun branch, Kazerun, Iran.

3 Department of Biology, Islamic Azad University, Jahrom Branch, Jahrom, Iran.

4 Department of English, Emam Reza International University, Mashhad, Iran.

Email: [email protected]

Introduction: Saffron is widely known as a food flavor and coloring powder and also it is used as a medical treatment. Recent studies have revealed the physiological effects of the main components of this herb on different parts of body biological systems. The aim of this research is to assess the possible effects of saffron aqueous extract on concentrations of FSH, LH and testosterone in adult male rat blood serum.

Materials and Methods: Thirty five adult male rats in 5 groups each including 7 rats were chosen. Rats weights were limited to 170-180g. Distilled water was administrated as placebo to control group and 3 test groups received aqueous saffron extract in doses of (25mg/kg/24h, 50mg/kg/24h, 100mg/kg/24h) and witness group left without any special and attendance. Both water and saffron extract were injected intraperitoneally for 21 days. 12h after the last injection, blood samples were collected and their serum was extracted and immune enzyme test was done via RIA.

Results: The average level of FSH, LH concentrations in serum samples of test groups didn't show any significant difference as compared with control group and witness group. But levels of testosterone concentrations increased significantly in serum samples of test groups.

Conclusion: The results indicate that saffron affects performance of internal release of hypothalamic-pituitary-gonadal axis (also HPG axis) hormones, so it can affect reproductive system activity in male rat.

Key words: Saffron, Reproductive system, FSH, LH, Testosterone, Rat.

P-63

The effect of carbaryl on structure of testis

Fattahi S1, Jorsaraei S2, Sohan Faraji A2, Pourdadash Amiri P2, Esmaili Z2.

1 Department of Biology, Islamic Azad University, Ayatollah Amoli Branch, Amol, Iran.

2 Department of Anatomy and Embryology, Babol University of Medical Sciences, Babol, Iran.

Email: [email protected]

Introduction: Carbaryl with The chemical name, 1- naphthol N-methylcarbamate is a carbamate insecticide which widely applied for pest's control. Carbaryl adversely effects on reproductive system and wide variety of enzymes in animals. Therefore, the aim of recent study; we investigated carbaryl effects on structure of testis in mice.

Materials and Methods: He present study, adult male mice were divided into, experimental, control and sham groups. In the experimental groups, mice were injected with consecutive doses of carbaryl (10 and 30 mg/kg IP, five days in week for one month), sham which IP injected of Corn oil and control no injection. Animals were scarified 7 days after the last treatment. Testis tissues sections were provided to investigate the changes of spermatogenic and Leydig cells. Testis and seminiferous diameter were assayed with micrometer and eye piece, respectively. Data were analyzed using of one-way ANOVA and t-test methods.

Results: The results show no significant differences in body weight of experimental groups compared with control group. But, testis weight significantly decreased. Also, a significant decline in the numbers of spermatogonia, spermatocyts, spermatids, Leydig cells were observed. There were significant differences in the Testis and seminiferous diameter (p<0.05). The results show no significant within parameters on sham group compared with control group.

Conclusion: These results demonstrated that carbaryl could have adverse effect on sperm production. Therefore, application of carbaryl should be designed program.

Key words: Carbaryl, Testis, Leydig cells, Spermatogenic cells.

P-64

The expression of imprinting genes (H19-Igf2-Mest) in vitrified-warmed mouse 8-cell embryos

Sahraei S1, Movaghar B1, Farrokhi A2, Shah Hoseini3.

1 Department of Embryology, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

2 Department of Stem Cell, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

3 Department of Genetics, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Email: [email protected]

Introduction: Vitrification is an effective method for cryopreservation of mammalian embryos. It seems to be safe and does not significantly increase the frequency of birth of children with diseases or congenital malformations. Although genetic disorders are relatively rare, epigenetic effects on those children born from assisted reproductive technologies (ARTs) should not be neglected. Many imprinting genes are involved in regulating proper embryo development and cell proliferation; therefore, imprinting disorders can be associated with intrauterine growth retardation (IUGR), low birth weight (LBW), and tumor genesis. The aim of this study is evaluation of vitrification procedure effect on expression status of H19, Igf2 and Mest genes on mouse embryos.

Materials and Methods: The expression status of H19, Igf2 and Mest genes was analyzed by RT-PCR and quantified real-time reverse-transcription polymerase chain reaction in four embryo groups. In the first group (G1) fresh 8-cell embryos were cultured in HamsF10 medium supplemented with 10%BSA into blastocyst stage. Second group (G2): vitrified-warmed 8-cell embryos were cultured at the same condition as the G1. Third group (G3): in vivo 8-cell embryos and fourth group (G4): in vivo blastocysts as control group.

Results: The results of this study showed that the expression level of all genes in group II was decreased significantly in comparison with control group. But only H19 and Igf2 had significant decreasing in group III. Also expression level of Igf2 and Mest are lower in blastocyst stage in comparision with 8-cell embryos but expression of H19 is higher in blastocyst stage as compared with 8-cell embryos.

Conclusion: The present study showed that cryotop vitrification has a negative effect on H19, Igf2 and Mest gene expression. However down regulation of these genes has no effect on embryo morphology, later stages of growth and development can be affected, because of the important role of these genes in embryo development.

Key words: Vitrification, Gene expression, H19, Igf2, Mest.

P-65

Effect of fatty acid profile of phospholipids in human follicular fluid on laboratory fertilization rate in patients undergoing IVF

Mehdizadeh A, Rahimipour L, Farzadi L, Shahnazi V, Darabi M, Shaaker M, Nouri M.

Infertility Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Biochemical characteristics of follicular fluid play an important role in oocyte development, women fertility and embryonic development that may be effective in the success of IVF. The aim of this study was to investigate the correlation between fatty acid composition of phospholipids in human follicular fluid and different fertilization rates in patients undergoing IVF.

Materials and Methods: Follicular fluid samples were obtained from 79 patients referred to Tabriz Alzahra Hospital undergoing IVF. Total lipids of follicular fluid were extracted, phospholipids were isolated by thin layer chromatography (TLC) and derivated fatty acids of follicular fluid phospholipids were analysed by gas liquid chromatography (GLC).

Results: Fertilization success rate (FR) in IVF was investigated in 3 groups with different percentages of fertilized oocytes. The first group of patients had FR less than 50%, the second group rated between 51% to 69% and the third group had FR over 70%.The mean amounts of linoleic acid (p=0.006) and arachidonic acid (p=0.049) was different in groups under study so that linoleic acid relation was positive and arachidonic acid was negative with FR respectively after adjustment for age, HDL-C and CETP.

Conclusion: This survey indicates that fatty acid profile of follicular fluid phospholipids plays an important role in efficiency of fertilization in laboratory levels.

Key words: In Vitro Fertilization, Fatty acid, Fertility.

P-66

The effect of verapamill on mouse ovarian heterotopic transplantation

Saber M1, 2, Eimani H2, 3, Soleimani M1, Shahverdi A2, Momeni HR1.

1 Department of Biology, Faculty of Sciences, Arak University of Medical Sciences, Arak, Iran.

2 Department of Embryology, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

3 Department of Anatomy, Faculty of Medicine, Baqiyatallah University, Tehran, Iran.

Email: [email protected]

Introduction: In recent years improvements in oncologic treatment regimens have led to an increase in life expectancy for young cancer patients. As a result, the quality of life of cancer survivors has become a major issue. Unfortunately, aggressive chemotherapy, ionizing radiotherapy, and bone marrow transplantation can severely affect the ovarian follicular reserve and subsequently lead to loss of fertility and premature menopause. One of emerging technique is ovarian tissue transplantation. The major objective of ovarian transplantation is to preserve fertility by minimizing loss of primordial follicles and oocytes and optimizing follicular development. But Despite encouraging results in this technique, some important concerns still limit the application of the procedure and its success. One of the challenges in ovarian graft transplantation is overcoming the Ischaemia/Reperfusion injury (IRI) that induces a high rate of follicular loss and disordered follicular activation. The most important hypotheses explaining the cellular events in I/R processes are calcium overload and oxygen free radicals constitute. Hence, the calciumchannel blocker verapamil might protect tissues against IRI. The aim of this study was to examine the effect of verapamill on autograft ovarian tissue heterothopic transplantation in mice.

Materials and Methods: Female NMRI mice (age between 28 and 35 days) were randomly divided into 2 groups. In the controls (group 1), only ovarian tissue transplantation was performed. In group 2, Verapamill (3 mg/kg) was given interaperitoneally 1 hour before remove ovarian tissue and autotransplantation to the back muscle and susequently received it every other day for 14 days after transplantation. At 14 days after transplantation, ovarian grafts recovered and processed histologically for follicle number counting.

Results: In this experiment results are indicating that verapamil increased the number of primordial, primary and preantral follicles in transplanted ovaries.

Conclusion: Verapamil usage was desirable for efficient ovarian transplantation. It was suggested that Increasing effects are concluded to be related to the ability of verapamile to block calcium channel and inhibiting reactive.

Key words: Cancer, Chemotherapy, Tissue transplantation.

P-67

Prenatal sex determination of bovine fetus using non-invasive method

Davoudi A1, 2, Aleyasin A2, Salehi1, Tahmoressi2.

1 Department of Animal Sciences, Aboreihan Campus, Tehran University, Tehran, Iran.

2 Department of Medical Genetic, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran.

Email: [email protected]

Introduction: In order to establish a reliable non-invasive method for bovine fetal sex determination in routine setting the possibility of identifying the fetal X and Y-chromosomes specific sequences has been evaluated in maternal plasma using conventional multiplex PCR analysis. The aim of this study was to provide a rapid and reliable method for sexing bovine fetuses.

Materials and Methods: Peripheral blood samples were taken from 38 pregnant heifers with gestational weeks of 12 to 38. DNA template was extracted by phenol-chloroform method from 350 µl maternal plasma. Two primer pairs for bovine amelogenin gene (bAML) and BC1.2 were used to amplify fragments from X and Y chromosomes. A multiplex PCR reaction has been optimized for amplification of 467 bp and 341 bp producted from X and Y bAML gene respectively and a 190 bp fragment from BC1.2 related to Y chromosome.

Results: The 467 bp fragment was detected in all 38 samples and 341 and 190 bp fragments were detected only in 24 plasma samples that delivered a male calf. The sensitivity and specificity of test was 100% with no false negative and false positive results.

Conclusion: The results showed that phenol-chloroform method is a simple and sensational for isolation fetal DNA in maternal plasma. The multiplex PCR is a available noninvasive methods which is cost efficient and replicable and is easily for bovine fetal sexing.

Key words: Sex determination, Non-invasive, Bovine fetus, Fetal DNA, Maternal plasma.

P-68

Screening of thrombophilic panel common mutations in high risk families for idiopathic spontaneous abortions

Ebrahimi A, Yassaee VR.

Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduciton: A number of genetic and environmental risk factors have been found or suspected to predispose to Infertility and Idiopathic Spontaneous Abortion or other kind of pregnancy loss. The environmental components associated with Idiopathic Spontaneous Abortion are physical activity; diet, alcohol and drug consumption, smoking and stress. The other main groups of risk factors are chromosomal abnormalities of Chr. 13, 18, 21. Genetic susceptibility may be caused by mutations and polymorphisms in a variety of genes mainly involved in blood coagulation, regulation of blood pressure and metabolism of lipids, glucose, homocysteine or iron. Among the candidate markers for idiopathic spontaneous abortions risk are variations in the genes for blood coagulation factors V (FV), II (prothrombin),and XIII (FXIII), ß-fibrinogen (FGB), platelet glycoprotein IIIa (GPIIIa), plasminogen activator inhibitor-1 (PAI-1), 5,10-methylene tetra hydrofolate reductase (MTHFR), angiotensin-converting enzyme (ACE), as well as apolipoproteins B (Apo B) and E (Apo E).

Materials and Methods: We used a Strip Assay method which provides materials for the isolation of DNA from human whole blood, the in vitro amplification of relevant gene sequences, and the subsequent detection of twelve mutations associated with Abortion and infertility by reverse hybridization.

Results: The assay covers the 12 mutations include: FV R506Q (Leiden), FV H1299R (R2), Prothrombin G20210A, Factor XIII V34L, ß-Fibrinogen-455 G-A, PAI-1 4G/5G, GPIIIa L33P (HPA-1), MTHFR C677T, MTHFR A1298C, ACE I/D, Apo B R3500Q, Apo E2/E3/E4.

Conculsion: We found high rate and significant association between this mutation panel and susceptibility to spontaneous abortions especially in consanguineous families.

Key words: Spontaneous Abortion, Chromosomal abnormalities, Mutation.

P-69

Factor V Leiden G1691A and factor II G20210A mutations in women with a history of at least three consecutive fetal losses: a study from the North-West of Iran

Bagheri M1, Abdi Rad I2, Nanbakhsh F3.

1 Department of Genetics, Urmia University of Medical Sciences, Urmia, Iran.

2 Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran.

3 Department ofObstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.

Email: [email protected]

Introduction: The roles of several risk factors for venous thromboembolism predisposition have been evaluated in women with habitual abortion. We studied the prevalence of FVL G1691A and FII G20210A mutations in women with habitual abortion and controls.

Materials and Methods: 60 unrelated-fertile females (controls) and 70 women with at least three consecutive fetal losses (cases) entered at present study. Allele Specific Multiplex Polymerase Chain Reaction was carried out for detection of FVL G1691A and FII G20210A mutations.

Results: FVL G1691A mutation was not found in studied cases and controls; all of cases and controls had normal FVL 1691 GG genotype. FII 20210AA genotype was not found in any case of patients or controls group. 3 individuals among controls and 22 individuals among cases had FII 20210GA genotype. 2.5% of alleles (3 out of 120 chromosomes) in controls and 15.714% of alleles (22 out of 140 chromosomes) in cases had FII 20210A mutation. It means that FII G20210A mutation was found in about 5% of controls and 31.429% of cases. The FII G20210A allele frequency was 0.157 in cases and 0.025 in controls. The distribution of GG, GA and AA genotypes were 48 (68.57%), 22 (31.43%) and 0 (0%) in cases and 95 (95%), 5 (5%) and 0 (0%) in controls, respectively, regarding FII G20210A mutation. Significant differences in both FII G20210A alleles and FII G20210A genotypes frequencies were observed in cases versus controls. But this is not fit to FVL G1691A alleles and genotypes.

Conclusion: FII G20210A mutation is significantly associated with habitual abortion.

Key words: Factor V Leiden G1691A, Factor II G20210A, Habitual abortion.

P-70

Mutations and polymorphisms of cystic fibrosis transmembrane conductance regulator gene in Iranian infertile males with azoospermia

Asadi F, Mirzajani R, Mirfakhraie S, Amiri Fard.

Islamic Azad University, Ize Branch, Ize, Iran.

Email: [email protected]

Introduction: Human male infertility is a major health problem worldwide. Azoospermia, defined as complete absence of sperm in semen, is present in about 10 to15 percent of infertile men. It is assumed that in about 30 % of cases male infertility is caused by chromosome aberrations or mutations in genes functioning in the male germ line. More than 3000 genes are known to be involved in the genetic control circuits regulating the expression of male fertility. Recent finding indicates that mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene are a relatively frequent cause of male infertility.

Materials and Methods: In this study, blood samples were collected from 50 Iranian male with non obstruvtive azoospermia and 50 healthy male as normal control. Genomic DNA was isolated by salting out procedure and common mutations of CFTR gene including (DF508, G542X ,N1303K , W1282X) by ARMS-PCR and IVS8-Tn polymorphism by using RFLP-PCR were analysed.

Results: No mutation or significant frequency difference was found in patient?s and healthy normal sample.

Conclusion: Since mutations in CFTR gene is known as frequent mutations in Iranian population, more investigation on whole CFTR gene of infertile Iranian men is suggested to find out the role of mutations and polymorphism of this gene in Iranian infertile men.

Key words: Male infertility, CFTR gene, Azoospermia.

P-71

Association study of polymorphism KIT gene with non-obstructive male infertility

Davoudi A1, Aminni Sadr M2,3, Javadi Gh2, Aleyasin A1,3.

1 Department of Medical Genetic, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran.

2 Department of Genetic, Faculty of Sciences, Azad Islamic University of Tehran, Iran.

3 Navid Infertility Institute of Tehran, Tehran, Iran.

Email: [email protected]

Introduction: The KIT encodes for a transmemberane receptor is associated with maturation of several cell types, including germ cells. The ligand of the receptor has been identifed as stem cell factor (SCF). KIT is expressed in the cytoplasm of spematogonia, acrosomal granules of spermatids and leydig cells. Diffects in this gene expression have also been shown in human testicular dysfunctions, reduction in SCF/KIT expression in oligozoospermia with an increase in the germ cell apoptosis process. In addition KIT seems to be a good marker of seminoma testicular tumours. An important role for the KIT is spermatogenesis and involvement in spermatogenetic defects. Three single-nocleotide polymorphisms (SNPs) have been identified and these have been studied to discover their implication in the male infertility. We have studied one single-nocleotide polymorphism SNP rs3819392 located within the genomic region of the KIT. We carried out a genetic association study to provide the role of the KIT gene in male infertility.

Materials and Methods: These have been studied in 100 normal male cases and 100 azoospermia male. PCR and RFLP thechniques were used for this study of the polymorphism.

Results: Our results showed a positive correlation between KIT 1101 G>A and male infertility.

Conclusion: Our data revealed the KIT may plaied an important role in male infertility and thus KIT 1101 G>A can be one of the genetical risk factor for the male azoospermia.

Key words: Male infertility, KIT, Polymorphism, Azoospermia.

P-72

Angiotensin converting enzyme and plasminogen activator inhibitor-1 polymorphisms in patients with recurrent spontaneous abortion

Sakhinia E1,3, Poursadegh Zonouzi A2, Firoozi A3, Karimi Ansari N3, Chaparzadeh N2, Mehrzad Sadaghiani M4, Farzadi L4, Ghasemzadeh A4.

1 Department of Biochemistry, Molecular Medicine Division, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Department of Cellular and Molecular Biology, Faculty of Sciences, Azarbaijan University of Tarbiat Moallem, Tabriz, Iran.

3 Tabriz Genetic Analysis Centre (TGAC), Sheikh Alraeis Clinic, Specialized and Subspecialized Outpatient Clinic, Tabriz University of Medical Sciences, Tabriz, Iran.

4 Department of Obstetrics and Gynecology. Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Angiotensin Converting Enzyme (ACE) catalyses the conversion of angiotensin I to angiotensin II, which increases the plasminogen activator inhibitor-1 (PAI-1) plasma level. The insertion/ deletion (I/D) polymorphism in intron 16 of the ACE gene is associated with the ACE expression. Homozygosity for the D allele of the ACE gene, which results in elevated PAI-1 concentrations and hypofibrinolysis, is related with an elevated risk of thrombophilic diseases such as pulmonary thromboembolism, deep venous thrombosis, and pregnancy outcome. We investigated polymorphisms of ACE and PAI-1 genes and their association with recurrent spontaneous abortion (RSA) in Iranian patients and normal healthy controls by a case-control study in North West of Iran.

Materials and Methods: DNA was extracted from peripheral blood leukocytes of 89 RSA patients and 50 controls. Genotyping of (I/D) ACE polymorphism and PAI-1 (4G/5G) were carried out by Amplification Refractory Mutation System (ARMS-PCR) method.

Results: The ACE polymorphisms of the 89 patients identified that 26% had I/I genotype, 34%were I/D and 40% were D/D. Among the 50 controls 16% had I/I genotype, 56% were I/D and 28% had D/D genotype. The PAI-1 polymorphisms of the patients identified that 28% had 4G/4G genotype, 57% were 4G/5G and 15% were 5G/5G. Among the controls 30% had 4G/4G genotype, 56% were 4G/5G and 14% had 5G/5G genotype.

Conclusion: In conclusion, our results demonstrate that few statistically significant differences in the prevalence of this ACE and PAI-1 genes polymorphism in patients who are suffer from RSA; however the data should be verified with the aid of a larger population.

Key words: Recurrent spontaneous abortion, Angiotensin Converting Enzyme, Plasminogen activator inhibitor-1.

P-73

Prevalence of molecular genetic markers thromboplilia in Iranian patient with recurrent pregnancy loss

Sakhinia E1,3, Poursadegh Zonouzi A2, Firoozi A3, Karimi Ansari N3, Chaparzadeh N2, Mehrzad Sadaghiani M4, Farzadi L4, Ghasemzadeh A4.

1 Department of Biochemistry, Molecular Medicine Division, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Department of Cellular and Molecular Biology, Faculty of science, Azarbaijan University of Tarbiat Moallem, Tabriz, Iran.

3 Tabriz Genetic Analysis Centre (TGAC), Sheikh Alraeis Clinic, Specialized and Subspecialized Outpatient Clinic, Tabriz University of Medical Sciences, Tabriz, Iran.

4 Department of Obstetrics and Gynecology, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: Recurrent spontaneous abortion is a multifactorial disorder. Predisposition for thrombosis has been shown to be a risk factor for it. In present study we investigated the incidences of 4 thrombophilic genes to determine the relation of inherited thrombophilia and recurrent spontaneous abortion.

