Initiation of spermatogenesis in primates is triggered at puberty by an increase in gonadotropins... more Initiation of spermatogenesis in primates is triggered at puberty by an increase in gonadotropins; i.e., follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Prior to puberty, testis of the monkey contains only undifferentiated germ cells. However, sermatogonial differentiation and spermatogenesis may be initiated prior to puberty after stimulation with exogenous LH and FSH. Retinoic acid (RA) signaling is considered to be a major component that drives spermatogonial differentiation. We were interested in evaluating the relative role of LH and FSH, either alone or in combination, in regulating the retinoic acid signaling in monkey testis. Sixteen juvenile male rhesus monkeys (Macaca mulatta) were infused with intermittent recombinant single chain human LH (schLH) or recombinant human FSH (rhFSH) or a combination of both for 11 days. We then analyzed the expression of the several putative RA signaling pathway related genes; i.e. RDH10, RDH11, ALDH1A1, ALDH1A2, CYP26B1, CRABP1, CRABP2, STRA6, STRA8 in the testis after 11 days of stimulation with vehicle, LH, FSH and combination LH/FSH using quantitative real-time PCR (qPCR). The qPCR results analysis showed that administration of gonadotropins affected a significant change in expression of some RA signaling related genes in the monkey testis. The gonadotropins, either alone or in combination dramatically increased expression of CRABP2 (p≤0.001), whereas there was a decrease in ALDH1A2 expression (p≤0.001). Moreover, combined gonadotropin treatment led to the significant decrease in CRABP1 expression (p≤0.05). These findings are the first evidence that the activity of retinoic acid signaling in the monkey testis is regulated through gonadotropins (LH/FSH) levels.
JOURNAL OF REPRODUCTION AND INFERTILITY, Apr 1, 2002
Infertility treatment has reached to prominent improvements in recent years and new methods of AR... more Infertility treatment has reached to prominent improvements in recent years and new methods of ART have important role in these improvements. Several factors are considered for patient's evaluation in these methods. For this purpose, we decided to evaluate the relation between third day LH with ovarian response in IVF cycles. This is a prospective study and 78 IVF candidates were chosen base on study requirements and were divided into two groups according to third day LH level. First group was consisted of 14 women with LH<3 mIU/ml, and second group was consisted of 64 women with LH>3. Patients had gone under treatment cycle base on long treatment plan with agonist gonadotropins and human gonadotropins. Then two groups were compared for number of follicle, number of retrieved oocyte, duration of ovarian stimulation, number of used gonadotropin ampules, number of resulted embryos, cancellation rate of cycles and finally pregnancy rate. Base on results and considering P value<0.05, significant differences were not observed between the two groups in third day LH, patient age, kind of infertility, cause of infertility and duration of infertility. In other hand, two groups did not show any significance difference in ovarian response, number of follicle and retrieved oocyte, stimulation duration, number of used ampules, cancellation rate of cycles and pregnancy rate. This reveals third day LH level is not associated with success rate in IVF cycles.
Introduction: Infertility is one of the major health problem in different communities. A consider... more Introduction: Infertility is one of the major health problem in different communities. A considerable part of infertility is related to environmental factors and is preventable. According to the prevalence of infertility in iran, and the role of life-style related factors such as: dietary pattern, exercise and weight management in causing reproductive problems, this study was performed with aim to compare food intake, physical activity and weight of infertile women and healthy women aged 25-40 years. Methods: This descriptive and analytic study was performed on 144 infertile women and 144 healthy women referred to Vali-Asr Fertility Research Center, Tehran Gynecology Hospital, and Health Center of East Tehran during 2013 to 2014. General information, dietary intake and physical activity were collected through interviews. Anthropometric measurements were recorded. Data were analyzed by SPSS software (version 16) and using T- test, Chi-square test and logistic regression. PResults: Me...
