Papers by Kiandokht Kiani
The prolonged retention of fetal bone structure is an uncommon condition after a previous abortio... more The prolonged retention of fetal bone structure is an uncommon condition after a previous abortion. We describe two cases with fetal bone fragment amongst 3589 hysteroscopies (0.05%), who had no complaint other than secondary infertility. In both patients, hyperechogenic areas were found through transvaginal ultrasound and the bones were removed by hysteroscopy. Despite meticulous evaluation during hysteroscopy, some bones were not observed and were stable during the next sonography. According to the formation of fetal bones after 11 weeks of pregnancy; patients with secondary infertility who have a history of abortion that progressed beyond this time and endometrial hyperechoic areas by transvaginal ultrasound should be evaluated for any retained fetal bone. Hysteroscopy should be performed under abdominal ultrasonography guide to ensure fetal bone tissue is entirely removed during a single surgery.
Background: The objective was to evaluate whether extending the embryo culture period from 2 to 3... more Background: The objective was to evaluate whether extending the embryo culture period from 2 to 3 days would yield a more optimal selection of viable embryos, thereby increasing the pregnancy rate. Materials and Methods: We have retrospectively analyzed pregnancy rates in the patients who had embryo transfer either on day 2 (582 patients) or on day 3 (387 patients) post-insemination over a 10-month period. The relationship between the quality score of day 2 and day 3 embryos and their respective pregnancy rates was also analyzed. Results: The demographic and clinical characteristics were similar in both groups. Embryos transferred on day 2 or day 3, were similar morphologically& we found no difference in the distribution of grades between patients who became pregnant and those who failed to become pregnant. Pregnancy rates were slightly higher in patients who had embryo transfer on day 3 (40.72%) than patients who had transferred on day 2 (38.96%), but this difference was not signif...
Background This study was designed to evaluate the incidence of uterine pathologies in infertile ... more Background This study was designed to evaluate the incidence of uterine pathologies in infertile women with a history of two implantation failures after in vitro fertilization (IVF) and estimate the effect of hysteroscopic correction on achieving a pregnancy in these patients. Materials and Methods The retrospective study population included 238 infertile women attended the outpatient infertility clinic between November 2007 and December 2008. Patients with at least two previous IVF failures were eligible for this study. All patients had normal findings on hysterosalpingography performed prior their first attempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopy were performed in patients before the subsequent IVF attempt. Results Out of 238 patients with previous IVF failure who underwent hysteroscopic evaluation, 158 patients (66.4%) showed normal uterine cavity. Abnormal cavity was found in 80 patients (33.6%). We found polyp as the most common abnormalit...
Journal of Ethnopharmacology
ETHNOPHARMACOLOGICAL RELEVANCE Calligonum comosum is a desert plant that is applied in traditiona... more ETHNOPHARMACOLOGICAL RELEVANCE Calligonum comosum is a desert plant that is applied in traditional folkloric medicine for the treatment of abnormally heavy or prolonged menstruation and menstrual cramps. Moreover, it has been suggested for the treatment of infertility-causing conditions. Its bioactive chemical constituents inhibit multiple processes, such as angiogenesis, inflammation and invasive tissue growth, which may be beneficial in the therapy of endometriosis. AIM OF THE STUDY We investigated the effects of Calligonum comosum on the development of endometriotic lesions. MATERIALS AND METHODS We evaluated the anti-angiogenic activity of Calligonum comosum ethyl acetate fraction (CCEAF) in different in vitro angiogenesis assays. Moreover, we surgically induced endometriotic lesions in BALB/c mice, which received 50 mg/kg Calligonum comosum total extract (CCTE) or vehicle (control) over 4 weeks. The growth, cyst formation, vascularization and immune cell infiltration of the lesions were assessed with high-resolution ultrasound imaging, caliper measurements, histology and immunohistochemistry. RESULTS CCEAF doses of up to 10 μg/mL did not impair the viability of human dermal microvascular endothelial cells (HDMEC), but dose-dependently suppressed their migration, tube formation and sprouting, indicating a substantial anti-angiogenic effect of CCEAF. Furthermore, CCTE significantly inhibited the growth and cyst formation of developing murine endometriotic lesions when compared to vehicle-treated controls. This was associated with a reduced vascularization, cell proliferation and immune cell infiltration. CONCLUSIONS Our findings show that Calligonum comosum targets multiple, fundamental processes in the pathogenesis of endometriosis, which may be beneficial for the treatment of this common gynecological disorder.