Materials and Methods: A total of 139 women were included in this study: 89 women with a history of first trimester recurrent miscarriage and 50 fertile women with at least two live births from many different regions of North West of Iran that all referred by specialist. After genomic DNA extraction, we used Amplification Refractory Mutation System (ARMS-PCR) and restriction fragment length polymorphisms (RFLP) method to identification of metal methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), Prothrombin (20210G/A), Factor XIII (Val34Leu) and Beta-fibrinogen (-455G/A) polymorphisms.

Results: We found that the mutant allels of frequency for MTHFR C677T , MTHFR A1298C, Prothrombin, Factor XIII and Beta-fibrinogen polymorphisms were 23.5%, 36%, 1.7%, 28%, 20% in patients and 24%, 40%, 0%, 28% and 13% in controls respectively. No difference in the frequency of specific gene mutation was detected between two groups. However the prevalence homozygous mutation and total gene mutation among women with RSA (26%) was less significantly higher than healthy controls (14%).

Conclusion: In conclusion, compound thromboplilic gene mutations rather than specific gene mutation can be risk factor for first trimester RSA however; further studies on larger series are needed to better understand the role of these gene mutations, in this clinical setting.

Key words: Recurrent spontaneous abortion, Metal methylenetetrahydrofolate reductase, Prothrombin, Factor XIII and Beta-fibrinogen.

P-74

Pattern of antral follicular development in left and right ovaries

Mirshamsi M, Karami-Shabankareh H, Soltani L.

Department of Animal Sciences, Razi University, Kermanshah, Iran.

Email: [email protected]

Introduction: It is generally assumed that ovulation from each of the two (left and right) ovaries occurs approximately the same number of times. However, different studies have shown that the right-side ovulation tends to undertake more ovulation than the left ovary. Therefore, population and growth pattern of antral follicles may be also differing between left and right ovaries. The objective of this study was to evaluate the population, selection rate and dominant rate of antral follicles in left and right ovaries.

Materials and Methods: Bovine left and right ovaries were obtained from an abattoir and transported to the laboratory. The diameters of antral follicles were measured and classified in the size groups: Group a (<3mm), Group 2 (2-6mm) and Group 3 (>6mm). The nubber of antral follicles were registered. Oocytes were aspirated and numbers of apoptotic oocytes (for registration of atretic follicles) were analyzed. After data collection, selection rate and dominant rate were evaluated in left and right ovaries.

Results: The number of small, medium and large growing follicles (6.9, 5.1 and 0.2 respectively) was lower (p<0.05) in left-side ovary versus right-side ovary (10.2, 7.7 and 0.6 respectively). The selection was similar in right and left ovaries (0.78% versus 0.73% respectively). However, a dominant rate in right-side ovary (0.08%) was higher (0.01) than that left-side ovary (0.04%).

Conclusion: The follicular population in right-side ovary was higher than left-side ovary. Morever, the patterns follicular development (selection and dominant rate) in the bovine also differ between left and right ovaries.

Key words: Ovary, Follicular development, Apoptotic.

P-75

Brilliant cresyl blue (BCB) scoring system as a efficient tool for zygotes selection

Mirshamsi M, Karami-Shabankareh H, Soltani L.

Department of Animal Sciences, Razi University, Kermanshah, Iran.

Email: [email protected]

Introduction: One of the most important problems in IVF units is the need to oocytes and zygotes selection, a crucial point maintain high performance in in vitro embryo production (IVEP). Optimization of IVEP protocols is vital not only for generating viable embryos but also to support the development of subsequent offspring into normal adults. The aim of tjis study was investigate the embryo development and quality of categorized oocytes and zygotes by Brilliant cresyl blue (BCB) staining to validate BCB test as non-invasive option for selection of oocytes and zygotes.

Materials and Methods: Sheep oocytes and presumptive zygotes were exposed to BCB stain diluted in modified DPBS for 90 and 10 min (respectively) at 38.5 ?C in a humidified air. The oocytes with or without blue coloration of the cytoplasm were designated as BCB+ and BCB-, respectively. Zygotes were categorized into 3 categories according to whether they were still stained (category 1), moderately stained (category 2) or unstained (category 3).

Results: BCB+ oocytes yielded more blastocysts than BCB- and control oocytes (untested). In addition, category 3 zygotes yielded more blastocyst rate than control, category 2 and category 1 zygotes. Moreover, the proportion of blastocyst formation of category 3 zygotes (30.5%) was higher (p<0.05) than that of BCB+ oocytes (24.6%).

Conclusion: The variation in the developmental potential between oocytes and zygotes of different stain categories is an indicator of tendency of BCB test to discriminate oocytes and zygotes according to the growth phase and metabolism status.

Key words: Oocytes, Zygote, IVF.

P-76

Pattern of oocyte development in left and right ovaries

Mirshamsi M, Karami-Shabankareh H, Soltani L.

Department of Animal Science, Razi University, Kermanshah, Iran.

Email: [email protected]

Introduction: A limited number of studies demonstrated that the developmental potential of human oocytes was affected by the side of ovary. In addition, the competence of an oocyte to resume and complete meiosis and, after fertilization, to develop into a blastocyst is markedly increased during preovulatory development through a process called oocyte capacitation. To our knowledge, there are no reports regarding in oocyte development in left and right ovaries. The objective of the present study was to evaluate oocyte development in left and right ovaries.

Materials and Methods: Bovine left and right ovaries were obtained from an abattoir and transported to the laboratory. The follicles were aspirated at 33 °C and divided according to their diameter into three groups: small follicles: <3 mm, medium follicles: 3-5 mm and large follicles: >5 mm. The means of oocyte diameter (by ocular micrometric method) and percentage of fully grown oocytes (by brilliant cresyl blue test) was recorded for each follicle categories.

Results: Oocyte diameter and percentage of fully grown BCB+ oocytes increases in parallel with follicular size in left and right side ovaries. The results set out in the current study, indicate that the oocyte diameter, cytoplasm volume and percentage of fully grown oocytes in right-side ovary was higher than that left-side ovary.

Conclusion: We can deduce a relationship between side of ovary and oocyte development. In addition, we can conclude a positive relationship between follicle diameter, fully grown oocytes, and oocyte diameter in left and right side ovaries.

Key words: Oocytes, Zygote, IVF.

P-77

Pattern of oocyte development in cyclic and acyclic ovaries

Mirshamsi M, Karami-Shabankareh H, Soltani L.

Department of Animal Sciences, Razi University, Kermanshah, Iran.

Email: [email protected]

Introduction: The correct concentration of FSH is crucial for appropriate regulation paracrine factors to promote oocyte development. Therefore, FSH is important for the acquisition of oocyte developmental potential, but the correct concentration of FSH is required to prevent premature follicle differentiation that would impair oocyte growth and developmental competence. The current study was conducted for investigating the biology of oocyte development in cyclic (sergic concentration of gonadotropins) and acyclic ovary (tonic concentration of gonadotropins).

Materials and Methods: Ovaries were collected from cyclic (during breeding season) and acyclic Sanjabi ewes (out of breeding season) at a local abattoir and brought to the laboratory. Preantral follicles were classified into two categories: primary and secondary follicles. Antral follicles were categorized into three categories: early (<3 mm) mid (3-6 mm) and late (>6 mm) antral follicles. After oocyte collection, oocyte growth (by brilliant cresyl blue test) and diameter (by ocular micrometric method) were analyzed.

Results: The percentage of fully grown oocytes and oocyte diameter was increased in parallel with follicle size in both cyclic and acyclic ovaries. The percentage of fully grown oocytes (83%) and means of oocyte diameter (157.8 µm) collected from cyclic ovary was higher (P<0.05) than that a cyclic ovary (72% and 152.5 µm respectively).

Conclusion: Pattern of oocyte development is similar in cyclic and acyclic ovaries. However, rate of oocyte development in cyclic ovary is higher than acyclic ovary.

Key words: Oocytes, Zygote, IVF.

P-78

In vitro maturation of sheep oocytes: influences of sera and hormones

Mirshamsi M, Karami-Shabankareh H, Soltani L.

Department of Animal Sciences, Razi University, Kermanshah, Iran.

Email: [email protected]

Introduction: In vitro embryo production (IVEP) technology has been successfully applied in a number of animal species with transferred embryos resulting in live offspring. The successive steps of IVEP of embryos are: in vitro maturation (IVM), in vitro fertilization (IVF) and in vitro culture (IVC). The maturation medium and the selection of protein supplements and hormones for IVM play an important role in subsequent IVF and in vitro development. The aim of this study was to investigate the effect of adding ovine umbilical cord serum (OUCS) and two kind hormone treatments to IVM medium on subsequent embryonic development.

Materials and Methods: Oocytes were collected by aspiration and allocated in two Experiments. In Exp 1, oocytes were matured in IVM medium supplemented with OUCS or fetal bovine serum (FBS). In Exp 2, oocytes were transferred into IVM medium supplemented with FSH-LH (each 0.075 IU/ml) or PMSG-HCG (each 10 IU/ml). After IVF and IVC rate of blastocyst formation were analyzed.

Results: There was no significant difference (p>0.05) among OUCS and FBS groups for percentage of blastocyst production (26% and 28% respectively). The results set out in Exp 2, indicate that the percentage of blastocys formation was similar (p>0.05) among FSH-LH (21%) and PMSG-HCG (24%).

Conclusion: OUCS and FBS for IVM treatment supported similar rate of embryo development. Furthermore, the matured oocytes in IVM medium supplemented with FSH-LH or PMSG-HCG were similar in their ability to blastocyst formation.

Key words: Oocytes, Zygote, IVF.

P-79

Developmental potential in vitro of ovine oocytes cultured in defined maturation media containing different concentration of MEM vitamins

Soltani L, Karami-Shabankareh H, Kafilzadeh F.

Department of Animal Sciences, Faculty of Agriculture, Razi University, Kermanshah, Iran.

Email: [email protected]

Introduction: This study was carried out to evaluate the various concentrations of MEM vitamins during in vitro maturation of sheep oocytes in defined maturation medium (DMM).

Materials and Methods: Oocytes collected from a slaughterhouse were matured in SOF medium supplemented with, eCG, hCG, EGF and PVA in various concentrations of MEM vitamins (control, 0.5, 1 and 1.5×) for 24h. COCs were then fertilized and cultured in vitro for 8 days when the ratios of in vitro embryo development of the hatched blastocysts were assessed and compared with the control group (p<0.05).

Results: The mean percentage of cleavage rate was not significantly different between treatments (Control: 60.41%, 0.5 × MEM: 52.25%, 1× MEM: 65.73% and 1.5× MEM: 57.88%). There were no differences between treatments in the percentage of embryos successfully developing to the blastocyst stage, expressed as a percentage of total cleaved embryos stage (Control: 17.22%, 0.5× MEM: 18.86%, 1× MEM: 18.83% and 1.5× MEM: 16.55%).

Conclusion: Thus, it seems that addition of MEM vitamins has not effect on blastocyst rate.

