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international journal of fertility and sterility Int J Fertil Steril

international journal of fertility and sterility Int J Fertil Steril

International Journal of Fertility & Sterility is a peer review and quarterly English publication of Royan Institute. The aim of the journal is to disseminate information through publishing the most recent scientific research studies on Fertility and Sterility and other related topics. Int J Fertil Steril has been certified by Ministry of Culture and Islamic Guidance in 2007 and was accredited as a scientific and research journal by HBI (Health and Biomedical Information) Journal Accreditation Commission in 2008. Int J Fertil Steril is an Open Access journal.
Phone: +9821-22510895
Address: 5th Floor, No 9, Royan Institute Cell Therapy Center, East Shaghayegh Alley, Bani Hashem Sq, Bani Hashem St, Resalat Highway, Tehran, Iran.
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Papers by international journal of fertility and sterility Int J Fertil Steril

Research paper thumbnail of The Impact of Embryo Donation Technology on Child Psychological Adjustment and Parenting Styles: A Historical Cohort Study
Volume 19, Issue 1, January, 2025
Background: Despite the remarkable advancements in the use of embryo donation, concerns have aris... moreBackground: Despite the remarkable advancements in the use of embryo donation, concerns have arisen regarding its potential effects on the psychological well-being of children conceived through this assisted reproductive technology and their parent-child relationships. The aim of the study is to evaluate children's psychological adjustment and parenting style in families with donor-conceived children and compare them with the normal population. Materials and Methods: A historical cohort study was conducted to assess the psychological adjustment of 31 children aged 3 to 7 years born via embryo donation and to compare the results with those of 30 age-matched children from families who conceived naturally using the Strengths and Difficulties Questionnaire. The sample size was determined using G power, and the samples were selected using a convenient sampling method. Parenting styles within these families were also evaluated using the Baumrind Parenting Styles Inventory through clinical interviews. Results: Although 8 out of 31 children born through embryo donation (25.8%) and 3 out of 30 children from families with natural conception exhibited psychological maladjustment, this difference was not statistically significant (P=0.249). Furthermore, there were no significant differences in parenting styles between the two groups (P values for permissive, authoritarian, and authoritative parenting styles were 0.424, 0.656, and 0.219, respectively). Conclusion: The lack of genetic parent-child relationships does not seem to be a dominant factor affecting the psychological adjustment of children or parenting styles.
Research paper thumbnail of Combined Effects of Chrysin Supplementation and Exercise Training on Diabetes-Induced Oxidative Stress and Apoptosis in Rat Testicular Tissue
Volume 19, Issue 1, January, 2025
Background: Diabetes mellitus (DM), one of the most pervasive and enduring metabolic diseases, ha... moreBackground: Diabetes mellitus (DM), one of the most pervasive and enduring metabolic diseases, has been demonstrated to adversely impact male fertility. Conversely, both exercise training and Chrysin have been identified as potential interventions capable of mitigating the deleterious effects of diabetes on spermatogenesis. Thus, the current study aims to explore the individual and combined influences of Chrysin supplementation and running exercise on oxidative stress and germ cell apoptosis in the testicular tissue of diabetic adult rats. Materials and Methods: In this experimental study, the DM was induced by streptozotocin (STZ,50 mg/kg). Rats were divided into control (received STZ solvent), DM-sole, Chrysin-sole (50 mg/kg, daily), moderate-intensity running exercise training (MIRET-sole, warm-up, 5 minutes at 30% of Smax1 (Maximum speed); Moderate intensity exercise, 60 minutes at 60% of Smax1, and recovery, 5 minutes to 30% of Smax1), DM+Chrysin, DM+MIRET, and DM+MIRET+Chrysin. Following 8 weeks, the histopathological changes (Johnson's score, epithelial height, and tubular diameter), testicular malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPX), and the mRNA levels of anti-apoptotic gene Bcl-2 and pro-apoptotic gene Bax was analyzed. Results: Chrysin solely and simultaneous with MIRET could remarkably (P=0.001) improve the DM-induced histopathological damages, increase the testicular SOD and GPx levels, and decline the DM-increased MDA content. Moreover, our results showed that Chrysin solely and more simultaneously with MIRET could significantly (P=0.001) decrease the mRNA expression of Bax and improve the Bcl-2 expression and rebalance the Bax/Bcl-2 balance. Conclusion: Our findings showed that co-administration of Chrysin along with MIRET can significantly ameliorate the DM-induced histopathological, and biochemical impairments and reduce the pro-apoptotic impact of DM on testicular tissue.
Research paper thumbnail of Impact of Varicocele on The Expression of Testicular Enzymes Involved in The Transsulfuration Pathway
Volume 19, Issue 1, January, 2025
Background: Oxidative aggression is a hallmark of varicocele and may depend on decreased reactive... moreBackground: Oxidative aggression is a hallmark of varicocele and may depend on decreased reactive ability of the endogenous antioxidant system following heat stress. We aimed to investigate the underlying mechanisms. Therefore, the expression of the main enzyme proteins involved in the generation of endogenous antioxidant power, cystathionine beta-synthase (CBS), cystathionine gamma-lyase (CSE), heme oxygenase (HO-1), and also, some of the metabolites (methionine, homocysteine, taurine and vitamin B6) reporting on their activity was investigated using a surgical varicocele model in rats. Materials and Methods: In this experimental study, thirty male Wistar rats (7-8 weeks old, weighing 180-220 g) were divided into three groups: control, sham, and varicocele. We evaluated sperm parameters and functional tests, as well as the expression of CBS, CSE, and HO-1 proteins using Western blot analysis. Serum levels of methionine, homocysteine, and taurine were analyzed through high-performance liquid chromatography, while vitamin B6 concentrations were measured using enzyme-linked immunosorbent assay. For group comparisons, we employed ANOVA and the Tukey test, considering a P<0.05 as significant. Results: We observed a significant reduction in both sperm quality and functional parameters. Additionally, there was a notable decrease in the expression of CBS, CSE, and HO-1 proteins, as well as circulating vitamin B6 levels, in the varicocele group compared to the control and sham groups (P<0.001). Conclusion: The results of this study suggest that one possible cause of increased oxidative stress in varicocele may be the reduced expression of testicular enzymes involved in the production of endogenous antioxidants, which are associated with the transsulfuration pathway. However, further studies are needed to confirm these findings.
Research paper thumbnail of Effectiveness of Voytik-Harbin Protocol in Fabrication of Ram's Testicular-Derived Hydrogel and Its Impact on Mouse In Vitro Spermatogenesis
Volume 19, Issue 1, January, 2025
Abs tract Background: The utilization of decellularized extracellular matrix (dECM) derived from ... moreAbs tract Background: The utilization of decellularized extracellular matrix (dECM) derived from animal testis tissue has demonstrated potential as a component of tissue-specific scaffolds. Current research is mostly centered around dECM as a natural resource for culturing testicular cells. This study aimed to assess firstly the comparison of Voytik-Harbin (VH) and Frytes protocol in creating Ram's dECM testis hydrogel and secondly the evaluation of the best protocol effect on in vitro spermatogenesis. Materials and Methods: In this experimental study, the six testes of mature rams were decellularized and the hydrogel production was performed by i. The Frytes protocol utilized a concentration of 1 mg/mL of pepsin, dissolved in either 0.1 or 0.01 M HCl, and ii. The VH protocol was involved 10 mg of pepsin per 100 mg of ECM in 0.5 M of acetic acid. Subsequently, mouse testicular cells were cultivated on collagen hydrogel as the control and the more effective testicular-derived hydrogel (TDH) to evaluate the early stages of in vitro spermatogenesis. Results: While the Freytes protocol produced a homogeneous pre-gel solution with both HCl concentrations; elevating the pH to 7.4 loosened the hydrogel and made gelation problematic. In contrast, the VH protocol solidified the hydrogel and produced a strong hydrogel due to its gelation consistency. Furthermore, the prepared hydrogel by VH with 25 mg of dECM had a significantly higher priority in terms of rheology and structure (P<0.05). Following mouse testicular cell culture, TDH and collagen hydrogel did not differ significantly in terms of cell survival rates and the mRNA expression of early spermatogenesis genes. Conclusion: Using the VH protocol for producing ram TDH resulted in a firm hydrogel with a high frequency of repeat, which may be suited for testicular cell growth.
Research paper thumbnail of Effect of Exogenous of Transforming Growth Factor-β1 on Pregnancy Outcome in Mice with Recurrent Pregnancy Loss by Persistent Enhancement of Placental Tissue Indoleamine 2,3-Dioxygenase Expression
Volume 19, Issue 1, January, 2025
Abstract Background: The immunologic factors are the chief reason for recurrent pregnancy loss (R... moreAbstract Background: The immunologic factors are the chief reason for recurrent pregnancy loss (RPL) and induction of maternal-fetal tolerance is the main treatment for this cause of RPL, but the effect of this method is uncertainly and needs multiple doses and/or interventions. The aim of this study was to investigate whether a single administration of transforming growth factor-β1 (TGF-β1) can improve the pregnancy outcomes of RPL mice and whether the improvement is cause by TGF-β1 driving the expression of immune tolerance molecule indoleamine 2,3-dioxygenase (IDO). Materials and Methods: In this experimental study, 40 RPL model mice were equally divided into a control group, that received 0.01 M phosphate-buffered saline (PBS), and a treatment group, that received PBS containing 2, 20, and 200 ng/ml TGF-β1 via tail vein injection. The mice were sacrificed at 13.5 days of pregnancy and the embryo resorption rate was determined. The expression of IDO, TGF-β1, and TGF-β3 were detected in the placenta using western blotting and immunohistochemistry techniques. Results: The expression of IDO was positively correlated with TGF-β1 in the placental tissue of RPL mice (r=0.591, P<0.001). In all treatment groups, the embryo resorption rates were significantly lower than the control group and the expression of IDO in the placental tissue of all treatment groups was significantly higher than the control group. The expression of TGF-β1 increased gradually from, 2, 20 to 200 ng/ml in treatment groups, and the concentration of exogenous TGF-β1 positively correlated with the expression of TGF-β1, in placental tissues in treatment groups (r=0.372, P=0.018). Conclusion: Exogenous TGF-β1 improves pregnancy outcomes in RPL mice, and the possible therapeutic mechanism is that exogenous TGF-β1 induces the persistent expression of endogenous TGF-β1 and IDO due to mutually induced expression of the other. This experiment may provide a new direction and idea for the future treatment of RPL patients.