Introduction: Meig1 is a highly conserved gene first identified in the mouse, where it encodes mu... more Introduction: Meig1 is a highly conserved gene first identified in the mouse, where it encodes multiple alternative transcripts. These transcripts share a common coding region but differ in their 5'UTR due to alternative promoters. In the testis, one of these transcripts is predominantly expressed in Leydig cells, whereas another transcript is exclusive to the germ cells. The MEIG1 protein has a specific tyrosine phosphorylated form that enters the nucleus of primary spermatocytes as they enter the prophase stage of the first meiotic division, and physically associates with the meiotic chromosomes forming foci-like structures along them. Meig1 stays localized to the nucleus of spermatids throughout sperm differentiation. In an attempt to elucidate the role of MEIG1 during gamete production, we created Meig1 knockout (KO) mice and found that Meig1 is a critical spermatogenic gene, whose absence results in complete male infertility. In this study we further elucidated the reasons why Meig1 KO mice are infertile. Material and Methods: Given MEIG1's predominant expression in Leydig cells, and given the foci-like appearance of MEIG1 along the meiotic chromosomes in spermatocytes, we monitored serum and testis testosterone levels in KO males, compared to wild-type males, and analyzed DNA integrity in the few seemingly mature spermatozoa that reached the epididymis in KO males. Results: We consistently found a significant reduction (about 5 fold) in testicular testosterone levels in KO males, concomitant to increased levels of LH receptors on Leydig cells. No change in serum testosterone was monitored. Regarding sperm DNA integrity, we found that the few seemingly mature spermatozoa that reached the epididymis in KO males, had highly fragmented DNA. Earlier spermatogenic stages were characterized by increased apoptotic rates of spermatocytes and spermatids. Moreover, our recent results suggest that MEIG1 is involved in the cell's DNA damage response in somatic cells as well. Conclusions: We concluded that multiple spermatogenic processes are affected by deletion of the Meig1 gene, leading to complete male sterility. These include, but not restricted to, hormonal regulation of spermatogenesis and inefficient repair after meiotic recombination and/or chromatin rearrangement during spermiogenesis. These results, together with the very high conservation of this gene, suggest it might be involved not only in as of yet unexplained human infertility, but with cancerous processes as well.
Objective Quality of life (QoL) in breast cancer patients is still an important topic. Despite nu... more Objective Quality of life (QoL) in breast cancer patients is still an important topic. Despite numerous quantitative scales, qualitative studies can help to in-depth understand the QoL of breast cancer patients. The purpose of this systematic review was to integrate qualitative studies on the QoL of women with breast cancer. Methods A literature search was performed in electronic databases including PubMed, Scopus, and Web of Science from January 1, 2010 until June 28, 2022 to find out qualitative studies assessing breast cancer patient’s QoL. Two authors independently evaluated methodological quality according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were extracted and reported by themes for cancer-free women and patients with metastatic cancer separately. Results In all, 1565 citations were retrieved. After removing 1387 duplicate and irrelevant papers, the full texts of 27 articles were reviewed and finally, 9 were eligible for evalu...