Key words: Embryo development, IVM, MEM vitamins, Sheep, DMEM.

P-80

Developmentel exposure to EMF and its effect on spermatogenesis in adulthood in mice

Hamdi BA1, Soleimani Rad J2, Khaki AA2, Roshangar L2.

1 Department of Clinical Analysis, Pharmacy College, Hawler Medical University, Kurdistan Region, Iraq.

2 Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: [email protected]

Introduction: The study is designed to evaluate the effects of 50 Hz extremely low frequency electromegnatic field (EMF) exposure on testicular development and it is impact on sprmatogenisis in adulthood in mice.

Materials and Methods: Pregnant BALB/c mice aging 8 weeks were divided in two groups as control (15 mice). The experimental group were exposed to 3mT 50Hz EMF for 4h/day for 21 (from the first day of pregnancy). The experimental group was placed in similar condition without exposure to EMF. After the pregnancy period and delivery the male pups were divided into two groups half of them were killed immediately after birth and the testis were fixed and studied with light microscope , and the other half were kept to reach adulthood.Then the mice were killed and the testis were fixed and studid with light microscope.

Results: The result showed that the seminiferous tubule in the experimental group were widly sepereted from each other in comparison to control group .It appeared that the population of sertoli cells were decreased in experimental groups . Then were also some huge cells in the center of the tubules which is gonocytes. In the adult mice that were exposed to EMF during the developmental periode there were several intercellular spaces and spermatogenic cells had condensed nuclei .The other spermatogenic cells appeared normal and sertoli cells were not affected.

Conclusion: The result indicates that exposur to EMF during developmental period not only could affect on the Testicular development but its effect will continued till adulthood and may affect fertility.

Key words: Gastation, EMF, Pups, Gonad development, Adulthood.

P-81

Effect of oxidative stress induced by BSO on fertility of ovume in in-vitro in mice

Roshangar L, Soleimani Rad J, Sabetkam S.

Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Email: leila roshangar [email protected]

Intoduction: Antioxidents and reactive oxygen species (ROS) are in balance in the body. Whenever the balance between these molecules is disrupted towards an overbundance of ROS, oxidative stress(OS) occurs. Mostly, OS is the result of increased ROS generation, rather than a depletion of antioxidants.There are evidence that gluthatione as an intracellular antioxidant plays an importent role against ROS in female reproductive system.Regarding the effect of BSO as a selective inhibitor of gluthatione peroxidase the aim of the present study is to investigate BSO induced OS on fertility of ovume.

Materials and Methods: For this purpose,30 adult female and 5 adult male bulb/c mice were kept in standard condition and divided into 3 groups of experimental,sham and control.The experimental group received 2 mmol/kg BSO daily for 2 weeks as IP injection.The sham group was received the solvent of BSO and the control group didnot received any.After the injection periode the mice in all 3 groups received 7.5unit hMG and 48 hours later 7.5 unit hCG as IP injection.36 hours later the mice were killed by cervical dislocation and oocytes were collected by uterine tube flashing and sperms from male mice from the cauda epididymis by incubating the pieces of epididymis in 37° oven.The sperm were added to the medium drops containing oocytes 50 in each group and embryo formation was considered as fertility.The number of embryos in each group was counted and compared with each other by using ANOVA.

Results: The results showed that the percent of embryo formation in experimental group comparing to control and sham groups were significantly reduced (p<0.01).

Conclusion: The result indicates that BSO-induced OS could affect the fertility of oocytes and reduces embryo formation.

Key words: L-buthionine-sulfoximine, IVF, Ovary.

P-82

Effect of embryo quality on cropreservation outcome

Mansouri M, Aram R, Fadavi Islam R, Sabouri E, Rustaii H, Khalili Far H, Nasiri R.

Novin Infertility Center, Mashhad, Iran.

Email: [email protected]

Introduction: The purpose of the study is to determine the effect of embryo quality on the survival and developmental rate of vitrified-thawed embryos. These factors were examined in 83 vitrified -thawed cycles, including 287 embryos.

Materials and Methods: Day 2 to 3 embryos were frozen by vitrification before being plunged into liquid nitrogen. Kitazato Vitrification Media (Etilen glycol and DMSO) was used as the cryoprotectant and, following thawing, the embryos were incubated for 20 - 24 hours. Embryos were classified morphologically before and after freezing into 3grades (A: blastomers without any fragmentations; B: blastomers of equal or unequal size and medium cytoplasmic fragmentation) C: blastomeres of unequal size and major cytoplasmic fragmentation .Only embryos of grade A and B were frozen.

Results: The survival rates of thawed embryos in graded A and B were 98% and 79%, respectively. The result showed that there is a significant difference in survival rate between two groups .Although there was no significant statistically difference between Grade A and B embryo development after in-vitro culture (73% and 64% respectively)(Paired Student's t- test , p≤0.05).

Conclusion: These results indicate that embryo quality is an important factor for successful cryopreserved-thawed outcome. Embryo grade at the time of freezing could influence the survival rate of frozen -thawed embryos. As a result it could be concluded that There is a significant decreasing trend in survival rate with Grade B embryos at the time of freezing (p<0.001).The fact that the survival rate of good morphology embryo was higher (98%) than poor morphology ones (79%) suggested poor-quality embryos are more likely to be damaged during the cryopreservation process. Although embryo quality could impact survival rate of thawed embryos, it seems that it has little effect on developmental rate .So it might indicate that freezing of low-quality embryos could be valuable in some cases.

Key words: Cryopreservation, Embryo quality, In-Vitro Fertilization, ICSI.

P-83

Antimotility effect of uropathogenic E. coli SIF on sperm

Rastgou Z1, Mohabati Mobarez A2, Movahedin M3.

1 Department of Biology, Islamic Azad University, Sciences and Research Branch, Tehran, Iran.

2 Department of Bacteriology, Tarbiat Modares University, Tehran, Iran.

3 Department of Anatomy, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: Bacterial infections have long been recognized as having an association with infertility. It is also known that bacteria are capable of agglutinating and immobilizing spermatozoa. E.coli is the most frequently isolated microorganism in genitourinary infections. Immobilization of spermatozoa by E.coli is associated with tight adhesions between bacteria and spermatozoa resulting in agglutination of spermatozoa. Adhesion and agglutination is followed by profound alterations and damage of the ultra- structure of spermatozoa.

Materials and Methods: Highly motile spermatozoa from normo-zoospermic patients were co incubated with E. coli for 4 hours. Sperm motility was determined at 1, 2 and 4 hours of incubation, the factor (SIF) responsible for sperm immobilization without agglutination was isolated and purified from filtrates. Spermatozoa incubated with this factor revealed multiple and profound alterations, involving all superficial structures of spermatozoa as observed by scanning electron microscopy.

Results: Sperm immobilization factor (SIF) from E-coli was immobilized but did not kill spermatozoa. After removing the SIF and re-suspending the sperm in normal seminal plasma indicating that the mechanism is reversible.

Conclusion: Immobilization of spermatozoa by SIF of E. coli demonstrate this factor can causes variable structural damage as probable morphological correlates of immobilization.

Key words: Uropathogenic E. coli, Sperm, Motility

P-84

Comparing the efficiency of different culture systems on proliferation and purification of the human spermatogonial stem cells

Zahiri M1, Movahedin M1, Mowla S2, Noruzinia M3.

1 Department of Anatomy, Tarbiat Modares University, Tehran, Iran.

2 Department of Genetics, Tarbiat Modares University, Tehran, Iran.

3 Department of Hematology, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: The aim of this study was to providing an appropriate in vitro system to proliferate and enrichment of human spermatogonial stem cells from obstructive asospermic patients.

Materials and Methods: Testicular cells isolated from testis biopsies after enzymatic digestion. Four cultural systems were disigned: co-culture with sertoli, culture on gelatin coated dishes, culture of testicular fragments and culture on uncoated dishes. The rate of colony formation and the diameter of each colony were investigated.

Results: Our results showed that there are significant differences (p<0.05) in colony numbers and the time of colony formation in the culture of testis fragments compared with other groups. Culture of testis fragmenteds showed the more number of colony and colonies appeared more rapidly. Regarding the diameter of colonies, there are not any significant differences between the three groups, while culture of isolated spermatogonial cells on uncoated dishes showed the lowest colony diameter between groups.

Conclusion: In conclusion designing appreciated cultural system is very important in culture, proliferation and enrichment of SSCs and it should be considered to close these systems to in vivo.

Keywords: Spermatogonial Stem Cells, Colony Formation, Culture, Human.

P-85

The changes of ?v, β3, ?4, β1 integrins expression and osteopontin their ligands in murine estrous cycle

Peyghambarl F1, Salehnia M2, Rezazadeh Valujerdi M2, Forouzandeh M3.

1 Department of Anatomy, Faculty of Medical Sciences, Islamic Azad University, Yazd, Iran.

2 Department of Anatomy, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

3 Department of Biotechnology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: Considering the importance of integrin molecules in the implantation and lack of sufficient information in the expression pattern of these molecules in various phases of estrous cycle. It seemed to be necessary to investigate these molecules in mouse endometrial during the various phases of oestrous cycle .

Materials and Methods: Female NMRI mice (n=15) aged 6-8 weeks were studied. Various phases of estrous cycle including proestrus, estrus, metestrus and diestrus were determined by vaginal smear. The mice were sacrificed (at least 3 per each phase) by cervical dislocation and the tissues were obtained from the middle 1/3 part of their uterine horns at each phase then the cryosections at thicknesses between 8-10 I.l were obtained. Then the immunohistochemistry were done for integrins of ?4, β1, ?v, β3 and their ligand osteopontine.

Results: The integrins were expressed only in the metestrous phase of oestrous cycle in the different locations of mouse endometrium. The positive reactions were observed for ?v, ?4 and β3 in the apical and basal membrane of glandular epithelium. Also the positive reaction for β1 was found in surface and glandular epithelium as well as stroma. The osteopontin expression was seen in the apical membranes of surface and glandular epithelium and was not seen in other locations .

Conclousion: It seems that expression of integrins in endometrium is based on their role in the implantation, therefore the molecules a4, ~1 and OPN that are expressed on the surface epithelial may be involve in the adhesion of cell to cell and integrins of av, ~3 that are expressed in the glandular

Key words: Endometrium, Integrins, Oestrous cycle, Immunohistochemistry.

P-86

Tumorigenic potential of bone marrow mesenchymal stem cells in relation with C-Myc expression

Mazaheri Z1, Movahedin M1, Rahbarizadeh F2, Amanpour S3, Muhammadnejad S3.

1 Department of Anatomy, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran.

2 Department of Biotechnology, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran.

3 Cancer Research Center, Vali-e-Asr Reproductive Research Center, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran.