International Journal of Reproductive BioMedicine
Background: Establishment of a standardized animal endometriosis model is necessary for evaluatio... more Background: Establishment of a standardized animal endometriosis model is necessary for evaluation of new drug effects and for explaining different ethological aspects of this disease. For this purpose, we need a model which has more similarity to human endometriosis. Objective: Our objective was to establish an autologous endometriosis mouse model based on endogenous estrogen level and analyze the influence of estrus cycle on the maintenance of endometriotic lesions. Materials and Methods: In this experimental study, endometriotic lesions were induced in 52 female NMRI mice by suturing uterine tissue samples to the abdominal wall. The transplantation was either performed at proestrus/estrus or at metestrus/diestrus cycles. Urine-soaked beddings from males and also male vasectomized mice were transferred to the cages to synchronize and maintenance of estrus cycle in female mice. The mice were sacrificed after different transplantation periods (2, 4, 6 or 8 wk). The lesions size, macroscopic growth, model success rate, histological and immune-histochemical analyses were assessed at the end. Results: From a total of 200 tissue samples sutured into the peritoneal cavity, 83 endometriotic lesions were confirmed by histopathology (41.5%). Model success rate for proestrus/estrus mice was 60.7% vs. 79.2% for metestrus/diestrus mice. The endometriotic lesions had similar growth in both groups. Number of caspase-3, Ki67-positive cells and CD31-positive micro vessels were also similar in endometriotic lesions of two groups. Conclusion: If we maintain the endogenous estrogen levels in mice, we can induce endometriosis mouse model in both proestrus/estrus and metestrus/diestrus cycle without any significant difference.
Evidence-based Preclinical Medicine, 2016
Endometriosis is defined as the endometrial tissue growth (containing both glandular and stromal ... more Endometriosis is defined as the endometrial tissue growth (containing both glandular and stromal components) on the extra uterine places especially peritoneal and visceral surfaces of the pelvis. The current medical treatments are mainly based on inhibiting oestrogen or treating the symptoms rather than curing the disease. The recurrence rate is nearly high after both current medical and surgical treatments for endometriosis. In recent years, medicinal herbs and other botanical products have become popular for relieving the symptoms of several gynaecologic disorders such as endometriosis. The objective of this systematic review and meta-analysis is to provide the pre-clinical researches on medicinal plants (Not Chinese combinations) and its compounds studied in the treatment of experimental endometriosis. It will also prepare the strengths and limitations of available studies and offer future perspectives in this field. The following electronic databases will be searched up to December 2015: Medline (PubMed platform), Scopus. The grey literatures, Google scholar, and the reference list of all known primary articles, and relevant conference proceedings will also be checked. Only non-Chinese language papers will be placed in our searches or study selection. For assessing the risk of bias of the included studies, we will use the SYstematic Review Centre for Laboratory animal Experimentation risk of bias tool for animal studies (SYRCLE’s RoB tool). If the studies are sufficiently comparable, outcome data will be pooled. For outcome measures where a meta-analysis is not possible a qualitative data synthesis of the results from individual studies will be performed.
CalligonumcomosumL`Her (C. comosum) belongs to the polygonaceae family and is known as Escanbil i... more CalligonumcomosumL`Her (C. comosum) belongs to the polygonaceae family and is known as Escanbil in Iran. The objective of this study was to assess quantification of phenolic antioxidants quercetin, catechin, and β-sitosterol, antioxidant, and toxic effects of ethyl acetate fraction from different parts including root, fruit, stems, aerial (leaves and flowers) and the whole parts ofC. comosum.HPLC with UV detection was employed for quantification of quercetin, catechin, and β-Sitosterol present in different parts of C. comosum. Antioxidant activity of all samples was evaluated using 2, 2-diphenyl-1-picryl-hydrazyl (DPPH) method. Toxicity of extracts was assayed by brine shrimp, MTT, and animal models.HPLC analysis of quercetin showed high levels of this compound in fruits (2/7 ± 0.25 mg/g)and aerial parts (2/1 ± 0.14 mg/g) as well as, catechin in the plant root (83/9 ± 9.85mg/g) of C. comosum. Aerial parts and then the whole plant extract also containing β-sitostrol in the highest am...
International Journal of Fertility Sterility, 2013
Background: The aim of this study was to compare the effects of easy and difficult embryo transfe... more Background: The aim of this study was to compare the effects of easy and difficult embryo transfers (ET) on implantation and pregnancy rates. Materials and methods: In this prospective study, we analyzed the results of 706 ET procedures over a 12-month period. An easy ET was defined as a transfer that occurred without the use of force or other instrumentation. A difficult ET was defined as the use of force for catheter placement, and/or the use of additional instruments, and/or manipulation. Pregnancy rate was compared between patients with easy or difficult ETs. Results: There was a significantly higher implantation rate in the easy group (21.7%) compared to the difficult group (12.1%, p<0.05).The easy group had a higher pregnancy rate (38.1%) compared to patients who had difficult ETs (21.4%; p<0.05). Conclusion: Any uterine manipulation during ET adversely affects in vitro fertilization (IVF). Precaution should be taken to identify possibly difficult ET cases in advance.