Polycystic ovary syndrome (PCOS) is characterized by various reproductive and cardiometabolic dis... more Polycystic ovary syndrome (PCOS) is characterized by various reproductive and cardiometabolic disorders. Asymmetric dimethylarginine (ADMA) is associated with cardiovascular, metabolic, and hormonal status. Selenium, a micronutrient with antioxidant properties, could affect multiple physiological pathways. This study aimed to investigate the effect of selenium supplementation on ADMA, cardiometabolic risk factors, and hormonal status in women with PCOS. In this randomized, double-blind, placebo-controlled clinical trial, 66 women with PCOS, aged 18-45 years, were randomly assigned to receive either 200 μg/day selenium or placebo, for 12 weeks. Circulating concentrations of ADMA, testosterone, sex hormone-binding globulin (SHBG), lipid profiles, and glycemic parameters were assessed at baseline and following supplementation. ADMA concentration decreased significantly compared to baseline values (85.14 ± 75 to 56.4 ± 38.64 ng/l, p = 0.02) in the selenium group. This change was marginally significant compared with the placebo group (28.74 ± 68.63 vs. − 1.77 ± 52.88 ng/l, p = 0.056). Serum testosterone levels declined significantly in the intervention compared to the placebo group (0.01 ± 0.17 vs. − 0.08 ± 0.18 ng/ml, p = 0.038). Pre-to post-Apo-B100/Apo-A1 ratio declined considerably in the intervention group (0.72 ± 0.16 to 0.65 ± 0.16, p = 0.003). No further differences were observed in SHBG, lipid profiles, Apo-A1, Apo-B100, Apo-B100/Apo-A1 ratio, and glycemic control between the two groups at the end of the study. Selenium supplementation for 12 weeks had beneficial effects on reduction of circulating ADMA and total testosterone levels in women with PCOS. No significant improvements were seen in other cardiometabolic risk factors. The effects of selenium supplementation on hormonal, reproductive, and cardiometabolic disorders, considering the potential mediating role of ADMA, should be further investigated.
Background and Aim: Over 200 million pregnancies occur worldwide annually; one third are unwanted... more Background and Aim: Over 200 million pregnancies occur worldwide annually; one third are unwanted and half end up in abortion. This study aimed to determine the prevalence of unwanted pregnancies and induced abortions during women's childbearing age over a period of 30 years (divided into 5-year intervals) in Tehran, Iran. Materials and Methods: This cross-sectional study was conducted in 2014 on 518 married women 15 to 55 years old living in Tehran with a history of at least one pregnancy. A questionnaire containing two sets of questions on individual and demographic characteristics and women's abortion history was used to collect the data for a period of 30 years (divided into 5-year intervals). The data collected were analyzed using SPSS 16 (the significance level was a p-value of <0.05). Results: Of the 966 pregnancies among the 518 women studied, 665 (68.4%) were planned and 307 (31.6%) unwanted. There were 249 abortions, 108 (43.4%) of which were miscarriages, 41 cases (16.5%) for medical reasons, and 100 cases (40.2%) induced (deliberate). The proportion of induced abortions in unwanted pregnancies increased from 0.0% in 1981-1986 to 41.7% in 2011-2014. Conclusion: Based on the findings it can be concluded that due to changes in family planning program effectiveness and accessibility of contraception methods in Iran unwanted pregnancies and the subsequent abortions have become more common.
Endometriosis is a debilitating disorder, defined as the presence of endometrial gland and stroma... more Endometriosis is a debilitating disorder, defined as the presence of endometrial gland and stroma outside of the uterus. It may affect angiogenesis and vascular endothelial growth factor (VEGF) is one of the angiogenic factors that plays an important role in both physiological and pathological angiogenesis. The present study aimed to evaluate the association of VEGF -2549 insertion/deletion (I/D) polymorphism with endometriosis. This case-control study enrolled 244 (100 cases and 144 controls) women who were admitted for laparoscopy or laparotomy for gynecological procedures. Genomic DNA was separated from peripheral blood leukocytes and polymerase chain reaction (PCR) amplification was performed for genotyping of the VEGF gene Insertion/Deletion (I/D) polymorphism. The frequency of the II, ID, and DD genotype was 14%, 52% and 34% in patients versus 18.8%, 47.8% and 34% in controls. The results did not provide any evidence supporting the endometriosis risk related to the VEGF polymorphism in a group of Iranian women population.