Email: [email protected]

Introduction: The expression of C-Myc as a protoncogene was measured to determine of tumorigenic potential of bone mesenchymal stem cells (BMSCs) which are important source of stem cell for cell therapy.

Materials and Methods: The BMSCs were cultured for 4 passages, then spindle shaped cell were prepared for characterization of mesenchymal cell surface markers by flowcytometery, immunocytochemistry and differentiation to osteogenic and adipogenic leanages by defined medium. The expression of C-Myc was calculated in 4 hours & 4 passages after isolation of BMSCs by quantitative RT-PCR. For in vivo tumorigenic potential of BMSCs, 4×106 cells were implanted in flank region of athymic mice.

Results: Quantitative RT-PCR results showed over expression of C-Myc, the latency period of BMSCs inoculated for tumorigenicity was 47 days.

Conclusion: Undifferentiated mesenchymal stem cells could be able tumorigenic because of over expression of oncogenic gene such as C-Myc. However, more study is need in cell therapy with heterogenous population of differentiated & undifferentiated stem cells.

Key words: Tumorigenicity, BMSC, Oncogene.

P-87

The distribution of uterus Natural Killer cells on pregnanant mice after hyper stimulation protocol

Doorfeshan P1, Salehnia M1, Moezeni M2.

1 Department of Anatomy, Tarbiat Modares University, Tehran, Iran.

2 Department of Immunology, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: Natural Killer cellsare predominant immune cells in decidua early pregnancy and these cells express progesteron receptors. Hyperstimulation process results in supraphysiological concentrations ofesterogen and progesteron. In this study, the distribution of classic NK cells in hyperstimylated mice in comparisson with control group were studied.

Materials and Methods: For this purpose, the sampaleswere obtained from implantation sites of NMARI pregnant mice at seventh day of pregnancy after hyperstimulation with PMSG and HCG. Cryosections at 5 micrometerethickness were provided from endometrium of both groups and stained with CD3 and CD161 monoclonal antibodies by double staining immunohistochemical method. NKcells were studied under light microscope at 400x magnification.

Results: The results showed that the distribution of CD3?CD161+NK cells almost similar in decidua ofhyperstimulated and control groups. These cells mainly observed in decidua and myometrum.It seems that NK cells population was prominent in hyperstimylated group in compare to the control group.

Conclusion: This increase may be related to the expression of progesterone receptore by Natural Killer cells and it may affect on the implantation process.However it needs additional studies.

Key words: Natural Killer cells, Hyper Stimulation, pregnancy.

P-88

The effect of lipoic acid on Reactive Oxygen Species (ROS) concentration of cultured mouse preantral follicles

Talebi A, Zavareh S, Kashani M, Lashgarbluki T.

Faculty of Biology, Damghan University, Damghan, Iran.

Email: [email protected]

Introduction: Oxygen concentration is higher in in vitro cultures than in in vivo conditions, thus leading to formation of reaction oxygen species (ROS) which can cause oxidative stress. Antioxidants have been used to prevent the uncontrolled formation of ROS. Lipoic acid (LA) is a potent antioxidant that may protect the cells from oxidative stress.

Materials and Methods: Preantral follicles were isolated from 2 weeks old NMRI mice ovaries and cultured in ?-MEM medium supplemented with 5% FBS, 100 mlU/ml FSH, 1% Insulin-Transferrin-Selenium, 10 ng/ml rEGF and different concentrations (50, 100, 250 and 500 µM) of LA, for experiment groups. At 12th day of culturing, ovulation was induced by addition of 1.5 IU/ml human chorionic gonadotropin. The effect of LA was investigated on follicular growth, (Diameter, survival and antrum formation rates) and developmental stages (GV, GVBD and MII) of released oocytes.

Results: After 0, 24, 48, 72 and 96 h of culture of preantral follicles in the presence of different concentrations of LA (0, 50, 100, 250 and 500 µM), ROS production was measured by spectrofluorometery. Also total antioxidant capacity (TAC) levels were evaluated by FRAP assay in the same groups. In the presence of 100 µM LA, mean of diameter, survival and antrum formation rates of follicles and the percentage of MII oocyte derived from follicles were significantly higher than other groups (P<0.05). The ROS levels decreased in follicles which were cultured with 100 µM than the control but the increases in the level of TAC were observed than the control (P<0.05).

Conclusion: Our study demonstrated that LA (100 µM) improves the in vitro development of follicles. This effect may be mediated by decrease in ROS concentration and increase in follicular TAC level during culture period.

Key words : F ollicle culture , Developmental competence , L ipoic acid , ROS , TAC.

P-89

Variation of macrophage- drived chemokine (MDC/CCL22) in patient with gestational trophoblastic disease

Naeimi S1, Erfani N2, Samsami Dehaghani A3, Ghaderi A2.

1 Islamic Azad University, Kazerun Branch, Kazerun, Iran.

2 Shiraz Inistitue for Cancer Research, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.

Email: [email protected]

Introduction: Gestational trophoblastic disease (GTD) consists of a spectrum of disorders that are characterized by an abnormal proliferation of trophoblastic tissue, following to abnormal fertilization. These comprise a unique group of diseases with the maternal tissue being invaded by tissues from the concept us which is genetically distinct from the mother. Some of these lesions are frank neoplastic tissues e.g., CC and PSTT while others represent abnormal placental tissues with a potential of malignant transformation e.g., HM.

CCL22 is one chemo attractant molecule preferentially expressed by macrophage, dendritic cells and tumors cells, and therefore, is likely to participate in the recruitment of antigen-specific Th2 and T regulatory cells to sites of tumor exposure. Variations in CCL22 have been reported. In this study we intend to find out the relationship between polymorphism of this gene at the site of 16C/A and GTD.

Materials and Methods: In order to this , the polymorphisms of the CCL22 gene at the sites of 16 C/A was investigated in 110 patients with proved GTD and 120 age-sex matched healthy individuals were recruited and these two groups were compared in respect their genotypes and alleles.

Results: There isn't significant difference was seen in genotype and allele prevalence of 16 C/A in ccl22 gene in the two above mentioned groups (p>0.05).

Conclusion: Therefore further researches in larger groups of patient and with paying attention relation between polymorphism of this gene and type of disease is suggested.

Key words: CCL22, Polymorphism, GTD, Genotype.

3- Midwifery

P-90

Comparison of iron and folic acid supplement taking and adequate maternal weight in intended and unintended pregnancies

Ghodsi Z.

Department of Midwifery, IAU of Toyserkan, Toyserkan, Iran.

Email: [email protected]

Introduction: Unintended pregnancy is one of the health problems in family and society. The large number of women with unintended pregnancy reveals different health behaviors. Prevent of unintended pregnancies through decreasing of mother and neonatal problems, is cased increase of society health level. This research has conducted on aim of comparison of iron and folic acid supplement taking and adequate weight increase of pregnancy periods in intended and unintended pregnancies.

Materials and Methods: This study which is a part of large study is a case-control survey. By using a continued method, selected 270 parturient presented for vaginal delivery at Taamin Ejtemaee hospital, and based on intended or unintended pregnancy, were placed in 2 groups. Maternal behaviors including beginning time and regular take of iron and folic acid and adequate weight increase were completed with questions of them, and visited prenatal care centers if there was any prenatal care. Students` t-test, man-Whitney and chi-squared test were used in order to data analysis.

Results: Based on finding the study, there were meaningful statistical evidences about maternal behaviors in pregnancy period such as folic acid and iron initiate taking, using, and adequate weight increase between 2 groups.

Conclusion: According to findings of the present study, unintended pregnancies case changes on maternal health behaviors in pregnancy period. Therefore it is recommended to Improve of quality and access to family planning and emergency contraception, preconception counseling improving, reproductive health education, and increase of preventive health cares in order to control of conception time and aimed with increase of society health level.

Key words: Unintended pregnancy, Folic acid, iron, Weight increase.

P-91

Evaluation of age at menarche in girls of Markazi (Central) Province, Iran

Bayat PD1, Khazaei M2, Ghanbari A2.

1 Department of Anatomy, Arak University of Medical Sciences, Arak, Iran.

2 Fertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Email: [email protected]

Introduction: The age at menarche is an indicator of racial, geographical and nutritional patterns of different societies. This study aimed to complement previous data of age at menarche in Iran and evaluate the changes that have taken place in the Markazi (central) province of Iran and the entire world.

Materials and Methods: This cross-sectional study conducted on 1223 girls aged 14-20 years who were students of national high school in the Markazi (Central) Province, Iran in 2009. According to the objectives of the study, the age at menarche, the main variable, was determined for each city and compared between different cities. The statistical analyses included ?2 test for determining statistically significant differences, variance analysis for determining the difference between groups, and Pearson correlation coefficient for determining the relationship between variables.

Results: The average age of first menstruation was 13.21 ± 1.33 years in the Markazi Province, with no significant difference among the cities of the province. The average age of first menstruation is inversely related to body mass index, nutritional status and weight. The pattern of distribution of body mass index is similar for the cities in the province.

Conclusion: The average age at menarche in the Markazi (central) province, a cold area, is higher compared to warmer regions of Iran. Considering the lowered age at menarche in Markazi Province compared to previous studies, it may be stated that social well-being and nutritional standards have improved in the province.

Key words: Age at menarche, Body Mass Index (BMI), Fertility, Growth, Iran.

P-92

The effect of abdominal pressure on the duration of the second stage of labor in Iran

Peyman A, Shishegar F, Abasi Z.

Faculty of Midwifery, Islamic Azad University, Tehran Medical Branch, Tehran, Iran.

Email: [email protected]

Introduction: The role of fundal pressure (FP) during the second stage of labor is controversial. The prevalence of its use is unknown. There is little evidence to demonstrate that the use of fundal pressure is effective to during the second stage of labor and several anecdotal reports suggest that fundal pressure is associated with neonatal complications.

Objectives: To find out what percentage of pregnant women who have referred to the hospitals underwent FP, Also to determine the time of second stage of labor and show neonatal complication.

Material and Methods: This is a randomized controlled trial that was performed on 2631 pregnant women with 38-42 gestational age, single birth and cephalic presentation, who went to Tehran's hospitals for delivery since 2005 for three years. During the second stage of delivery FP was used for some of the mothers and we researched for the frequency of use of FP and the duration of the second stage.

Results: FP was applied for 1171 women. There were differences in the mean duration of the second stage of labor for nullipara and multipara. There was some evidence that use of maneuver was a disadvantage to the fetus.

Conclusion: Application of fundal pressure on a delivering woman was effective in shortening the second stage of labor. Nevertheless, newborn, s Apgar score was unsatisfactory.

Key words: Labor, Fundal pressure, Second Stage.

P-93

Self-management in primary dysmenorrhea: toward evidence-based education

Kabirian M1, Abedian Z1, Mazlom SR2, Mahram B2.

1 Department of Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Medical and Surgical Nursing, Mashhad University of Medical Sciences, Mashhad, Iran.