Research paper thumbnail of Embryo Mosaicism Rate in National Referral Hospital of Indonesia Detected Using Next-Generation Sequencing: A Retrospective Study
Volume 19, Issue 1, January, 2025
Background: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its ... moreBackground: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its prevalence and inherent unpredictability, leading to variations in embryo mosaic rates across different centers. This research endeavors to assess the prevalence of mosaicism and its characteristics within the scope of our preimplantation genetic testing-A (PGT-A) services in Indonesia. Specifically focusing on our center's experience since 2020, this study aims to elucidate mosaic rates among embryos in our care. Materials and Methods: In a retrospective approach, we collected secondary data sourced from our PGT-A outcomes dating back to 2020. A total of 196 embryos underwent analysis, their characteristics were documented and presented descriptively. Notably, the incidence of specific chromosome abnormalities was outlined. We assess a comparative analysis to investigate the relationship between mosaicism and its corresponding clinical characteristics. Results: In the analysis of 196 embryos, 106 (54.1%) displayed chromosomal anomalies spanning from low-level mosaicism to whole chromosome aneuploidy. Low mosaicism was observed in 25 (12.8%) of the embryos, while high mosaicism was identified in 8 (4.1%) embryos. Notably, low-level mosaicism predominated in chromosome 9 (n=10, 5.1%), whereas abnormality prevalence was highest in chromosome 21 (n=20, 10.2%). Statistical analysis revealed no significant disparity in mean maternal age among embryos with low-level mosaicism, high mosaicism, and normal chromosomes (33.88 vs. 35 vs. 33.26 years old, respectively). However, a statistically significant difference in mean maternal age (35.84 vs. 33.26 years) was observed between embryos with aneuploidy (monosomy or trisomy) and those with normal chromosomes. Furthermore, a significant difference in high mosaicism rates was detected in patients with unexplained infertility (P<0.05). Conclusion: In contrast to the study conducted elsewhere, our center had a higher mosaicism rate. Chromosomes 9, 8, and 6 were the most frequently affected. There was a significant difference in the high mosaicism rate for PGT-Arelated unexplained infertility causes.
Research paper thumbnail of The Relationship between Homocysteine Levels, MTHFR C677T and A1298C Polymorphism, and Pregnancy Outcomes in Georgian Women with Polycystic Ovary Syndrome: A Case-Control Study
Volume 19, Issue 1, January, 2025
Background: Over the past decade, numerous studies have been conducted to determine the role of h... moreBackground: Over the past decade, numerous studies have been conducted to determine the role of homocysteine and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms in the pathogenesis of polycystic ovary syndrome (PCOS), yet the results are inconsistent. The aim of the current study was to determine the association between homocysteine levels (Hcy), MTHFR C677T and A1298C polymorphisms, and pregnancy outcomes in Georgian women with PCOS. Materials and Methods: This case-control study included 177 female participants, of which 96 women were diagnosed with PCOS, and 81 age-matched women were without PCOS. Participants were divided into four groups; group I: 59 PCOS patients with history of recurrent pregnancy loss (RPL), group II: 37 PCOS patients with live birth in history and without RPL, group III: 39 women with RPL, without PCOS, group IV: controls, 42 women with live birth in history, without RPL and PCOS. These groups were compared based on their serum Hcy and the presence of two common single nucleotide polymorphisms (SNPs) in the MTHFR gene: C677T and A1298C. Results: The mean Hcy, frequency of hyperhomocysteinemia (Hhcy) and the prevalence of C677T and A1298C polymorphisms in MTHFR gene in PCOS patients were significantly higher than those without PCOS (P<0.05). Group I (PCOS with RPL) showed significantly elevated Hcy (13.7 ± 2.7) compared to group II (10.3 ± 2.6), group III (11.5 ± 2.3), and group IV (7.3 ± 2.2), P<0.001. In group I, the frequencies of the C677T-CT, A1298C-AC genotypes, and the compound heterozygous of C677T-CT/A1298C-AC were significantly higher than in the other groups (P<0.05). The prevalence of MTHFR A1298C (CC) was significantly higher in group II (PCOS patients with live birth) than in other comparison groups (P<0.05). Conclusion: The study reveals a significant correlation between hyperhomocysteinemia, MTHFR polymorphisms (C677T and A1298C), and PCOS, impacting pregnancy outcomes.
Research paper thumbnail of Association of The MCP-1 rs1024611 Polymorphism with Polycystic Ovary Syndrome in A Population of Indian Women: A Case-Control Study
Volume 19, Issue 1, January, 2025
Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine conditions th... moreBackground: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine conditions that significantly impact the life quality of reproductive-aged women. In the Indian population, its prevalence varies from 3.7 to 22.5% depending on ethnicity and diagnostic criteria. Chronic inflammation plays a pivotal role in PCOS pathogenesis. The monocyte chemoattractant protein-1 (MCP-1) is an important chemotactic factor for inflammatory response of monocytes. Genetic variations in the MCP-1 gene may modulate MCP-1 expression. Although the association of the MCP-1 promoter polymorphism (-2518A/G) was extensively studied in different inflammatory conditions, there is only one report in PCOS conditions. Since no study was reported from the Indian population, we aimed to explore the association of the MCP-1-2518A/G polymorphism (rs1024611) with PCOS. Materials and Methods: In this case-control study, to analyse the distribution and association of rs1024611 with PCOS, polymerase chain reaction-fragment length polymorphism (PCR-RFLP) analysis was carried out in 202 patients who exhibited PCOS from menarche onwards or with higher severity of symptoms and 122 age-matched controls. Results: In our study, no significant correlation was observed in rs1024611 polymorphism with PCOS patients in comparison with control. In addition to this, we found no significant difference in the genotype and allele frequencies between obese and non-obese PCOS patients. Conclusion: Our finding suggests that the MCP-1-2518 A/G polymorphism has not been associated with PCOS predisposition.
Research paper thumbnail of Role of Prothrombin and Methylenetetrahydrofolate Reductase Gene Polymorphisms as well as Thrombophilia Markers, as Risk Factors for Unexplained Recurrent Miscarriage: A Case-Control Study
19, Issue 1, January, 2025
Background: Unexplained recurrent miscarriage (RM) is still an unsolved reproductive health probl... moreBackground: Unexplained recurrent miscarriage (RM) is still an unsolved reproductive health problem. Inherited thrombophilias have been one of the causes. Mutation in genes encoding coagulation proteins, including prothrombin (PT G20210A) and methylenetetrahydrofolate reductase (MTHFR) genes, increase tendency for venous thromboembolism. This study aimed to evaluate association between polymorphisms in prothrombine and MTHFR genes with RM. We also evaluated association between protein C (PC), protein S (PS), antithrombin III (ATIII), and homocystiene with RM. Materials and Methods: We conducted a case-control study on women with history of miscarriages and healthy controls. Genetic analysis was done using (TaqMan) polymerase chain reaction (PCR) technique and the other tests were performed to check general health indications and thrombophilia markers. Results: In this study, 195 RM group (group I) participants and 90 healthy controls (group II), PC, PS, ATIII deficiency and Hyperhomocysteinemia were in 7.2, 65.6, 9.2, 10.8% of group I respectively, but was 1.1, 7.8, 2.2, 2.2% of group II. PT G20210A showed two in group I were A/G, no A/G in group II, and no AA carrier in the either group. G allele was observed in 99.5% of the group I and 100% of the group II, while A allele was detected in 0.5% of group I. MTHFR C677T gene showed C/T mutation in 33.3% of group I and 32.2% of group II, while T/T mutation was detected in 12.8% of group I and 8.9% of the group II. C allele was found in 70.5% of group I and 75% of group II, while T allele was found in 29.5% of group I and 25% of group II (P=0.269). Conclusion: PT G20210A and MTHFR C677T gene mutations are not correlated with RM in the Egyptian population. However, Egyptian women with RM are strongly associated with hyperhomocysteinemia, PC, PS, and ATIII deficiencies (registration number: NCT03209063).