Background: The aim of this study was to identify the appropriateness of cesarean sections, perfo... more Background: The aim of this study was to identify the appropriateness of cesarean sections, performed in Tehran hospitals using standardized Rand Appropriateness Method (RAM) criteria. Methods: In this study we used the RAM criteria. In order to prepare the list of cesarean scenarios, clinical guidelines were selected, and the Appraisal of Guidelines for Research and Evaluation was used to choose the most appropriate. Two panels were held with the participation of related specialists. The scenarios derived through this method were compared with data existing in the medical records of 250 women who underwent cesarean sections in selected hospitals affiliated with Tehran University of Medical Sciences. The appropriateness rate of the cesarean sections was calculated. Results: Out of 250 cases of cesarean sections performed, 91 (36.4%) were inappropriate, 41 (16.4%) were equivocal and 118 (47.2%) were considered to be appropriate. Appropriateness differed between public and private hospitals, which were statistically significant. Conclusion: This study shows that as with many other health services, cesarean section has many scenarios that there are different opinions about them and no decision about presenting these scenarios as yet. Moreover the result of study showed the rate of inappropriate cesarean sections in this study is one of the highest reported rates from different communities.
The study assessed the efficacy of low dose ketoconazole in addition to clomiphene citrate (CC) a... more The study assessed the efficacy of low dose ketoconazole in addition to clomiphene citrate (CC) and hMG on ovulation induction. Materials and methods:A double blind, randomized, clinical trial was performed on fifty infertile patients with PCOS who had failed to respond to a daily dose of hMG and 100 mg CC for controlled ovarian hyperstimulation in Vali-e-Asr Reproductive Health Research Center.These patients were randomly divided into two equal groups receiving ketoconazole or placebo.All patients received CC and hMG for controlled ovarian hyperstimulation.Number of mature follicles, estradiol and progesterone levels at the time of hCG adminstration, endometrial thickness, ovarian hyperstimulation syndrome(OHSS), pregnancy rate, abortion, multiple pregnancies were measured. SPSS 11 software was used for statistical analysis. Statistical significance was defined as P < 0.05. Results: No significant statistical differences existed in the number of mature follicles, estradiol and progesterone levels prior to hCG administration ,endometrial thickness, OHSS and pregnancy rate between two groups. Estradiol level was lower among those receiving ketoconazole. No abortion and multiple pregnancy were found. Conclusion: Ketoconazole may suppress steroid production in resistant PCOS patients undergoing CC and hMG induction. But it has no effects on follicular maturation and OHSS prevention.
Journal of Trace Elements in Medicine and Biology, Mar 1, 2016
Objective: To our knowledge, no reports are available indicating the effects of selenium suppleme... more Objective: To our knowledge, no reports are available indicating the effects of selenium supplementation on metabolic parameters, inflammatory factors and oxidative stress in gestational diabetes (GDM). This study was designed to assess the effects of selenium supplementation on metabolic status among pregnant women with GDM who were not on oral hypoglycemic agents. Methods: This randomized double-blind placebo-controlled clinical trial was performed among 70 women with GDM. Patients were randomly assigned to receive either 200 µg selenium supplements as tablet (n=35) or placebo (n=35) for 6 weeks from week 24-28 of gestation. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify related variables. Results: Selenium supplementation resulted in a significant reduction in fasting plasma glucose (FPG) (-10.5±11.9 vs. +4.5±12.9 mg/dL, P<0.001), serum insulin levels (-1.98±11.25 vs. +5.26±9.33 µIU/mL, P=0.005), homeostasis model of assessment-insulin resistance (HOMA-IR) (-0.84±2.76 vs. +1.47±2.46, P<0.001) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0.008±0.03 vs.-0.01±0.01, P=0.009) compared with placebo. In addition, a significant decrease in serum high sensitivity C-reactive protein (hs-CRP) levels (-791.8±2271.8 vs. +500.5±2563.3 ng/mL, P=0.02) was seen after the administration of selenium supplements compared with placebo. Additionally, we observed a significant elevation in plasma glutathione (GSH) (+52.14±58.31 vs.-39.93±153.52 µmol/L, P=0.002) and a significant reduction in plasma malondialdehyde (MDA) levels (-0.01±0.36 vs. +0.67±1.90 µmol/L, P=0.04) following the consumption of selenium supplements compared with placebo. We did not find any significant effect of taking selenium supplements on homeostatic model assessment
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Middle East Fertility Society Journal, Feb 23, 2023
Background Endometriosis is a chronic deliberating disease with devastating effects on reproducti... more Background Endometriosis is a chronic deliberating disease with devastating effects on reproductive health. The present study aimed to investigate the impact of education based on the theory of planned behavior (TPB) on the reproductive health of women with endometriosis. This research was a randomized controlled trial performed on 71 women with endometriosis (35 intervention and 36 control groups) referred to the infertility clinic of Imam Khomeini Hospital in Tehran, Iran. The educational intervention based on the structures of the TPB was performed in the intervention group in 4 sessions, weekly for 90-120 min. The demographic questionnaire, model constructs questionnaire, and endometriosis reproductive health questionnaire (ERHQ) in both groups were completed in 3 stages (before intervention, 4, and 8 weeks after the intervention). Data were analyzed using SPSS software version 24. Results After the educational intervention, TPB values and overall reproductive health of women with endometriosis improved significantly in the intervention group (p < 0.05), while changes were not significant in the control group. Conclusion The study results showed that education based on the TPB had positive effects on the reproductive health of patients.