Email: [email protected]

Introduction: There is not an evidence-based education that reinforces use of scientific research in the context of self- management in primary dysmenorrhea. This study was conducted to determine the effect of evidence-based education on dysmenorrheic girl's self-care behaviors and the severity of primary dysmenorrhea at dormitories of Ferdowsi University in Mashhad, Iran.

Materials and Methods: The method of this study involves the following steps:

A/ Formulation of answerable questions to address self-care methods in primary dysmenorrhea.

B/ Systematic searching for the research evidence that could be used to answer the questions.

C/ Appraisal of the validity, relevance and applicability of the research evidence.

D/ Designing of the protocol of evidence-based education based on the best acquired evidence.

E/ Evaluation the effect of evidence-based education on dysmenorrheic girl's self-care behaviors and the severity of primary dysmenorrhea.

Results: There was a significant reduction in pain score at the first (-0.6±1.7 vs 1.1±2.1 p=0.000) and second (-1.9±1.5 vs 0.1±1.6 p=0.000) menstrual period after intervention in the evidence-based education group compared with the girls in the control group. Also, the difference in self-care behaviors between evidence-based education versus control group at the second menstrual period after intervention (105.8±8.9 vs. 80.4±11.3 p=0.021) was significant.

Conclusion: Evidence-based care leads to remarkable advances in the management of primary dysmenorrhea. Health education systems can use evidence-based education in order to promote self-management behaviours among primary dysmenorrheic girls.

Key words: Evidence-based Education, Self-management, Primary Dysmenorrhea.

P-94

Internal perceived of Zanjanian pregnant women about control of pregnancy outcomes

Maleki A1, Ahmadnia E1, Mazloomzadeh S2.

1 Department of Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.

2 Department of Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran.

Email: [email protected]

Introduction: Considering the importance of the belief structures and perception of women about affecting pregnancy outcome to determine the internal perceived of Zanjanian pregnant women about control of pregnancy outcomes seems to be necessary.

Materials and Methods: In a descriptive study internal perceived of 361 pregnant women was investigated by using of convenience sampling. Data collection was done with questionnaire included demographics status and questions related to internal perceived that was analyzed using t-test, ANOVA, regression, and frequency table. The Cronbakh ? of questionnaire was 0.65.Scores were in the 10-25 range that their mean were calculated. Range Mean ±SD was considered as an average internal perceived, greater than it as a good, and lower than it as a low internal perceived.

Results: 18% of women had a low, 64.5% had an average, and 17.5% had a good internal perceived. Having adverse pregnancy outcome, intake and having knowledge about acid folic, parity, job and educational status of women had significant relation with mean of internal perceived nevertheless age of women and gestational age had not. There was a positive correlation between internal perceived and knowledge about acid folic nevertheless it was negative with parity. In logistic analysis knowledge about acid folic and education were associated with higher internal perceived therefore, having high level of knowledge about acid folic and h education increased odds of having high level of internal perceived.

Conclusion: With regards in our study the majority of pregnant women had an average internal perceived that influenced by demographic factors such as education; planning to improve internal perceived of women before and during pregnancy, especially uneducated people seem necessary.

Key words: Internal perceived, Pregnancy outcomes, Pregnancy.

P-95

Comparison of K-K9 and P6 points acupressure on nausea and vomiting in the first half of pregnancy

Snourani SH1, Aparnak F1, Sadr Nabavi R2, Ebrahimzadeh S3.

1 Department of Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Neuropathology, University of Heidelberg Germany, Vienna, USA.

3 Faculty of Biostatistics, Mashhad University of Medical Sciences, Mashhad, Iran.

Email: Midwife61s2006 @ yahoo.com

Introduction: Nausea and vomiting are uncomfortable and common complaint encountered in early pregnancy and experienced by between 50 and 90 % of women. Various factors have been implicated in nausea and vomiting of pregnancy and have a significant impact on family life, on the ability to perform usual daily activities on social functioning.

The Chinese Acupuncture point P6 and the Korean Hand Acupressure point K-K9 were noted for the treatment of nausea and vomiting. The aim of this study was to compare of K-K9 and P6 points acupressure on nausea and vomiting in the first half of pregnancy.

Materials and Methods: This clinical trial study, the sample were 99 eligible that were identified by adopting the random sampling method in three groups: 33 women in The K-K9 group, 33 women in P6 group and 33 women in the sham group. The study occurred in three sequences and over a 10-days period and the average total degree of nausea and vomiting was measured in three sequences by Rhodes index. During days 1-3, any intervention for three groups was not done. During days 4-7, the K-K9 and the shame groups applied acupressure seed and the P6 group applied Sea-Band. And removed them during days 8-10. To analysis data, ANOVA-Test, Kruskal-Wallis and Chi-square were employed and the analysis was accomplished by means of SPSS soft ware.

Results: There was a significant difference in the average total degree of nausea during (p=0.004) and after (p=0.001) intervention, in the average total degree of vomiting during (p=0.000) and after (p=0.003) intervention and in the average total degree of retching during (p=0.009) and after (p=0.001) intervention between groups. The Effect of acupressure on K-K9 and P6 point decrease of nausea on the first half of pregnancy is not the same and on reduction of vomiting and retching on the first half of pregnancy are the same.

Conclusion: Acupressure is a method for reduction of nausea and vomiting without any side-effect, and can easily instruct to the patient.

Key words: Nausea and Vomiting, Pregnancy, Acupressure, K-K9 Point, P6 Point.

P-96

The influence of serum lipoprotiens and body mass index on the age of menarche

Farahmand M, Ramezani Tehrani F, Azizi F.

Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Emil: [email protected]

Introduction: Menarcheal age is an important event in human life and it is influenced by a various genetic,demographic, socio economic and inviromental factors.There is controversy regarding the effect of antropometric and biochemical variables on age of menarche and the data regarding the menarcheal age and its related factors among Iranian girls is limited.

The objective of the present study is to evaluate the effect of antropometric, demographic and serum lipoproteins on the age of menarche.

Materials and Methods: 370 girls form Tehran Lipid and Glucose Study (TLGS), aged 10-16, whoes menstruation have been started 6 months prior to the study, were considered in the present descriptive study.

Results: The mean age of menarche, weight, height, waist circumference and body mass index were 12.6±1.1years, 53.7±10.5kg, 157.3±5.5cm, 72.5±9.8cm and 21.7±3.9 kg/m2, respectively. There were a statistically significance relationship between age of menarche with body mass index, height, waist circumference and the level of mother's education, however there was not any significat correlation between menarcheal age and weight or serum lipoprotiens.

Conclusion: It is not supposed that the serum lipoprotiens could highly influence the menarcheal age in girls.

Key words: Age of menarche, Body Mass Index, Serum lipoprotiens, Waist circumference, Adolescents.

P-97

Age at menopause and its related factors in Tehran Lipid and Glucose Study (TLGS)

Farahmand M, Ramezani Tehrani F, Azizi F.

Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Emil: [email protected]

Introduction: Menopause is considered as the cessation of menstrual cycles and reproductive potential. There is not any consensus on the factors that have effect on age at menopause in literature. We aimed to determine the menopausal age and its related factors among the Tehran Lipid and Glucose Study (TLGS) women.

Materials and Methods: There was 1114 naturally menopausal women aged between 39-70 in the TLGS .They have been interviewed by a trained interviewer with an standard questionnaire contain socio- demographic and reproductive questions and a general physical exam have been done for them. Menopause was defined according to the World Health Organization classification (WHO) as a condition of absence of spontaneous menstrual bleeding for more than 12 months, for which no other pathologic or physiologic cause could be determined. Age at menopause (AMP) was calculated based on their reported last menstrual cycle. Data were analyzed by ordinal regression and ANOVA with using SPSS version15.

Results: The mean and standard deviation of age at menopause were 49.6±4.5. The age at menopause was affected by smoking, menarcheal age and number of birth; it has been increased with increase the age at menarche or increase number of birth and decrease with having the previous history of smoking.

Conclusion: Smoking behavior, reproductive history and age at menarche are considered as influential factors for age at menopause among Iranian population.

Key words: Menopause, Reproductive history, Smoking.

P-98

Prevalence of premenstrual syndrome and its effective factors in Iranian reproductive aged 18-45 women

Hashemi S, Ramezani Tehrani H, Robab Allameh M.

Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Premenstrual syndrome (PMS) is defined as an experience of specific physical and psychological symptoms periodically in the last few days of the menstrual cycle. These symptoms are severe and disabling in some women therefore interferes with their social function and family relations. Various prevalence has been reported. This is the first population-based study in Iran that estimated the prevalence of PMS and its effective factors.

Materials and Methods: Using the stratified, multistage probability cluster sampling method, with a probability in proportion to size procedure, 1200 women aged 18-45 years, were randomly selected among reproductive aged women, living in urban areas from four randomly selected provinces of different geographic regions of Iran (Qazvin, Kermanshah, Golestan, Hormozgan). PMS was determined using a standard questionnaire.

Results: The mean age of participants was 32.9±7.8 years. The estimated prevalence of PMS was 52.9% and about one third of them suffered from its severe type. The logistic regression analysis demonstrates that age and education can predicted PMS; the probability of this syndrome among women aged ? 30 was 0.66 (95% CI 0.46-0.88) less than older women.

Conclusion: PMS is a common syndrome among reproductive aged women and affects the life of more than half of these women. This syndrome decreases the women's quality of life and has considerable economic and psychological aspects at the both individual and society levels. Developing an appropriate interventional program on PMS is a cost benefit strategy.

Key words: Premenstrual syndrome, Population based study, Prevalence, Menstruation, Iran.

P-99

The association between daily zinc intake and reproductive characteristics in pregnancy

Lamyian M1, Goshtasebi A2, Reisian F1, Bakouei S1, Ghodsi N3.

1 Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran.

2 Department of Family Health, Iranian Institute for Health Sciences Research (ACECR), Tehran, Iran.

3 National Nutrition and Food Technology Research Institute, Tehran, Iran.

Email: [email protected]

Introduction: The aim of this study was to examine the association between daily zinc intakes and reproductive characteristics in pregnant women.

Materials and Methods: During May- December 2010 a cross sectional study was conducted at prenatal clinics of 10 public hospitals in Tehran-Iran. 440 pregnant women before 20 weeks of gestation with parity less than 3 and singleton pregnancy were interviewed. Daily zinc intake was measured using an Iranian version of food frequency questionnaire (FFQ), gravid, parity and abortion history were obtained. Data were analyzed using ?2 Test.

Results: The mean daily zinc intake was 10.8mg/d .About %75 of the studied women had daily zinc intake less than pregnancy RDA. There was no significant relationship between daily zinc intake and gravid and parity but having an abortion or more was associated with less than RDA zinc intake (p<0.049).