Research paper thumbnail of Relation of Follicular Fluid Soluble Receptor for Advanced Glycation End-Products Concentration and Anti Mullerian Hormone in Polycystic Ovary Syndrome and Non-PCOS Women Referring to In Vitro Fertilization Center: Case-Control Study
Volume 19, Issue 1, January, 2025
Background: Reproductive dysfunctions of polycystic ovary syndrome (PCOS) and blood anti-mulleria... moreBackground: Reproductive dysfunctions of polycystic ovary syndrome (PCOS) and blood anti-mullerian hormone (AMH) concentration are significantly influenced by the dietary advanced glycation end products (AGEs). The interplay between AGEs and their soluble form of receptor, might exert a protective role on the follicular environment and affect AMH concentration. This study investigated the relationship between soluble receptor for advanced glycation end-products (sRAGE) levels in follicular fluid (FF) and serum AMH levels in PCOS and non-PCOS women. Materials and Methods: Among 43 women of reproductive age who participated in this case-control study 26 non-PCOS women were assigned to the control group, while 17 participants were diagnosed with PCOS and allocated to the case group. Prior to the in vitro fertilization (IVF) procedure, fluid samples were collected and levels of FF sRAGEs and serum AMH were recorded through the use of commercially available ELISA kits. Results: Correlation analysis, without age adjusting, revealed a statistically considerable and positive association between FF sRAGE and serum AMH concentration in PCOS women (P=0.012, r=0.596). Moreover, after age stratification, the same pattern was observed in some age groups; in PCOS women aged 40 years or older (r=1, P<0.001), as well as those younger than 30 years (r=0.922, P=0.003), correlation analysis demonstrated a significant and positive relationship between FF sRAGE and serum AMH levels. Conclusion: The association between sRAGE and AMH in women with PCOS is primarily affected by their age, whereas non-PCOS women showed no relationship. The results show that the levels of these receptors (sRAGE) show their specific effects in young women and women over 40 years old and not in middle age and target the ovarian reserve. It seems to act as a defensive shield in older women and increase fertility in young women.
Research paper thumbnail of Comparison of In Vitro Fertilization Outcomes between Normal and T-Shaped Uteri, Diagnosed by Hysterosalpingography in Women with infertility: A Retrospective Cohort Study
Volume 19, Issue 1, January, 2025
Background: T-shaped uterus is a subclass of dysmorphic uteri according to the European Society o... moreBackground: T-shaped uterus is a subclass of dysmorphic uteri according to the European Society of Human Reproduction and Embryology (ESHRE) classification. A T-shaped uterus might be related to poor reproductive outcomes or pregnancy complications. We aim to compare the success rates of in vitro fertilization (IVF) between individuals with a normal uterus and those with a T-shaped uterus identified through Hysterosalpingography. Materials and Methods: A retrospective cohort study was done in Royan Institute, Iran, in April 2020-April 2021. In line with the criteria for inclusion and exclusion, 468 cases were selected. Inclusion criteria were as follow: women of 20-45 years old, primary infertility, no repeated implantation failure (RIF), embryo quality "grade A" or "grade B" (freeze), and no consumption of smoking or alcohol. Patients with uterine fibroid, polyp, metabolic disorders, previous uterine surgery were excluded. Based on the hysterosalpingography (HSG) images, the patients were categorized as: "T-shaped uterus" or "normal uterus". IVF outcomes including positive or negative chemical pregnancy were entered into SPSS software. Using the Chi-square test, the success rate of IVF in those groups was compared. Results: Of 468 cases, 91 cases had T-shaped uterus and 377 cases had normal uterus. The mean age of patients was 34 ± 3. The frequency of positive chemical pregnancy in the T-shaped uterus group was 42.9%, but 48% in the normal uterus group. The distribution of positive clinical pregnancy was 34.06% in the T-shaped uterus group and 46.1% in the normal uterus group. The distribution of failed pregnancies was 20.5% in women with T-shaped uteri and 19.8% in the normal uterus group (P=0.867). There was no significant difference observed between the two groups. Conclusion: The success rate of IVF and pregnancy outcomes of patients in the T-shape and normal groups were not found to be statistically significantly different.
Research paper thumbnail of Clinical Pregnancy Rates in Relation to Vitamin D Supplementation among Women with Hyperandrogenic Polycystic Ovarian Syndrome: A Prospective Study
Volume 19, Issue 1, January, 2025
Background: Pregnant mothers frequently have vitamin D deficiency, which has potential consequenc... moreBackground: Pregnant mothers frequently have vitamin D deficiency, which has potential consequences for the health of their unborn children. Prenatal vitamin D administration raises maternal and foetal 25(OH)D levels. This study aims to assess the effects of 25(OH)D supplementation on clinical pregnancy and miscarriage rates in women diagnosed with hyperandrogenic polycystic ovarian syndrome (PCOS). Materials and Methods: This prospective study was conducted on 200 patients with hyperandrogenic PCOS who attended an outpatient infertility clinic at Menoufia University Hospital from March 2021 until March 2022. Participants were divided into two groups-(A) women who received a therapeutic dose of 25(OH)D supplements (n=100) and (B) women who did not receive 25(OH)D supplements (n=100). Results: The duration needed to reach follicles that were ≥18 mm was significantly higher in group B (16.74 ± 2.57) compared with group A (13.40 ± 2.12). Midluteal progesterone was significantly higher in group A (19.63 ± 2.12) compared with group B (17.74 ± 2.36, P<0.001). Our results indicate that women with adequate 25(OH)D levels are far more likely to experience clinical pregnancies than those with 25(OH)D deficiency. Conclusion: More research is necessary to determine whether vitamin D supplementation can be a simple and economical solution to increase pregnancy rates. Our study population had a significant 25(OH)D deficit or insufficiency prevalence. Determining 25(OH)D levels as part of a routine infertility assessment may be advantageous.
Research paper thumbnail of The Effects of Three Methods of Luteal Phase Support on Pregnancy Outcomes in Poor Ovarian Responders: A Randomized Clinical Trial
Volume 19, Issue 1, January, 2025
Abs tract Background: The effectiveness of changing the type of luteal phase support in patients ... moreAbs tract Background: The effectiveness of changing the type of luteal phase support in patients with poor ovarian response (POR) remains unclear based on the available evidence. This study aimed to compare the effectiveness of various luteal phase support (LPS) methods, including progesterone alone, human chorionic gonadotropin (hCG) alone, and the combination of progesterone with hCG, in these patients. Materials and Methods: In this randomized clinical trial, 375 patients diagnosed with POR based on the Bologna criteria underwent intracytoplasmic sperm injection-embryo transfer (ET) cycles at the Royan Institute between November 2015 and June 2019. The patients were allocated randomly into three different LPS groups on the day of oocyte pickup. In the first group, 1500 IU of hCG on the ET day, as well as 4 days after that were administrated intramuscularly. In the second group, the patients received 1500 IU of hCG IM on the ET day, as well as 3 and 6 days after the ET along with vaginal progesterone suppositories of 400 mg twice daily. For the third group, only vaginal suppositories twice daily were administrated from the day of oocyte pick up until the pregnancy test day. The clinical pregnancy, miscarriage and live birth rates were compared among groups using appropriate statistical tests. Results: The data analysis indicated that the three groups were comparable, and there were no significant differences among the groups in terms of implantation, clinical pregnancy, miscarriage, and live birth rates. The twin pregnancy rate in the hCG-only group was higher than in the other two groups, although this difference did not reach statistical significance (P=0.060). Conclusion: Similar pregnancy and live birth rates were observed among different LPS regimens. Interestingly, the use of two boluses of low-dose hCG (1500) was associated with a slight increase in multiple pregnancies. We suggest this effective method, which is easier and more patient-friendly (registration number: NCT02798653).
Research paper thumbnail of Fertility Preservation in Female Patients with Cancer Part II: Royan Institute Clinical Practice Guideline for Girls and Women with Cancer; A Review Study
Volume 19, Issue 1, January, 2025
The fertility preservation (FP) is a paramount concern for oncology patients and should be regard... moreThe fertility preservation (FP) is a paramount concern for oncology patients and should be regarded as an essential component of their overall cancer management strategy. The magnitude of this issue has been recognized in FP guidelines. The formulation and execution of harmonized guidelines and policies concerning the provision of FP services, inclusive of therapeutic strategies and standardization of procedures, are crucial to surmount disagreements regarding the delivery of these therapeutic services and avert delays in cancer treatment. The matter of FP and the methodology for managing the treatment and follow-up of cancer patients should be documented as a component of their management guideline, thereby providing patients with clear recommendations on fertility preservation. In this manuscript, we provide a succinct overview of existing international guidelines history and reference comprehensive networks of FP services for oncology patients. Furthermore, we present the Royan Institute's guideline specifically designed for preserving the fertility of female oncology patients.
Research paper thumbnail of Depressive and Anxiety Symptoms in Women with Threatened Abortion: A Case-Control Study
Volume 18, Issue 4, October, 2024
Background: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the a... moreBackground: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the attention paid to the adverse outcomes of obstetrics, only a few studies have been conducted on the psychological status of women with threatened abortion. This study aimed to compare the symptoms of depression and anxiety in women with TA and those without threatened abortion. Materials and Methods: In a case-control study, 136 women with TA (the case group) and 136 women without TA (the control group), were matched with the case group in terms of gestational age, education level, age, and number of pregnancies, were examined from Obstetric clinics of Babol University of Medical Sciences. Demographic information and pregnancy history were obtained from all participants. Additionally, the women filled out the BSI-18 questionnaire. Statistical analysis was performed using SPSS version 22 software. Results: The results showed that in women with threatened abortion, the likelihood of experiencing depression symptoms was 1.9 times higher [odds ratio (OR)=1.91, 95% confidence interval (CI)=1.13-3.23, P=0.015], anxiety symptoms were 1.8 times higher (OR=1.83, 95% CI=1.08-3.10, P=0.024), and somatization was 2.6 times higher (OR=2.65, 95% CI=1.61-4.37, P<0.001) compared to pregnant women without threatened abortion. Additionally, in women with threatened abortion, the risk of psychological distress was 3.3 times higher (OR=3.30, 95% CI=1.96-5.56, P<0.001) than in women without threatened abortion. Conclusion: This study suggests that gynecologists, midwives, and healthcare providers, in addition to providing medical care for women threatened with abortion, should identify women at risk of experiencing symptoms of depression and anxiety. Providing appropriate psychological support should be prioritized in the management of women with threatened abortion.