Initiation of spermatogenesis in primates is triggered at puberty by an increase in gonadotropins... more Initiation of spermatogenesis in primates is triggered at puberty by an increase in gonadotropins; i.e., follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Prior to puberty, testis of the monkey contains only undifferentiated germ cells. However, sermatogonial differentiation and spermatogenesis may be initiated prior to puberty after stimulation with exogenous LH and FSH. Retinoic acid (RA) signaling is considered to be a major component that drives spermatogonial differentiation. We were interested in evaluating the relative role of LH and FSH, either alone or in combination, in regulating the retinoic acid signaling in monkey testis. Sixteen juvenile male rhesus monkeys (Macaca mulatta) were infused with intermittent recombinant single chain human LH (schLH) or recombinant human FSH (rhFSH) or a combination of both for 11 days. We then analyzed the expression of the several putative RA signaling pathway related genes; i.e. RDH10, RDH11, ALDH1A1, ALDH1A2, CYP26B1, CRABP1, CRABP2, STRA6, STRA8 in the testis after 11 days of stimulation with vehicle, LH, FSH and combination LH/FSH using quantitative real-time PCR (qPCR). The qPCR results analysis showed that administration of gonadotropins affected a significant change in expression of some RA signaling related genes in the monkey testis. The gonadotropins, either alone or in combination dramatically increased expression of CRABP2 (p≤0.001), whereas there was a decrease in ALDH1A2 expression (p≤0.001). Moreover, combined gonadotropin treatment led to the significant decrease in CRABP1 expression (p≤0.05). These findings are the first evidence that the activity of retinoic acid signaling in the monkey testis is regulated through gonadotropins (LH/FSH) levels.
JOURNAL OF REPRODUCTION AND INFERTILITY, Apr 1, 2002
Infertility treatment has reached to prominent improvements in recent years and new methods of AR... more Infertility treatment has reached to prominent improvements in recent years and new methods of ART have important role in these improvements. Several factors are considered for patient's evaluation in these methods. For this purpose, we decided to evaluate the relation between third day LH with ovarian response in IVF cycles. This is a prospective study and 78 IVF candidates were chosen base on study requirements and were divided into two groups according to third day LH level. First group was consisted of 14 women with LH<3 mIU/ml, and second group was consisted of 64 women with LH>3. Patients had gone under treatment cycle base on long treatment plan with agonist gonadotropins and human gonadotropins. Then two groups were compared for number of follicle, number of retrieved oocyte, duration of ovarian stimulation, number of used gonadotropin ampules, number of resulted embryos, cancellation rate of cycles and finally pregnancy rate. Base on results and considering P value<0.05, significant differences were not observed between the two groups in third day LH, patient age, kind of infertility, cause of infertility and duration of infertility. In other hand, two groups did not show any significance difference in ovarian response, number of follicle and retrieved oocyte, stimulation duration, number of used ampules, cancellation rate of cycles and pregnancy rate. This reveals third day LH level is not associated with success rate in IVF cycles.