Conclusion: Our results suggest that women with a history of abortion need a careful nutritional plan with regards to micronutrients including zinc.

Key words: Pregnancy, Zinc, Reproductive Factors, FFQ, RDA.

P-100

The relationship between macronutrient's intake and demographic characteristics in pregnant women

Goshtasebi A1, Lamyian M2, Bakouei S2, Reisian F2, Amini L 3.

1 Department of Family Health, Iranian Institute for Health Sciences Research (ACECR), Tehran, Iran.

2 Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran.

3 National Nutrition and Food Technology Research Institute, Tehran, Iran.

Email: [email protected]

Introduction: The aim of this study was to investigate the relationship between macronutrients (protein, carbohydrate) daily intake and demographic characteristics (age, education, job) in pregnant women.

Materials and Methods: During May- December 2010 a cross sectional study was conducted at prenatal clinics of 10 public hospitals in Tehran-Iran. 440 pregnant women before 20 weeks of gestation with parity less than 3 and singleton pregnancy were interviewed. Daily intake of protein and carbohydrate was measured using an Iranian version of food frequency questionnaire (FFQ). Data were analyzed by binary regression analysis.

Results: The mean (SD) daily protein and carbohydrate intake in the studied women was 91.2 (90.07) g/d and 356 (269.5) g/d respectively. Dietary intake of protein and carbohydrate was less than RDA in %47 and %14 of the women in order of reference. Demographic characteristics had no effect on carbohydrate and protein intake.

Conclusion: It seems that the importance of protein and its dietary sources should be more emphasized in pregnancy educations.

Key words: Macronutrients, Demographic Characteristics, pregnancy, FFQ, RDA, Protein, Carbohydrate.

P-101

The association between dietary intake of vitamin A, C, E and demographic characteristics in pregnancy

Goshtasebi A1, Lamyian M2, Sadeghian F2, Askari L2, Amini M3.

1 Department of Family Health, Iranian Institute for Health Sciences Research (ACECR), Tehran, Iran.

2 Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran.

3 National Nutrition and Food Technology Research Institute, Tehran, Iran.

Email: [email protected]

Introduction: To evaluate the association between selected antioxidant nutrients (vitamin A, C and E) in early pregnancy and demographic characteristics.

Materials and Methods: During May - December 2010 a cross sectional study was carried out at prenatal clinics of 10 public hospitals in Tehran-Iran. 440 pregnant women before 20 weeks of gestation with parity less than 3 and singleton pregnancy were interviewed. Dietary intake of vitamin A, C and E was measured using an Iranian version of Food Frequency Questionnaire (FFQ). The association between dietary intake of vitamin A, C, E and demographic characteristics was assessed by binary logistic regression analysis.

Results: The mean age of the studied women was 27 years (SD=4.32), the mean years of formal education was 11.9 (SD=3.38), most of them were housewives (83%). The mean (SD) daily intake of vitamin A, E and C were 1412.7 ?g/day (1974.18), 6.34 mg/day (41.43), 177.4 mg/day (295.91) respectively. Daily intake of vitamin A, E and C in 42%, 98%, and 38% of studied women was less than RDA values in order of reference. University educated women had a greater chance of receiving less than RDA vitamin C (OR=2.05, CI=95% 1.23-4.6) and Vitamin A (OR=2.05, CI=95 1.07-3.95) compared with less educated women.

Conclusion: According to our finding, high education might not provide women with good nutritional knowledge and practice.

Key words: Antioxidants, Pregnancy, Demographic, Vitamin A, Vitamin C, Vitamin E, FFQ, RDA.

P-102

Comparision of daily intake of zinc in pregnancy with recommended dietary allowence and it's relation with reproductive factors

Lamyian M1, Goshtasebi A1, Reisian F1, Bakouei S1, Hadi N1, Hajizade E1, Ghodsi N2.

1 Department of Obestetric and Gynacology, Tarbiat Modares University, Tehran, Iran.

2 Department of Nutrition Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Zinc deficiency is prevalent in pregnant women.adequate maternal zinc nutrition during pregnancy is essential for normal embryonic and fetal development. We assessed Comparision of Daily intake of zinc in pregnancy with Recommended Dietary Allowence and it's relation with Reproductive Factors: gravida, parity and abortion.

Materials and Methods: We did a cross sectional study in 440 pregnant women in 14-20 weeks. And measured zinc intake with an Iranian version of food frequency questionnair (FFQ), the number of gravid, parity and abortion was obtained from demographic questionnaire. RDA scale used for comparision of zinc intake. Data were analysed using ?2 Test.

Results: The daily mean zinc intake was calculated as 10.8mg/d. For a bout %75 of the women, daily intake of zinc was less than pregnancy RDA (<11 mg/d). There was no significant relation between daily zinc intake with gravida and parity but abortion has significant relation(p<0.049).%14.5 of women has 1 history of abortion.daily intake of zinc in %60.9 of them was lower than RDA.%3.1 of women has 2 abortion in their history,%78.6 of them has intake lower than RDA.%0.9 of women has 3 history of abortion, % 75 of this group has intake lower than RDA.

Conclusion: Our results suggest that women with a history of abortion need a careful nutritional plan with regards to micronytriants including zinc.

Key words: Zinc, Reproductive Factors, Recommended Dietary Allowence.

P-103

Calcium supplementation in pregnancy and neonatal outcomes

MoghadamBanaem L, Aliyan Moghadam N.

Department of Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Email: [email protected]

Introduction: To study the effect of calcium supplementation in pregnancy on neonatal Apgar scores and anthropometric indices.

Materials and Methods: This cross sectional study was conducted on 1513 pregnant women attending delivery services in the five hospitals (Shohada, Valieasr, Mariam, Lolagar, Akbarabadi) in Tehran and Imam Khomeini hospital in Noor city in north of Iran. Subjects completed a questionnaire that included demographic characteristics and consumption of supplements during pregnancy, then the anthropometric indices and infant's Apgar score after five minutes was extracted from the newborns files. Of 1513 pregnant women, 835 (55.2%), consumed at least 500 mg of calcium supplements every other day from the18th week through the end of pregnancy.

Results: In 1513 infants born in this study, average weight, height, head circumference and Apgar score after five minutes were: 3305.97±451.29 g, 49.99±2.22 cm, 34.12±1.63 cm, and 8.85±0.61 respectively. To evaluate the effect of calcium supplementation on these indices, first we performed T-Test analysis, which showed that it had no significant impact on any of the indices. To assess the impact of all potentially effective factors on neonatal Apgar scores and anthropometric indices, linear logistic regression analysis was used and factors (maternal age (> 35 and <18), number of pregnancies, preeclampsia, body mass index (BMI), multivitamin supplements, preterm labor, passive smoking, along with calcium supplementation were included in the model. just for birth weight analysis, history of low birth weight was included in the model. Among all the factors studied, for birth weight: preeclampsia (p-value: 0.004, Beta: -2.89), BMI (p-value: 0.002, Beta: +3.10), preterm labor (p-value: 0.00, Beta : -17.20), for height of infants: preeclampsia (p-value: 0.001, Beta: -3.43), preterm labor (p-value: 0.00, Beta: -15.89), for head circumference in newborns: preeclampsia (p-value: 0.030, Beta: -2.20), multivitamin (p-value: 0.00, Beta: +4.16), passive smoking (p-value: 0.00, Beta: + 4.00) and preterm labor (p-value: 0.00, Beta: -16.31), and for 5th minute Apgar scores: maternal age (> 35 and <18)number of pregnancies (p-value: 0.02, Beta: +2.22), preeclampsiapreterm labor (p-value: 0.00, Beta: -8.10), had statistically significant relations.

Conclusion: Overall, the results obtained in this study showed no significant relationship between calcium supplementation in pregnancy and improving neonatal Apgar scores or anthropometric indices. But preterm labor and preeclampsia were the most effective factors, influencing these indices.

Key words: Pregnancy, Calcium supplementation, Apgar Scores, Newborn anthropometric Indices.

P-104

Evaluation of effective maternal factors on impaired Glucose Challenge Test (GCT) in pregnancy

Safary K1, Moghaddam Banaem L1, Amini M2.

1 Department of Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Institute of Nutritional Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Regarding the importance of Glucose Challenge Test (GCT) in the screening of Gestational Diabetes Mellitus (GDM), this study was performed to evaluate factors that may impair this test in the second trimester of pregnancy.

Materials and Methods: This cohort study was conducted in 2010 on 210 pregnant women with gestational age ?20 weeks and singleton pregnancy, who were visited in prenatal clinics of university hospitals in Iran. In 24-28 weeks of gestational age GCT was conducted with 75mg of oral glucose. If one hour after glucose consumption, blood sugar levels were higher than 140 mg/dl, then GCT was considered impaired and the subjects were referred for GTT (Glucose Tolerance Test). All subjects completed a questionnaire that included demographic characteristics and blood tests results in the first and second trimesters, also a nutritional questionnaire, Food Frequency Questioner (FFQ), was completed by interviewing the subjects in 14 to 20 weeks of pregnancy. We used T-Test and Chi-square to assess possible effective factors like job, age, height, number of pregnancies, weight before pregnancy, weight in first and second trimester of pregnancy, smoking, history of diabetes in the family and in previous pregnancies, Fasting Blood Sugar (FBS) levels in the first trimester, systolic and diastolic blood pressure in the first prenatal visit, haemoglobin levels in the first and second trimester, weekly nutritional reception of calories, carbohydrates, iron , protein, all types of fats, and also weekly reception of food groups such as milk, vegetables and fruit, bread, meat and fats on creating impaired GCT test.

Results: In this study 41 (19.4%) of 210 pregnant women had impaired GCT and were referred to perform GTT. Among the all the factors mentioned above, impaired GCT had significant relationships with maternal age (p-value: 0.02, 95% CI: 3.3-0.2), number of pregnancies (p-value:0.03, 95% CI:0.6-0.02)? weight before pregnancy (p-value: 0.05, 95% CI: 7.9-0.001), weight in first trimester of pregnancy )p-value:0.02, 95% CI:8.8-0.4 ( , weight in second trimester of pregnancy (p-value: 0.01, 95% CI:9.8-1.3), FBS levels )p- value: 0.002, 95% CI:9.7-2.1 ), and weekly nutritional reception of iron (p-value:0.04, 95% CI:25.8-3.5).

Conclusion: In general, the results obtained in this study showed that; maternal age, high parity, high weight before pregnancy, high weight in first and second trimesteres of pregnancy, high FBS levels in first trimester of pregnancy as well as high intake of nutritional iron are effective factors for impaired GCT in pregnant women.

Key words: Pregnancy, Glucose Challenge Test (GCT), Nutrition, Gestational Diabetes Melitus (GDM).

P-105

Actual experience of pregnant women about epidural painless

Mehran N1, Hasanzahraei P1, Fathizadeh N1, Abedi HA2.