Research paper thumbnail of Impact of Microfluidic Sperm Sorting on Embryonic Euploidy in Infertile Patients with Sperm DNA Damage: A Retrospective Study
Volume 18, Issue 4, October, 2024
Background: Sperm DNA fragmentation is an important factor that affects male fertility. This stud... moreBackground: Sperm DNA fragmentation is an important factor that affects male fertility. This study intends to evaluate the impact of sperm DNA damage [single-strand breaks (SSB) and double-strand breaks (DSB)] on fertilisation and embryonic euploidy after intracytoplasmic sperm injection (ICSI). Of the different sperm selection techniques, the novel microfluidic sperm sorting (MSS) ZyMōt™ ICSI device reduces both SSB and DSB in semen samples. The second objective is to study the impact of this MSS device on fertilisation and embryonic euploidy. Materials and Methods: This retrospective study included data from 167 ICSI treatments. The alkaline and neutral Comet assays were used to analyse SSB and DSB, respectively. Analysis of fertilisation and embryo euploidy rates was performed in four groups of patients with normal/altered SSB or DSB values. Density gradient centrifugation (DGC) and the ZyMōt™ ICSI MSS device were used for semen preparation. Results: Fertilisation rates in 167 ICSI cycles were higher when using sperm from patients with normal SSB values (70.84%) and patients with abnormal SSB whose samples were processed using the MSS device (69.71%) compared to patients with abnormal SSB values using DGC (58.49%). Preimplantation genetic testing for aneuploidies (PGT-A) revealed a higher embryo euploidy rate in patients with normal DSB values (60.00%) and patients with abnormal DSB whose samples were processed using the MSS device (44.59%) compared to patients with abnormal DSB values using DGC (36.84%). When female age was considered, there were fewer euploid embryos in women ≥35 years of age compared to younger women, independently of SSB and DSB. The number of euploid embryos increased when the MSS device was used. Conclusion: High SSB and DSB values in semen samples decreased fertilisation rates and embryonic euploidy, respectively. The ZyMōt™ ICSI device for semen preparation increased both rates, especially in couples that included women <35 years old.
Research paper thumbnail of Nanocurcumin Decreases Nucleotide-Binding Oligomerization Domain-Like Receptor Family Pyrin Domain-Containing 3 Complex Expressions in An Experimental Testicular Torsion Model
Volume 18, Issue 4, October, 2024
Background: Testicular torsion is a surgical emergency leads to severe acute ischemia injuries, a... moreBackground: Testicular torsion is a surgical emergency leads to severe acute ischemia injuries, and may eventually cause male infertility. The nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domaincontaining 3 (NLRP3) inflammasome is involved in testicular torsion pathophysiology. The aim of this study was to evaluate the effects of nanocurcumin (nCur) on testicular tissue and the NLRP3 inflammasome components. Materials and Methods: In this experimental study, male Wistar rats (n=36) were randomly divided into six equal groups: controls, ischemia-reperfusion (I/R), I/R+nCur (50 or 100 mg/kg thirty minutes before reperfusion), and I/ R+nCur (50 or 100 mg/kg thirty minutes before reperfusion and continued for seven days). The left testis was rotated 720 (2×360) degrees counterclockwise to induce testicular torsion. After two hours of ischemia, detorsion was performed. At the end of treatment, an orchiectomy was carried out. The testis histopathology and the mRNA levels of NLRP3, apoptosis-associated speck-like protein (ASC), and Caspase-1 were evaluated. Results: Our results revealed that, testicular I/R had a detrimental effect on testis histology such as the number of spermatogonia (14.5 ± 0.57, P<0.001) and the seminiferous tubules epithelium thickness (28.5 ± 11.7, P=0.007). It also significantly increased the expression of the NLRP3 inflammasome components (P<0.001). Treatment with nCur (in both doses) improved testicular damage and significantly reduced the expression of NLRP3 (P=0.007), ASC (P=0.003), and Caspase-1 (P<0.001). Conclusion: These results imply that nCur might be a useful therapeutic strategy in the field of reproductive medicine to diminish the side effects of testicular I/R via its anti-inflammatory properties and may be employed as adjuvant therapy to lessen testicular torsion complications.
Research paper thumbnail of The Relationship between The Expression of Sperm MicroRNA-149b and 34c and Sperm Quality in Men with Oligoasthenoteratozoospermia in Endometriosis
Volume 18, Issue 4, October, 2024
Background: The objective of this study was to investigate the correlation between the expression... moreBackground: The objective of this study was to investigate the correlation between the expression levels of sperm microRNA-149b and 34c and sperm quality in men diagnosed with oligoasthenoteratozoospermia. Materials and Methods: In the experimental study, we recruited 30 infertile men with oligoasthenoteratozoospermia and 30 control samples. In this study, miR-149b and miR 34c expression using reverse transcription polymerase chain reaction (RT-PCR) were evaluated. Semen samples were collected and subjected to initial analysis, including semen parameters, following the protocol provided by the World Health Organization (WHO). The levels of total antioxidant capacity (TAC) and malondialdehyde (MDA) were measured using an ELISA kit. Results: The expression levels of miR-149b and miR-34c were significantly downregulated in men with oligoasthenoteratozoospermia compared to age-matched normozoospermic men, as determined by RT-qPCR (P=0.001, and P=0.003 respectively). Correlation analysis revealed a positive correlation between the expression levels of miR-149b and miR-34c and various sperm parameters, including sperm count, motility, morphology, viability, sperm mitochondrial membrane potential, sperm capacity, and TAC. Additionally, an inverse correlation was observed between the expression levels of miR-149b, miR-34c, DNA fragmentation, and MDA levels. Conclusion: The findings of this study indicate that the decreased expression of miR-149b and miR-34c is associated with oligoasthenoteratozoospermia, potentially affecting fundamental semen parameters. These results provide a basis for future research aimed at exploring potential therapeutic interventions for male infertility.
Research paper thumbnail of Ceratonia siliqua L. pod Effects on Viability Gene Expression of Endometrial Mesenchymal Stromal/Stem Cells Isolated from Women with Endometriosis-Associated Infertility
Volume 18, Issue 4, October, 2024
Background: This study aims to investigate the effects of carob (Ceratonia siliqua L.) pod extrac... moreBackground: This study aims to investigate the effects of carob (Ceratonia siliqua L.) pod extract (CPE) on the viability of human endometrial mesenchymal stromal/stem cells (EnMSCs) and its impact on mRNA and protein expressions of DNA methyltransferases (DNMT1, DNMT3A, and DNMT3B), histone deacetylase 1 (HDAC1), matrix metalloproteinase-2 (MMP2), and cyclooxygenase-2 (COX-2) in endometriotic patients. Materials and Methods: In this experimental study, EnMSCs were derived from endometrium of patients with ovarian endometrioma (OMA-EnMSCs group) and deep infiltrative endometriosis (DIE) samples of 10 endometriosisassociated infertility (EAI) women (E-EnMSCs group) and compared to EnMSCs derived from the endometrium of an endometriosis-free, normal woman as the control group (C-EnMSCs). The metabolic activity of the control and case groups were evaluated by treating them with different concentrations of CPE. Cell viability was analysed by MTT. Real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to evaluate the expression of specific genes at the mRNA and protein levels, respectively. Results: Treatment with 0.8 and 2 μg/mL of CPE downregulated COX-2 and HDAC1 in the E-EnMSC group compared to the C-EnMSCs group. Treatment with 0.8 μg/mL of CPE also decreased MMP2 and DNMT3B gene expressions. The COX-2 and DNMT3A genes were significantly upregulated after treatment with 2 μg/mL of CPE. Expressions of the COX-2, HDAC1, DNMT1, DNMT3A, and DNMT3B peptides decreased in the all three groups
Research paper thumbnail of Potential Effects of Soy Isoflavones and Broccoli Extract on Oxidative Stress, Autophagy, and Apoptosis Gene Markers in Endometriosis
Volume 18, Issue 4, October, 2024
Background: Endometriosis is an idiopathic gynecological condition affecting women with pelvic pa... moreBackground: Endometriosis is an idiopathic gynecological condition affecting women with pelvic pain and infertility in reproductive ages. Due to preventive and therapeutic effects of soy isoflavones (SI) and broccoli extract (BE) on tumor angiogenesis, inflammation and oxidative stress and since endometriosis is accompanied by chronic inflammation, in this study, we aim to evaluate the potential role of these compounds on the pathological scores of endometriosis and also consider the expression level of the gene markers of autophagy, apoptosis, and oxidative stress in an endometriosis rat model. Materials and Methods: In the present experimental study, 45 mature female Sprague-Dawley rats weighing 220 ± 20 g at the age of eight weeks with surgically induced endometriosis was divided into five groups and treated for six weeks with normal saline (control group), BE, SI, BE+SI by oral gavage, and also Diphereline intramuscularly. The histopathological scores of the endometrial implants (0, 1, 2, 3: no, poorly, moderately and well-preserved epithelial layers, respectively) and the mRNA expression level of Bcl-2, Bax, Caspase-3, Beclin-1, Lc3, and Sod within peritoneal tissue were compared among the groups. Results: Pathologic scores of the implants in the Diphereline (1.2 ± 0.27) and BE+SI (1.2 ± 0.41) groups were declined significantly in comparison with the control group (2.08 ± 0.44) (P≤0.001). In the endometriotic structures, the mRNA expression levels of our target genes were improved significantly (P≤0.01) in comparison with the control group. Conclusion: The findings of the current study demonstrated that the simultaneous consumption of a certain amount of broccoli extract and SI can be considered as a promising therapeutic strategy for treatment of endometriosis.