Tahereh Madani, MD 1* , Mahnaz Ashrafi, MD 1, 2 , Kiandokht Kiani, M.Sc. 1 , Khafri Soraya, M.Sc.... more Tahereh Madani, MD 1* , Mahnaz Ashrafi, MD 1, 2 , Kiandokht Kiani, M.Sc. 1 , Khafri Soraya, M.Sc.3 ... 1. Endocrinology and Female Infertility Department, Reproductive Medicine Research Center, Royan Institute 2. Obstetrics and Gynecology Department, Iran University of ...
Background: The aim of this study was to compare prenatal outcome of intra cytoplasmic sperm inje... more Background: The aim of this study was to compare prenatal outcome of intra cytoplasmic sperm injection (ICSI) pregnancies with pregnancies obtained through in vitro fertilization (IVF). Materials and Methods: Retrospectively 532 pregnancies of ART cycles were assessed during 1999-2000. The main outcome measured including abortions, ectopic pregnancies, prematurity, low birth weight, cesarean section, prenatal mortality and malformation compared between IVF and ICSI groups. Results: The mean age was similar in both IVF and ICSI groups, as well as treatment protocols, and the number of transferred embryos. There were significant differences in duration of infertility, and times of ART cycles between groups (p<0.05). The total spontaneous abortion rate (19.09% in IVF and 16.42% in ICSI) showed no significant difference between groups. In addition, we could not find significantly differences about the first and second trimester abortion between two groups. ICSI patients experienced s...
Background: In vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) are recogni... more Background: In vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) are recognized as established and increasingly successful forms of treatment for infertility, yet significant numbers of couples discontinue treatment without achieving a live birth. This study aims to identify major factors that influence the decision to discontinue IVF/ICSI treatments. Materials and Methods: We studied the data of 338 couples who discontinued their infertility treatments after three cycles; based on medical records and phone contact. The main measure was the reason for stopping their treatments. Results: Economical problems were cited by 212 couples (62.7%), as their mean income was significantly less than other couples (p<0.0001). Lack of success was reported as a reason by 229 (67.8%), from whom 165 (72%) also had economical problems. Achieving independent-ART pregnancy was the reason for discontinuation in 20 (5.9%) couples. Psychological stress, depression and anxiety were...
Controlled ovarian hyper-stimulation (COH) is one of the most important stages in ART treatments.... more Controlled ovarian hyper-stimulation (COH) is one of the most important stages in ART treatments. The main goal of COH is to achieve efficient follicle numbers without compromising oocyte quality. During the natural ovarian cycle, different pituitary hormones are responsible for follicle recruitment and growth. In the early follicular phase, follicle stimulating hormone (FSH) is responsible for early follicular growth and development. However, in the middle or late phase, reduction in FSH levels will occur and LH gains the more important role. The more COH protocol can mimic the natural hormonal situations, the more efficacious it will be. In most infertile women, the administration of exogenous FSH 2 alone is usually sufficient for ovarian stimulation. In these patients, dominant follicles have LH receptors in addition to FSH ones and therefore can respond to endogenous LH. However, subgroups of cases either do not respond or over-respond to FSH. These patients may benefit from LH 3 activity supplementation during their mid or late follicular phase. Different studies have found that LH activity supplementation may lead to improved outcome in patients over the age of 35, patients with initial abnormal response to recombinant human FSH (r-hFSH), and those at risk for poor ovarian response (Alviggi et al., 2006). In patients beyond 35 years, the addition of LH in form of human menopausal gonadotropin (hMG) to r-FSH regimen may only improve the ovarian response but does not improve overall pregnancy rates (Sohrabvand et al., 2010). On the other hand, LH components induce the local production of various molecules such as inhibin B and IGF-1 4 from granulose cells and these factors in turn promote the growth of 1
Global Journal of Health Science, 2014
Aim and Scope: Hysterosalpingography (HSG) is the radiographic evaluation of the uterine cavity a... more Aim and Scope: Hysterosalpingography (HSG) is the radiographic evaluation of the uterine cavity and fallopian tubes, which is generally assumed as a stressful and painful procedure. This study aims to determine effect of oral Valeric capsules on anxiety severity in women under Hysterosalpingography. Method and Examination: this study, as a double-blind clinical trial, was conducted on 64 infertile women undergoing hysterosalpingography, who referred to radiology ward at Comprehensive Women's hospital. To measure anxiety, visual analog anxiety scale was used 90 minutes before starting procedure, individuals in intervention group (n=32) received a single dose (1,500 mg) of 3 Valeric capsules, together with routine prophylaxy, where routine prophylaxis contains Mefenamic acid 250mg capsules in 30 minutes before procedure, and the same capsules were prescribed to placebo group (n=32) with the same instruction. Anxiety severity before and once 90 minutes after intervention in both groups were measured and compared. Results: There was no difference on anxiety severity before intervention in both groups (p=0.26), and the groups were homogeneous; after intervention, a significant difference on anxiety severity was reported in both groups (p<0/0001), and anxiety score in intervention group compared to placebo reduced statistically. Conclusion: Present study indicated that Valeric was effective on reducing anxiety in women undergoing hysterosalpingography.