1 Department of Midwifery, Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran.

2 Depatmenet of Health, Qom University of Medical Sciences, Qom, Iran.

Email: [email protected]

Introduction: Regarding the recent increase in elective cesarean and satisfaction of women and physician, the Iranian government has tried to solve this problem by epidural painless delivery (E.P.D). Because of opposite views of people and society about epidural, this Study was done to find the real experiences of people. Its aim was description of mother's experiences of epidural painless delivery.

Materials and Methods: This is a qualitative, phenomenological study. We selected 12 pregnant women that under wont epidural painless delivery in Shabihkhani Hospital. We used sampling method of based on object and continued until reaching fullness of information. We used depth interview for collection of information. Data analysis was done via collaizzi seven-stage method.

Results: findings of these interviews were classified in 195 codes and 9 themes and 3 main concepts, consisting of choice of painless delivery.

Key words: Experience, Painless delivery, Epidural.

P-106

Investigating the relationship between physical activity and preterm birth

Mehran N1, Abbaszadeh F2, Bagheri A2.

1 Qom University of Medical Sciences, Qom, Iran.

2 Kashan University of Medical Sciences, Kashan, Iran.

Email: [email protected]

Introduction: Preterm birth is the main cause of neonatal mortality and morbidity and the importancy of knowing its causes is clear. Since, the effect of physical activity on preterm birth is unknown; we decided to do this study with the aim of determining the relation between physical activity and preterm birth.

Materials and Methods: In this case-control study. 300 pregnant women that reffered to Izadi hospital of Qom in the second half of 2008-2009, selected through simple sampling. The data were collected by pregnancy standard physical activity questionnaire the physical activity severity calculated as MET. Finally, the data analyzed by descriptive and analytic (x2 and t test) statistics.

Results: The findings didn't show any significant relation between physical activity and preterm birth. In addition, in view of activity type, fun/exercise and work activities (respectively) and in view of activity severity, sedentary and moderate activities (respectively) were associated with higher but nonsignificant rate of preterm birth. Among demographic factors, only gravidity of women was significantly associated with preterm birth.

Conclusion: Although, in this study, the significant relation between physical activity and preterm delivery wasn't seen, the same research with further sample is recommended.

Key words: Physical activity, Birth, Preterm birth.

P-107

General health and material conflicts infertile women

Sheikholeslami F, ghafarzadeh M, Rafati P, Yazdani MA, Nikoofarjam N.

Faculty of Nursing and Midwifery, University of Medical Sciences, Rasht, Giulan, Iran.

Email: [email protected]

Introduction: Today Infertility is a social concern which is associated with many psychological problems. This phenomenon as a stressful and exciting event has influenced the individual ,social and marital relationships and as a crisis has caused a threat for the mental health and reduced the quality of marital life and intimacy ,induced the fear of ending the marital relationship ,frustration and sometimes mental disorders. The aim of this study was determine the relationship between general health and marital conflicts in infertile women visited Alzahra educational and clinical Center in city of Rasht.

Materials and Methods: This is a descriptive analytical study which has been done on 90 infertile women visited in infertility clinics of Alzahra educational and clinical Center in city of Rasht by available sampling method which had the study entry criteria. Questionnaires were the data collection tool included demographic characteristics, general health GHQ-12 and MCQ marital conflicts. Data has been analyzed by SPSS 18.

Results: Results showed the mean age of women was 31.51with SD 5.71 and also the general health had a meaningful relationship with job p=0.00, kind of treatment p=0.003 and marital conflicts p=0.001. Findings also showed that the majority of research units (78.9%) were in a normal level and they had not marital conflicts.

Conclusion: According to the study, care of mental health of infertile women along with help of the psychiatric teams can prevent psychological and marital problems.

Key words: General health, Marital conflicts, Infertile women.

P-108

Evaluation of the relationship between consumption of daily food groups and daily intakes of zinc in the first half of pregnancy

Babaei M1, Soltanmorady S1, Moghadam Banaem L2, Ghodsi D3.

1 Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Obstetrics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

3 Nutritional Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: Zinc is required during pregnancy for normal metabolic actions and successful fertility. The main aim of this study is to determine the relationship between daily consumption of food groups in the diet of pregnant women and intake of zinc in the first half of gestation.

Materials and Methods: This cross sectional study was conducted on 436 18-35 year-old pregnant women whose gestational period was equal or less than 20 weeks and singleton pregnancy who attended prenatal clinics in the hospitals of Shahid Beheshti, Iran and Tehran Universities in 2010. The prenatal clinics were selected by stratified cluster sampling. All subjects completed two questionnaires that included demographic characteristics and food frequency questionnaire (FFQ). Received food for each person was determined by using nutritional software. To descriptive tests, Pearson's correlation coefficient and linear regression analysis, SPSS (Ver.16) software was used.

Results: The results of the current study showed that there is a correlation between the daily intakes of zinc and meat food groups (p<0.001, r: 0.163), dairy (p<0.05, r: 0.119), fat (p<0.05, r: 0.100), bread and cereals (p<0.05, r: 0.101). In the other hand, there wasn't any significant relationship between quotidian zinc intakes and vegetables (p> 0.05, r: 0.013), and fruits (p>0.05, r: 0.035). For more accuracy results, the linear regression was run and showed the strong association among the circadian consumption of meat food groups (p<0.05) and diurnal zinc. However, there was not any association between the daily intake of dairy products, fats, bread and cereals, vegetables, fruit, parity, abortion and chronic disease with daily zinc intake.

Conclusion: In this study, the obtained results show that there is a good source of zinc in meat food groups in comparison with dairy products, fats, breads and cereals and recommended that pregnant women consume meat daily for intake of Zinc.

Key words: Zinc, Food Frequency Questionnaire, Pregnancy, Diet.

P-109

Relationship between daily intake of iron, folate, and vitamin B12 of pregnant women with haemoglobin in the first half of pregnancy

Babaei M1, Soltanmorady S1, Moghadam Banaem L2, Ghodsi D3.

1 Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Obstetrics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

3 Nutritional Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: The most important factor during pregnancy is dieting and lack of proper nutrition can cause anemia and decreased blood factors in pregnant women. In this study, we attempt to find the relationship of intake status of iron, folate, and vitamin B12 in the daily diet of pregnant women with haemoglobin in the first half of gestation.

Materials and Methods: This cross sectional study was conducted on 436 18-35 year-old pregnant women, whose gestational period was equal or less than 20 weeks and singleton pregnancy, who attended prenatal clinics in the hospitals of Shahid Beheshti, Iran, and Tehran Universities in 2010. The prenatal clinics were selected by stratified cluster sampling. All subjects completed two questionnaires that included demographic characteristics and food frequency questionnaire (FFQ). The received food of each person was determined by using nutritional software. To descriptive tests, Pearson's correlation coefficient and linear regression analysis were run; we used SPSS Version16.

Results: The results show that there is no correlation between iron, folate, and vitamin B12 in the daily diet (p>0.05) with haemoglobin in the first half of gestation by the Pierson's correlation coefficient. For more accuracy results, the linear regression was run and showed the rate of iron, folate, vitamin B12, and calcium in the diurnal consumption does not have any significant correlation with the rate of haemoglobin in the first half of pregnancy.

Conclusion: According to the results of this study and the lack of correlation between nutritional ingredients for synthesis of haemoglobin, which was probably due to rather low samples, it is suggested that more research with larger samples, are needed to perform in order to establish these relationships.

Key words: Pregnancy, Haemoglobin Levels, Diet, Food Frequency Questionnaire.

P-110

Assessment of the relationship between daily protein intakes with BUN and Cr in first trimester

Babaei M1, Soltanmorady S1, Moghadam Banaem L2, Ghodsi D3.

1 Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

2 Obstetrics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

3 Nutritional Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email: [email protected]

Introduction: This study investigates the relationship between daily intakes of protein in pregnant women and BUN, Cr levels in the first trimester of pregnancy.

Materials and Methods: This cross sectional study was conducted on 436 18-35 year-old pregnant women, whose gestational age was equal or less than 20 weeks and singleton pregnancy who attended prenatal clinics in the hospitals of Shahid Beheshti, Iran and Tehran Universities in 2010. The prenatal clinics were selected by stratified cluster sampling. All subjects completed two questionnaires that included demographic characteristics and food frequency questionnaire (FFQ). Received food and calories of each person was determined by using nutritional software. To descriptive tests, Pearson's correlation coefficient and linear regression analysis, we used SPSS Version16.

Results: In this study, no relation between daily protein intake of dietary (p>0.05) with BUN, Cr first trimester in pregnant women has been seen. To more accurately evaluate, we run linear regression and no significant relationship among intake proteins, BUN, Cr first trimester (p>0.05) and parity, chronic diseases, smoking and maternal age was revealed.

Conclusion: According to the results, there wasn't any relationship between the daily protein intake and BUN, Cr first trimester that probably was due to comparatively low samples. It is suggested that more studies with larger samples be performed to establish these relationships.

Key words: Food Frequency Questionnaire, Daily Protein, BUN and Cr levels, first half of pregnancy.

P-111

The effect of education on knowledge about methods of contraception and sexual health in couples referred to the Health Center

Akbarbegloo M, Habibpour Z, Bayrami R

Faculty of Nursing and Health, Pediatric Nursing, Urmia University of Medical Sciences, Khoy, Iran.

Email: m.akbarbegloo @ yahoo.com

Introduction: Unwanted pregnancies are one of the important problems of countries. In our country despite the numerous efforts of authorities and cover a wide family planning, unwanted pregnancies and the consequences of that such as infectious abortions are common problems. Unwanted pregnancies are often due to lack of use or uncorrected use of common methods of contraception due to low knowledge and information. Therefore, its researchers have done to assess knowledge of young couples about contraceptive methods.

Materials and Methods: This study was an interventional study that was conducted in 1389. Environmental research was center health and temperament of Khoy city and the study populations were young couples in the health center that comprised within two months. Simple sampling done and available sample included 40 persons. Data collection tool was (teenage knowledge of contraception and sexual heath). The scientific validity has done by five faculty members and content validity determined by using Test-Retest (α=0.79). Results analysis was investigated by using SPSS software before and after training.

Results: The results showed that participating couples in all areas of contraception had moderate and poor information. The least information was about emergency contraception, and most information was about menstrual period. T test showed the significant difference before and after training (p=0.001), so that couples in all areas of knowledge after the training had reached the desired or medium level.

Conclusion: Considering the average knowledge about the emergency methods and poor knowledge of some cooperation about useful items, including the proper time to use the emergency contraceptive. This point shows that strengthening the quantitative and qualitative aspects of this centers can play a vital role in giving information, establish correct beliefs about contraceptive methods and all of this should be lead to efficient application of these methods and reduction in failure contraceptive methods.

Key words: Education, Prevention, Pregnancy, Knowledge.