Research paper thumbnail of The Impact of Embryo Donation Technology on Child Psychological Adjustment and Parenting Styles: A Historical Cohort Study
Volume 19, Issue 1, January, 2025
Background: Despite the remarkable advancements in the use of embryo donation, concerns have aris... moreBackground: Despite the remarkable advancements in the use of embryo donation, concerns have arisen regarding its potential effects on the psychological well-being of children conceived through this assisted reproductive technology and their parent-child relationships. The aim of the study is to evaluate children's psychological adjustment and parenting style in families with donor-conceived children and compare them with the normal population. Materials and Methods: A historical cohort study was conducted to assess the psychological adjustment of 31 children aged 3 to 7 years born via embryo donation and to compare the results with those of 30 age-matched children from families who conceived naturally using the Strengths and Difficulties Questionnaire. The sample size was determined using G power, and the samples were selected using a convenient sampling method. Parenting styles within these families were also evaluated using the Baumrind Parenting Styles Inventory through clinical interviews. Results: Although 8 out of 31 children born through embryo donation (25.8%) and 3 out of 30 children from families with natural conception exhibited psychological maladjustment, this difference was not statistically significant (P=0.249). Furthermore, there were no significant differences in parenting styles between the two groups (P values for permissive, authoritarian, and authoritative parenting styles were 0.424, 0.656, and 0.219, respectively). Conclusion: The lack of genetic parent-child relationships does not seem to be a dominant factor affecting the psychological adjustment of children or parenting styles.
Research paper thumbnail of Combined Effects of Chrysin Supplementation and Exercise Training on Diabetes-Induced Oxidative Stress and Apoptosis in Rat Testicular Tissue
Volume 19, Issue 1, January, 2025
Background: Diabetes mellitus (DM), one of the most pervasive and enduring metabolic diseases, ha... moreBackground: Diabetes mellitus (DM), one of the most pervasive and enduring metabolic diseases, has been demonstrated to adversely impact male fertility. Conversely, both exercise training and Chrysin have been identified as potential interventions capable of mitigating the deleterious effects of diabetes on spermatogenesis. Thus, the current study aims to explore the individual and combined influences of Chrysin supplementation and running exercise on oxidative stress and germ cell apoptosis in the testicular tissue of diabetic adult rats. Materials and Methods: In this experimental study, the DM was induced by streptozotocin (STZ,50 mg/kg). Rats were divided into control (received STZ solvent), DM-sole, Chrysin-sole (50 mg/kg, daily), moderate-intensity running exercise training (MIRET-sole, warm-up, 5 minutes at 30% of Smax1 (Maximum speed); Moderate intensity exercise, 60 minutes at 60% of Smax1, and recovery, 5 minutes to 30% of Smax1), DM+Chrysin, DM+MIRET, and DM+MIRET+Chrysin. Following 8 weeks, the histopathological changes (Johnson's score, epithelial height, and tubular diameter), testicular malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPX), and the mRNA levels of anti-apoptotic gene Bcl-2 and pro-apoptotic gene Bax was analyzed. Results: Chrysin solely and simultaneous with MIRET could remarkably (P=0.001) improve the DM-induced histopathological damages, increase the testicular SOD and GPx levels, and decline the DM-increased MDA content. Moreover, our results showed that Chrysin solely and more simultaneously with MIRET could significantly (P=0.001) decrease the mRNA expression of Bax and improve the Bcl-2 expression and rebalance the Bax/Bcl-2 balance. Conclusion: Our findings showed that co-administration of Chrysin along with MIRET can significantly ameliorate the DM-induced histopathological, and biochemical impairments and reduce the pro-apoptotic impact of DM on testicular tissue.
Research paper thumbnail of Impact of Varicocele on The Expression of Testicular Enzymes Involved in The Transsulfuration Pathway
Volume 19, Issue 1, January, 2025
Background: Oxidative aggression is a hallmark of varicocele and may depend on decreased reactive... moreBackground: Oxidative aggression is a hallmark of varicocele and may depend on decreased reactive ability of the endogenous antioxidant system following heat stress. We aimed to investigate the underlying mechanisms. Therefore, the expression of the main enzyme proteins involved in the generation of endogenous antioxidant power, cystathionine beta-synthase (CBS), cystathionine gamma-lyase (CSE), heme oxygenase (HO-1), and also, some of the metabolites (methionine, homocysteine, taurine and vitamin B6) reporting on their activity was investigated using a surgical varicocele model in rats. Materials and Methods: In this experimental study, thirty male Wistar rats (7-8 weeks old, weighing 180-220 g) were divided into three groups: control, sham, and varicocele. We evaluated sperm parameters and functional tests, as well as the expression of CBS, CSE, and HO-1 proteins using Western blot analysis. Serum levels of methionine, homocysteine, and taurine were analyzed through high-performance liquid chromatography, while vitamin B6 concentrations were measured using enzyme-linked immunosorbent assay. For group comparisons, we employed ANOVA and the Tukey test, considering a P<0.05 as significant. Results: We observed a significant reduction in both sperm quality and functional parameters. Additionally, there was a notable decrease in the expression of CBS, CSE, and HO-1 proteins, as well as circulating vitamin B6 levels, in the varicocele group compared to the control and sham groups (P<0.001). Conclusion: The results of this study suggest that one possible cause of increased oxidative stress in varicocele may be the reduced expression of testicular enzymes involved in the production of endogenous antioxidants, which are associated with the transsulfuration pathway. However, further studies are needed to confirm these findings.
Research paper thumbnail of Effectiveness of Voytik-Harbin Protocol in Fabrication of Ram's Testicular-Derived Hydrogel and Its Impact on Mouse In Vitro Spermatogenesis
Volume 19, Issue 1, January, 2025
Abs tract Background: The utilization of decellularized extracellular matrix (dECM) derived from ... moreAbs tract Background: The utilization of decellularized extracellular matrix (dECM) derived from animal testis tissue has demonstrated potential as a component of tissue-specific scaffolds. Current research is mostly centered around dECM as a natural resource for culturing testicular cells. This study aimed to assess firstly the comparison of Voytik-Harbin (VH) and Frytes protocol in creating Ram's dECM testis hydrogel and secondly the evaluation of the best protocol effect on in vitro spermatogenesis. Materials and Methods: In this experimental study, the six testes of mature rams were decellularized and the hydrogel production was performed by i. The Frytes protocol utilized a concentration of 1 mg/mL of pepsin, dissolved in either 0.1 or 0.01 M HCl, and ii. The VH protocol was involved 10 mg of pepsin per 100 mg of ECM in 0.5 M of acetic acid. Subsequently, mouse testicular cells were cultivated on collagen hydrogel as the control and the more effective testicular-derived hydrogel (TDH) to evaluate the early stages of in vitro spermatogenesis. Results: While the Freytes protocol produced a homogeneous pre-gel solution with both HCl concentrations; elevating the pH to 7.4 loosened the hydrogel and made gelation problematic. In contrast, the VH protocol solidified the hydrogel and produced a strong hydrogel due to its gelation consistency. Furthermore, the prepared hydrogel by VH with 25 mg of dECM had a significantly higher priority in terms of rheology and structure (P<0.05). Following mouse testicular cell culture, TDH and collagen hydrogel did not differ significantly in terms of cell survival rates and the mRNA expression of early spermatogenesis genes. Conclusion: Using the VH protocol for producing ram TDH resulted in a firm hydrogel with a high frequency of repeat, which may be suited for testicular cell growth.
Research paper thumbnail of Effect of Exogenous of Transforming Growth Factor-β1 on Pregnancy Outcome in Mice with Recurrent Pregnancy Loss by Persistent Enhancement of Placental Tissue Indoleamine 2,3-Dioxygenase Expression
Volume 19, Issue 1, January, 2025
Abstract Background: The immunologic factors are the chief reason for recurrent pregnancy loss (R... moreAbstract Background: The immunologic factors are the chief reason for recurrent pregnancy loss (RPL) and induction of maternal-fetal tolerance is the main treatment for this cause of RPL, but the effect of this method is uncertainly and needs multiple doses and/or interventions. The aim of this study was to investigate whether a single administration of transforming growth factor-β1 (TGF-β1) can improve the pregnancy outcomes of RPL mice and whether the improvement is cause by TGF-β1 driving the expression of immune tolerance molecule indoleamine 2,3-dioxygenase (IDO). Materials and Methods: In this experimental study, 40 RPL model mice were equally divided into a control group, that received 0.01 M phosphate-buffered saline (PBS), and a treatment group, that received PBS containing 2, 20, and 200 ng/ml TGF-β1 via tail vein injection. The mice were sacrificed at 13.5 days of pregnancy and the embryo resorption rate was determined. The expression of IDO, TGF-β1, and TGF-β3 were detected in the placenta using western blotting and immunohistochemistry techniques. Results: The expression of IDO was positively correlated with TGF-β1 in the placental tissue of RPL mice (r=0.591, P<0.001). In all treatment groups, the embryo resorption rates were significantly lower than the control group and the expression of IDO in the placental tissue of all treatment groups was significantly higher than the control group. The expression of TGF-β1 increased gradually from, 2, 20 to 200 ng/ml in treatment groups, and the concentration of exogenous TGF-β1 positively correlated with the expression of TGF-β1, in placental tissues in treatment groups (r=0.372, P=0.018). Conclusion: Exogenous TGF-β1 improves pregnancy outcomes in RPL mice, and the possible therapeutic mechanism is that exogenous TGF-β1 induces the persistent expression of endogenous TGF-β1 and IDO due to mutually induced expression of the other. This experiment may provide a new direction and idea for the future treatment of RPL patients.