International journal of fertility & sterility, 2014
Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes ... more Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes in in vitro fertilization cycles (IVF). In this prospective cohort study, we followed 103 patients who underwent intra-cytoplasmic sperm injection (ICSI) procedures over a 24-months period. The study group consisted of 47 infertile women with either unilateral or bilateral ovarian endometrial cysts of less than 3 cm. The control group consisting of 57 patients with mild male factor infertility was candidate for ICSI treatment during the same time period as the study groups. Both groups were compared for number of oocytes retrieved, grades of oocytes, as well as embryo quantity and quality. Our results showed similar follicle numbers, good embryo grades (A or B) and pregnancy rates in the compared groups. However, patients with endometrioma had higher gonadotropin consumption than the control group. The mean number of retrieved oocytes in patients with endometrioma was significantly lower...
International journal of fertility & sterility, 2013
The aim of this study was to compare the effects of easy and difficult embryo transfers (ET) on i... more The aim of this study was to compare the effects of easy and difficult embryo transfers (ET) on implantation and pregnancy rates. In this prospective study, we analyzed the results of 706 ET procedures over a 12-month period. An easy ET was defined as a transfer that occurred without the use of force or other instrumentation. A difficult ET was defined as the use of force for catheter placement, and/or the use of additional instruments, and/or manipulation. Pregnancy rate was compared between patients with easy or difficult ETs. There was a significantly higher implantation rate in the easy group (21.7%) compared to the difficult group (12.1%, p<0.05).The easy group had a higher pregnancy rate (38.1%) compared to patients who had difficult ETs (21.4%; p<0.05). Any uterine manipulation during ET adversely affects in vitro fertilization (IVF). Precaution should be taken to identify possibly difficult ET cases in advance.
International journal of fertility & sterility, 2012
This study was designed to evaluate the incidence of uterine pathologies in infertile women with ... more This study was designed to evaluate the incidence of uterine pathologies in infertile women with a history of two implantation failures after in vitro fertilization (IVF) and estimate the effect of hysteroscopic correction on achieving a pregnancy in these patients. The retrospective study population included 238 infertile women attended the outpatient infertility clinic between November 2007 and December 2008. Patients with at least two previous IVF failures were eligible for this study. All patients had normal findings on hysterosalpingography performed prior their first attempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopy were performed in patients before the subsequent IVF attempt. Out of 238 patients with previous IVF failure who underwent hysteroscopic evaluation, 158 patients (66.4%) showed normal uterine cavity. Abnormal cavity was found in 80 patients (33.6%). We found polyp as the most common abnormality (19.7%) in the patients with previous h...
International Journal of …, 2009
Received: 30 Dec 2008, Accepted: 31 Jan 2009 * Corresponding Address: POBox: 19395-4644, Endocrin... more Received: 30 Dec 2008, Accepted: 31 Jan 2009 * Corresponding Address: POBox: 19395-4644, Endocrinology and Female Infertility Department, Reproductive Medicine Research Center, Royan Institute, ACECR, Tehran, Iran Email: [email protected]
Health Care for Women International, 2013
The authors aimed to understand the social bridges and social barriers to women&amp;amp;amp;a... more The authors aimed to understand the social bridges and social barriers to women&amp;amp;amp;amp;#39;s health in Iran. We used a qualitative content analysis method and interviewed 22 women. The participants identified appropriate employment, physical exercise, and cultural and educational development as social bridges to women&amp;amp;amp;amp;#39;s health. Social barriers to women&amp;amp;amp;amp;#39;s health included gender inequalities, burden of responsibility, and financial difficulties. Based on the results of this study, we suggest an interdisciplinary approach to plan social-based health programs in order to improve women&amp;amp;amp;amp;#39;s health outcomes in the developing countries such as Iran.
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Papers by Kiandokht Kiani