Research paper thumbnail of Embryo Mosaicism Rate in National Referral Hospital of Indonesia Detected Using Next-Generation Sequencing: A Retrospective Study
Volume 19, Issue 1, January, 2025
Background: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its ... moreBackground: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its prevalence and inherent unpredictability, leading to variations in embryo mosaic rates across different centers. This research endeavors to assess the prevalence of mosaicism and its characteristics within the scope of our preimplantation genetic testing-A (PGT-A) services in Indonesia. Specifically focusing on our center's experience since 2020, this study aims to elucidate mosaic rates among embryos in our care. Materials and Methods: In a retrospective approach, we collected secondary data sourced from our PGT-A outcomes dating back to 2020. A total of 196 embryos underwent analysis, their characteristics were documented and presented descriptively. Notably, the incidence of specific chromosome abnormalities was outlined. We assess a comparative analysis to investigate the relationship between mosaicism and its corresponding clinical characteristics. Results: In the analysis of 196 embryos, 106 (54.1%) displayed chromosomal anomalies spanning from low-level mosaicism to whole chromosome aneuploidy. Low mosaicism was observed in 25 (12.8%) of the embryos, while high mosaicism was identified in 8 (4.1%) embryos. Notably, low-level mosaicism predominated in chromosome 9 (n=10, 5.1%), whereas abnormality prevalence was highest in chromosome 21 (n=20, 10.2%). Statistical analysis revealed no significant disparity in mean maternal age among embryos with low-level mosaicism, high mosaicism, and normal chromosomes (33.88 vs. 35 vs. 33.26 years old, respectively). However, a statistically significant difference in mean maternal age (35.84 vs. 33.26 years) was observed between embryos with aneuploidy (monosomy or trisomy) and those with normal chromosomes. Furthermore, a significant difference in high mosaicism rates was detected in patients with unexplained infertility (P<0.05). Conclusion: In contrast to the study conducted elsewhere, our center had a higher mosaicism rate. Chromosomes 9, 8, and 6 were the most frequently affected. There was a significant difference in the high mosaicism rate for PGT-Arelated unexplained infertility causes.
Research paper thumbnail of The Relationship between Homocysteine Levels, MTHFR C677T and A1298C Polymorphism, and Pregnancy Outcomes in Georgian Women with Polycystic Ovary Syndrome: A Case-Control Study
Volume 19, Issue 1, January, 2025
Background: Over the past decade, numerous studies have been conducted to determine the role of h... moreBackground: Over the past decade, numerous studies have been conducted to determine the role of homocysteine and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms in the pathogenesis of polycystic ovary syndrome (PCOS), yet the results are inconsistent. The aim of the current study was to determine the association between homocysteine levels (Hcy), MTHFR C677T and A1298C polymorphisms, and pregnancy outcomes in Georgian women with PCOS. Materials and Methods: This case-control study included 177 female participants, of which 96 women were diagnosed with PCOS, and 81 age-matched women were without PCOS. Participants were divided into four groups; group I: 59 PCOS patients with history of recurrent pregnancy loss (RPL), group II: 37 PCOS patients with live birth in history and without RPL, group III: 39 women with RPL, without PCOS, group IV: controls, 42 women with live birth in history, without RPL and PCOS. These groups were compared based on their serum Hcy and the presence of two common single nucleotide polymorphisms (SNPs) in the MTHFR gene: C677T and A1298C. Results: The mean Hcy, frequency of hyperhomocysteinemia (Hhcy) and the prevalence of C677T and A1298C polymorphisms in MTHFR gene in PCOS patients were significantly higher than those without PCOS (P<0.05). Group I (PCOS with RPL) showed significantly elevated Hcy (13.7 ± 2.7) compared to group II (10.3 ± 2.6), group III (11.5 ± 2.3), and group IV (7.3 ± 2.2), P<0.001. In group I, the frequencies of the C677T-CT, A1298C-AC genotypes, and the compound heterozygous of C677T-CT/A1298C-AC were significantly higher than in the other groups (P<0.05). The prevalence of MTHFR A1298C (CC) was significantly higher in group II (PCOS patients with live birth) than in other comparison groups (P<0.05). Conclusion: The study reveals a significant correlation between hyperhomocysteinemia, MTHFR polymorphisms (C677T and A1298C), and PCOS, impacting pregnancy outcomes.
Research paper thumbnail of Association of The MCP-1 rs1024611 Polymorphism with Polycystic Ovary Syndrome in A Population of Indian Women: A Case-Control Study
Volume 19, Issue 1, January, 2025
Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine conditions th... moreBackground: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine conditions that significantly impact the life quality of reproductive-aged women. In the Indian population, its prevalence varies from 3.7 to 22.5% depending on ethnicity and diagnostic criteria. Chronic inflammation plays a pivotal role in PCOS pathogenesis. The monocyte chemoattractant protein-1 (MCP-1) is an important chemotactic factor for inflammatory response of monocytes. Genetic variations in the MCP-1 gene may modulate MCP-1 expression. Although the association of the MCP-1 promoter polymorphism (-2518A/G) was extensively studied in different inflammatory conditions, there is only one report in PCOS conditions. Since no study was reported from the Indian population, we aimed to explore the association of the MCP-1-2518A/G polymorphism (rs1024611) with PCOS. Materials and Methods: In this case-control study, to analyse the distribution and association of rs1024611 with PCOS, polymerase chain reaction-fragment length polymorphism (PCR-RFLP) analysis was carried out in 202 patients who exhibited PCOS from menarche onwards or with higher severity of symptoms and 122 age-matched controls. Results: In our study, no significant correlation was observed in rs1024611 polymorphism with PCOS patients in comparison with control. In addition to this, we found no significant difference in the genotype and allele frequencies between obese and non-obese PCOS patients. Conclusion: Our finding suggests that the MCP-1-2518 A/G polymorphism has not been associated with PCOS predisposition.
Research paper thumbnail of Role of Prothrombin and Methylenetetrahydrofolate Reductase Gene Polymorphisms as well as Thrombophilia Markers, as Risk Factors for Unexplained Recurrent Miscarriage: A Case-Control Study
19, Issue 1, January, 2025
Background: Unexplained recurrent miscarriage (RM) is still an unsolved reproductive health probl... moreBackground: Unexplained recurrent miscarriage (RM) is still an unsolved reproductive health problem. Inherited thrombophilias have been one of the causes. Mutation in genes encoding coagulation proteins, including prothrombin (PT G20210A) and methylenetetrahydrofolate reductase (MTHFR) genes, increase tendency for venous thromboembolism. This study aimed to evaluate association between polymorphisms in prothrombine and MTHFR genes with RM. We also evaluated association between protein C (PC), protein S (PS), antithrombin III (ATIII), and homocystiene with RM. Materials and Methods: We conducted a case-control study on women with history of miscarriages and healthy controls. Genetic analysis was done using (TaqMan) polymerase chain reaction (PCR) technique and the other tests were performed to check general health indications and thrombophilia markers. Results: In this study, 195 RM group (group I) participants and 90 healthy controls (group II), PC, PS, ATIII deficiency and Hyperhomocysteinemia were in 7.2, 65.6, 9.2, 10.8% of group I respectively, but was 1.1, 7.8, 2.2, 2.2% of group II. PT G20210A showed two in group I were A/G, no A/G in group II, and no AA carrier in the either group. G allele was observed in 99.5% of the group I and 100% of the group II, while A allele was detected in 0.5% of group I. MTHFR C677T gene showed C/T mutation in 33.3% of group I and 32.2% of group II, while T/T mutation was detected in 12.8% of group I and 8.9% of the group II. C allele was found in 70.5% of group I and 75% of group II, while T allele was found in 29.5% of group I and 25% of group II (P=0.269). Conclusion: PT G20210A and MTHFR C677T gene mutations are not correlated with RM in the Egyptian population. However, Egyptian women with RM are strongly associated with hyperhomocysteinemia, PC, PS, and ATIII deficiencies (registration number: NCT03209063).
Research paper thumbnail of Relation of Follicular Fluid Soluble Receptor for Advanced Glycation End-Products Concentration and Anti Mullerian Hormone in Polycystic Ovary Syndrome and Non-PCOS Women Referring to In Vitro Fertilization Center: Case-Control Study
Volume 19, Issue 1, January, 2025
Background: Reproductive dysfunctions of polycystic ovary syndrome (PCOS) and blood anti-mulleria... moreBackground: Reproductive dysfunctions of polycystic ovary syndrome (PCOS) and blood anti-mullerian hormone (AMH) concentration are significantly influenced by the dietary advanced glycation end products (AGEs). The interplay between AGEs and their soluble form of receptor, might exert a protective role on the follicular environment and affect AMH concentration. This study investigated the relationship between soluble receptor for advanced glycation end-products (sRAGE) levels in follicular fluid (FF) and serum AMH levels in PCOS and non-PCOS women. Materials and Methods: Among 43 women of reproductive age who participated in this case-control study 26 non-PCOS women were assigned to the control group, while 17 participants were diagnosed with PCOS and allocated to the case group. Prior to the in vitro fertilization (IVF) procedure, fluid samples were collected and levels of FF sRAGEs and serum AMH were recorded through the use of commercially available ELISA kits. Results: Correlation analysis, without age adjusting, revealed a statistically considerable and positive association between FF sRAGE and serum AMH concentration in PCOS women (P=0.012, r=0.596). Moreover, after age stratification, the same pattern was observed in some age groups; in PCOS women aged 40 years or older (r=1, P<0.001), as well as those younger than 30 years (r=0.922, P=0.003), correlation analysis demonstrated a significant and positive relationship between FF sRAGE and serum AMH levels. Conclusion: The association between sRAGE and AMH in women with PCOS is primarily affected by their age, whereas non-PCOS women showed no relationship. The results show that the levels of these receptors (sRAGE) show their specific effects in young women and women over 40 years old and not in middle age and target the ovarian reserve. It seems to act as a defensive shield in older women and increase fertility in young women.
Research paper thumbnail of Comparison of In Vitro Fertilization Outcomes between Normal and T-Shaped Uteri, Diagnosed by Hysterosalpingography in Women with infertility: A Retrospective Cohort Study
Volume 19, Issue 1, January, 2025
Background: T-shaped uterus is a subclass of dysmorphic uteri according to the European Society o... moreBackground: T-shaped uterus is a subclass of dysmorphic uteri according to the European Society of Human Reproduction and Embryology (ESHRE) classification. A T-shaped uterus might be related to poor reproductive outcomes or pregnancy complications. We aim to compare the success rates of in vitro fertilization (IVF) between individuals with a normal uterus and those with a T-shaped uterus identified through Hysterosalpingography. Materials and Methods: A retrospective cohort study was done in Royan Institute, Iran, in April 2020-April 2021. In line with the criteria for inclusion and exclusion, 468 cases were selected. Inclusion criteria were as follow: women of 20-45 years old, primary infertility, no repeated implantation failure (RIF), embryo quality "grade A" or "grade B" (freeze), and no consumption of smoking or alcohol. Patients with uterine fibroid, polyp, metabolic disorders, previous uterine surgery were excluded. Based on the hysterosalpingography (HSG) images, the patients were categorized as: "T-shaped uterus" or "normal uterus". IVF outcomes including positive or negative chemical pregnancy were entered into SPSS software. Using the Chi-square test, the success rate of IVF in those groups was compared. Results: Of 468 cases, 91 cases had T-shaped uterus and 377 cases had normal uterus. The mean age of patients was 34 ± 3. The frequency of positive chemical pregnancy in the T-shaped uterus group was 42.9%, but 48% in the normal uterus group. The distribution of positive clinical pregnancy was 34.06% in the T-shaped uterus group and 46.1% in the normal uterus group. The distribution of failed pregnancies was 20.5% in women with T-shaped uteri and 19.8% in the normal uterus group (P=0.867). There was no significant difference observed between the two groups. Conclusion: The success rate of IVF and pregnancy outcomes of patients in the T-shape and normal groups were not found to be statistically significantly different.
Research paper thumbnail of Clinical Pregnancy Rates in Relation to Vitamin D Supplementation among Women with Hyperandrogenic Polycystic Ovarian Syndrome: A Prospective Study
Volume 19, Issue 1, January, 2025
Background: Pregnant mothers frequently have vitamin D deficiency, which has potential consequenc... moreBackground: Pregnant mothers frequently have vitamin D deficiency, which has potential consequences for the health of their unborn children. Prenatal vitamin D administration raises maternal and foetal 25(OH)D levels. This study aims to assess the effects of 25(OH)D supplementation on clinical pregnancy and miscarriage rates in women diagnosed with hyperandrogenic polycystic ovarian syndrome (PCOS). Materials and Methods: This prospective study was conducted on 200 patients with hyperandrogenic PCOS who attended an outpatient infertility clinic at Menoufia University Hospital from March 2021 until March 2022. Participants were divided into two groups-(A) women who received a therapeutic dose of 25(OH)D supplements (n=100) and (B) women who did not receive 25(OH)D supplements (n=100). Results: The duration needed to reach follicles that were ≥18 mm was significantly higher in group B (16.74 ± 2.57) compared with group A (13.40 ± 2.12). Midluteal progesterone was significantly higher in group A (19.63 ± 2.12) compared with group B (17.74 ± 2.36, P<0.001). Our results indicate that women with adequate 25(OH)D levels are far more likely to experience clinical pregnancies than those with 25(OH)D deficiency. Conclusion: More research is necessary to determine whether vitamin D supplementation can be a simple and economical solution to increase pregnancy rates. Our study population had a significant 25(OH)D deficit or insufficiency prevalence. Determining 25(OH)D levels as part of a routine infertility assessment may be advantageous.
Research paper thumbnail of The Effects of Three Methods of Luteal Phase Support on Pregnancy Outcomes in Poor Ovarian Responders: A Randomized Clinical Trial
Volume 19, Issue 1, January, 2025
Abs tract Background: The effectiveness of changing the type of luteal phase support in patients ... moreAbs tract Background: The effectiveness of changing the type of luteal phase support in patients with poor ovarian response (POR) remains unclear based on the available evidence. This study aimed to compare the effectiveness of various luteal phase support (LPS) methods, including progesterone alone, human chorionic gonadotropin (hCG) alone, and the combination of progesterone with hCG, in these patients. Materials and Methods: In this randomized clinical trial, 375 patients diagnosed with POR based on the Bologna criteria underwent intracytoplasmic sperm injection-embryo transfer (ET) cycles at the Royan Institute between November 2015 and June 2019. The patients were allocated randomly into three different LPS groups on the day of oocyte pickup. In the first group, 1500 IU of hCG on the ET day, as well as 4 days after that were administrated intramuscularly. In the second group, the patients received 1500 IU of hCG IM on the ET day, as well as 3 and 6 days after the ET along with vaginal progesterone suppositories of 400 mg twice daily. For the third group, only vaginal suppositories twice daily were administrated from the day of oocyte pick up until the pregnancy test day. The clinical pregnancy, miscarriage and live birth rates were compared among groups using appropriate statistical tests. Results: The data analysis indicated that the three groups were comparable, and there were no significant differences among the groups in terms of implantation, clinical pregnancy, miscarriage, and live birth rates. The twin pregnancy rate in the hCG-only group was higher than in the other two groups, although this difference did not reach statistical significance (P=0.060). Conclusion: Similar pregnancy and live birth rates were observed among different LPS regimens. Interestingly, the use of two boluses of low-dose hCG (1500) was associated with a slight increase in multiple pregnancies. We suggest this effective method, which is easier and more patient-friendly (registration number: NCT02798653).
Research paper thumbnail of Fertility Preservation in Female Patients with Cancer Part II: Royan Institute Clinical Practice Guideline for Girls and Women with Cancer; A Review Study
Volume 19, Issue 1, January, 2025
The fertility preservation (FP) is a paramount concern for oncology patients and should be regard... moreThe fertility preservation (FP) is a paramount concern for oncology patients and should be regarded as an essential component of their overall cancer management strategy. The magnitude of this issue has been recognized in FP guidelines. The formulation and execution of harmonized guidelines and policies concerning the provision of FP services, inclusive of therapeutic strategies and standardization of procedures, are crucial to surmount disagreements regarding the delivery of these therapeutic services and avert delays in cancer treatment. The matter of FP and the methodology for managing the treatment and follow-up of cancer patients should be documented as a component of their management guideline, thereby providing patients with clear recommendations on fertility preservation. In this manuscript, we provide a succinct overview of existing international guidelines history and reference comprehensive networks of FP services for oncology patients. Furthermore, we present the Royan Institute's guideline specifically designed for preserving the fertility of female oncology patients.
Research paper thumbnail of Depressive and Anxiety Symptoms in Women with Threatened Abortion: A Case-Control Study
Volume 18, Issue 4, October, 2024
Background: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the a... moreBackground: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the attention paid to the adverse outcomes of obstetrics, only a few studies have been conducted on the psychological status of women with threatened abortion. This study aimed to compare the symptoms of depression and anxiety in women with TA and those without threatened abortion. Materials and Methods: In a case-control study, 136 women with TA (the case group) and 136 women without TA (the control group), were matched with the case group in terms of gestational age, education level, age, and number of pregnancies, were examined from Obstetric clinics of Babol University of Medical Sciences. Demographic information and pregnancy history were obtained from all participants. Additionally, the women filled out the BSI-18 questionnaire. Statistical analysis was performed using SPSS version 22 software. Results: The results showed that in women with threatened abortion, the likelihood of experiencing depression symptoms was 1.9 times higher [odds ratio (OR)=1.91, 95% confidence interval (CI)=1.13-3.23, P=0.015], anxiety symptoms were 1.8 times higher (OR=1.83, 95% CI=1.08-3.10, P=0.024), and somatization was 2.6 times higher (OR=2.65, 95% CI=1.61-4.37, P<0.001) compared to pregnant women without threatened abortion. Additionally, in women with threatened abortion, the risk of psychological distress was 3.3 times higher (OR=3.30, 95% CI=1.96-5.56, P<0.001) than in women without threatened abortion. Conclusion: This study suggests that gynecologists, midwives, and healthcare providers, in addition to providing medical care for women threatened with abortion, should identify women at risk of experiencing symptoms of depression and anxiety. Providing appropriate psychological support should be prioritized in the management of women with threatened abortion.
Research paper thumbnail of Impact of Microfluidic Sperm Sorting on Embryonic Euploidy in Infertile Patients with Sperm DNA Damage: A Retrospective Study
Volume 18, Issue 4, October, 2024
Background: Sperm DNA fragmentation is an important factor that affects male fertility. This stud... moreBackground: Sperm DNA fragmentation is an important factor that affects male fertility. This study intends to evaluate the impact of sperm DNA damage [single-strand breaks (SSB) and double-strand breaks (DSB)] on fertilisation and embryonic euploidy after intracytoplasmic sperm injection (ICSI). Of the different sperm selection techniques, the novel microfluidic sperm sorting (MSS) ZyMōt™ ICSI device reduces both SSB and DSB in semen samples. The second objective is to study the impact of this MSS device on fertilisation and embryonic euploidy. Materials and Methods: This retrospective study included data from 167 ICSI treatments. The alkaline and neutral Comet assays were used to analyse SSB and DSB, respectively. Analysis of fertilisation and embryo euploidy rates was performed in four groups of patients with normal/altered SSB or DSB values. Density gradient centrifugation (DGC) and the ZyMōt™ ICSI MSS device were used for semen preparation. Results: Fertilisation rates in 167 ICSI cycles were higher when using sperm from patients with normal SSB values (70.84%) and patients with abnormal SSB whose samples were processed using the MSS device (69.71%) compared to patients with abnormal SSB values using DGC (58.49%). Preimplantation genetic testing for aneuploidies (PGT-A) revealed a higher embryo euploidy rate in patients with normal DSB values (60.00%) and patients with abnormal DSB whose samples were processed using the MSS device (44.59%) compared to patients with abnormal DSB values using DGC (36.84%). When female age was considered, there were fewer euploid embryos in women ≥35 years of age compared to younger women, independently of SSB and DSB. The number of euploid embryos increased when the MSS device was used. Conclusion: High SSB and DSB values in semen samples decreased fertilisation rates and embryonic euploidy, respectively. The ZyMōt™ ICSI device for semen preparation increased both rates, especially in couples that included women <35 years old.
Research paper thumbnail of Nanocurcumin Decreases Nucleotide-Binding Oligomerization Domain-Like Receptor Family Pyrin Domain-Containing 3 Complex Expressions in An Experimental Testicular Torsion Model
Volume 18, Issue 4, October, 2024
Background: Testicular torsion is a surgical emergency leads to severe acute ischemia injuries, a... moreBackground: Testicular torsion is a surgical emergency leads to severe acute ischemia injuries, and may eventually cause male infertility. The nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domaincontaining 3 (NLRP3) inflammasome is involved in testicular torsion pathophysiology. The aim of this study was to evaluate the effects of nanocurcumin (nCur) on testicular tissue and the NLRP3 inflammasome components. Materials and Methods: In this experimental study, male Wistar rats (n=36) were randomly divided into six equal groups: controls, ischemia-reperfusion (I/R), I/R+nCur (50 or 100 mg/kg thirty minutes before reperfusion), and I/ R+nCur (50 or 100 mg/kg thirty minutes before reperfusion and continued for seven days). The left testis was rotated 720 (2×360) degrees counterclockwise to induce testicular torsion. After two hours of ischemia, detorsion was performed. At the end of treatment, an orchiectomy was carried out. The testis histopathology and the mRNA levels of NLRP3, apoptosis-associated speck-like protein (ASC), and Caspase-1 were evaluated. Results: Our results revealed that, testicular I/R had a detrimental effect on testis histology such as the number of spermatogonia (14.5 ± 0.57, P<0.001) and the seminiferous tubules epithelium thickness (28.5 ± 11.7, P=0.007). It also significantly increased the expression of the NLRP3 inflammasome components (P<0.001). Treatment with nCur (in both doses) improved testicular damage and significantly reduced the expression of NLRP3 (P=0.007), ASC (P=0.003), and Caspase-1 (P<0.001). Conclusion: These results imply that nCur might be a useful therapeutic strategy in the field of reproductive medicine to diminish the side effects of testicular I/R via its anti-inflammatory properties and may be employed as adjuvant therapy to lessen testicular torsion complications.
Research paper thumbnail of The Relationship between The Expression of Sperm MicroRNA-149b and 34c and Sperm Quality in Men with Oligoasthenoteratozoospermia in Endometriosis
Volume 18, Issue 4, October, 2024
Background: The objective of this study was to investigate the correlation between the expression... moreBackground: The objective of this study was to investigate the correlation between the expression levels of sperm microRNA-149b and 34c and sperm quality in men diagnosed with oligoasthenoteratozoospermia. Materials and Methods: In the experimental study, we recruited 30 infertile men with oligoasthenoteratozoospermia and 30 control samples. In this study, miR-149b and miR 34c expression using reverse transcription polymerase chain reaction (RT-PCR) were evaluated. Semen samples were collected and subjected to initial analysis, including semen parameters, following the protocol provided by the World Health Organization (WHO). The levels of total antioxidant capacity (TAC) and malondialdehyde (MDA) were measured using an ELISA kit. Results: The expression levels of miR-149b and miR-34c were significantly downregulated in men with oligoasthenoteratozoospermia compared to age-matched normozoospermic men, as determined by RT-qPCR (P=0.001, and P=0.003 respectively). Correlation analysis revealed a positive correlation between the expression levels of miR-149b and miR-34c and various sperm parameters, including sperm count, motility, morphology, viability, sperm mitochondrial membrane potential, sperm capacity, and TAC. Additionally, an inverse correlation was observed between the expression levels of miR-149b, miR-34c, DNA fragmentation, and MDA levels. Conclusion: The findings of this study indicate that the decreased expression of miR-149b and miR-34c is associated with oligoasthenoteratozoospermia, potentially affecting fundamental semen parameters. These results provide a basis for future research aimed at exploring potential therapeutic interventions for male infertility.
Research paper thumbnail of Ceratonia siliqua L. pod Effects on Viability Gene Expression of Endometrial Mesenchymal Stromal/Stem Cells Isolated from Women with Endometriosis-Associated Infertility
Volume 18, Issue 4, October, 2024
Background: This study aims to investigate the effects of carob (Ceratonia siliqua L.) pod extrac... moreBackground: This study aims to investigate the effects of carob (Ceratonia siliqua L.) pod extract (CPE) on the viability of human endometrial mesenchymal stromal/stem cells (EnMSCs) and its impact on mRNA and protein expressions of DNA methyltransferases (DNMT1, DNMT3A, and DNMT3B), histone deacetylase 1 (HDAC1), matrix metalloproteinase-2 (MMP2), and cyclooxygenase-2 (COX-2) in endometriotic patients. Materials and Methods: In this experimental study, EnMSCs were derived from endometrium of patients with ovarian endometrioma (OMA-EnMSCs group) and deep infiltrative endometriosis (DIE) samples of 10 endometriosisassociated infertility (EAI) women (E-EnMSCs group) and compared to EnMSCs derived from the endometrium of an endometriosis-free, normal woman as the control group (C-EnMSCs). The metabolic activity of the control and case groups were evaluated by treating them with different concentrations of CPE. Cell viability was analysed by MTT. Real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to evaluate the expression of specific genes at the mRNA and protein levels, respectively. Results: Treatment with 0.8 and 2 μg/mL of CPE downregulated COX-2 and HDAC1 in the E-EnMSC group compared to the C-EnMSCs group. Treatment with 0.8 μg/mL of CPE also decreased MMP2 and DNMT3B gene expressions. The COX-2 and DNMT3A genes were significantly upregulated after treatment with 2 μg/mL of CPE. Expressions of the COX-2, HDAC1, DNMT1, DNMT3A, and DNMT3B peptides decreased in the all three groups
Research paper thumbnail of Potential Effects of Soy Isoflavones and Broccoli Extract on Oxidative Stress, Autophagy, and Apoptosis Gene Markers in Endometriosis
Volume 18, Issue 4, October, 2024
Background: Endometriosis is an idiopathic gynecological condition affecting women with pelvic pa... moreBackground: Endometriosis is an idiopathic gynecological condition affecting women with pelvic pain and infertility in reproductive ages. Due to preventive and therapeutic effects of soy isoflavones (SI) and broccoli extract (BE) on tumor angiogenesis, inflammation and oxidative stress and since endometriosis is accompanied by chronic inflammation, in this study, we aim to evaluate the potential role of these compounds on the pathological scores of endometriosis and also consider the expression level of the gene markers of autophagy, apoptosis, and oxidative stress in an endometriosis rat model. Materials and Methods: In the present experimental study, 45 mature female Sprague-Dawley rats weighing 220 ± 20 g at the age of eight weeks with surgically induced endometriosis was divided into five groups and treated for six weeks with normal saline (control group), BE, SI, BE+SI by oral gavage, and also Diphereline intramuscularly. The histopathological scores of the endometrial implants (0, 1, 2, 3: no, poorly, moderately and well-preserved epithelial layers, respectively) and the mRNA expression level of Bcl-2, Bax, Caspase-3, Beclin-1, Lc3, and Sod within peritoneal tissue were compared among the groups. Results: Pathologic scores of the implants in the Diphereline (1.2 ± 0.27) and BE+SI (1.2 ± 0.41) groups were declined significantly in comparison with the control group (2.08 ± 0.44) (P≤0.001). In the endometriotic structures, the mRNA expression levels of our target genes were improved significantly (P≤0.01) in comparison with the control group. Conclusion: The findings of the current study demonstrated that the simultaneous consumption of a certain amount of broccoli extract and SI can be considered as a promising therapeutic strategy for treatment of endometriosis.

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