Introduction: Infertility is one of the major health problem in different communities. A consider... more Introduction: Infertility is one of the major health problem in different communities. A considerable part of infertility is related to environmental factors and is preventable. According to the prevalence of infertility in iran, and the role of life-style related factors such as: dietary pattern, exercise and weight management in causing reproductive problems, this study was performed with aim to compare food intake, physical activity and weight of infertile women and healthy women aged 25-40 years. Methods: This descriptive and analytic study was performed on 144 infertile women and 144 healthy women referred to Vali-Asr Fertility Research Center, Tehran Gynecology Hospital, and Health Center of East Tehran during 2013 to 2014. General information, dietary intake and physical activity were collected through interviews. Anthropometric measurements were recorded. Data were analyzed by SPSS software (version 16) and using T- test, Chi-square test and logistic regression. PResults: Me...
Introduction: Meig1 is a highly conserved gene first identified in the mouse, where it encodes mu... more Introduction: Meig1 is a highly conserved gene first identified in the mouse, where it encodes multiple alternative transcripts. These transcripts share a common coding region but differ in their 5'UTR due to alternative promoters. In the testis, one of these transcripts is predominantly expressed in Leydig cells, whereas another transcript is exclusive to the germ cells. The MEIG1 protein has a specific tyrosine phosphorylated form that enters the nucleus of primary spermatocytes as they enter the prophase stage of the first meiotic division, and physically associates with the meiotic chromosomes forming foci-like structures along them. Meig1 stays localized to the nucleus of spermatids throughout sperm differentiation. In an attempt to elucidate the role of MEIG1 during gamete production, we created Meig1 knockout (KO) mice and found that Meig1 is a critical spermatogenic gene, whose absence results in complete male infertility. In this study we further elucidated the reasons why Meig1 KO mice are infertile. Material and Methods: Given MEIG1's predominant expression in Leydig cells, and given the foci-like appearance of MEIG1 along the meiotic chromosomes in spermatocytes, we monitored serum and testis testosterone levels in KO males, compared to wild-type males, and analyzed DNA integrity in the few seemingly mature spermatozoa that reached the epididymis in KO males. Results: We consistently found a significant reduction (about 5 fold) in testicular testosterone levels in KO males, concomitant to increased levels of LH receptors on Leydig cells. No change in serum testosterone was monitored. Regarding sperm DNA integrity, we found that the few seemingly mature spermatozoa that reached the epididymis in KO males, had highly fragmented DNA. Earlier spermatogenic stages were characterized by increased apoptotic rates of spermatocytes and spermatids. Moreover, our recent results suggest that MEIG1 is involved in the cell's DNA damage response in somatic cells as well. Conclusions: We concluded that multiple spermatogenic processes are affected by deletion of the Meig1 gene, leading to complete male sterility. These include, but not restricted to, hormonal regulation of spermatogenesis and inefficient repair after meiotic recombination and/or chromatin rearrangement during spermiogenesis. These results, together with the very high conservation of this gene, suggest it might be involved not only in as of yet unexplained human infertility, but with cancerous processes as well.
Objective Quality of life (QoL) in breast cancer patients is still an important topic. Despite nu... more Objective Quality of life (QoL) in breast cancer patients is still an important topic. Despite numerous quantitative scales, qualitative studies can help to in-depth understand the QoL of breast cancer patients. The purpose of this systematic review was to integrate qualitative studies on the QoL of women with breast cancer. Methods A literature search was performed in electronic databases including PubMed, Scopus, and Web of Science from January 1, 2010 until June 28, 2022 to find out qualitative studies assessing breast cancer patient’s QoL. Two authors independently evaluated methodological quality according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were extracted and reported by themes for cancer-free women and patients with metastatic cancer separately. Results In all, 1565 citations were retrieved. After removing 1387 duplicate and irrelevant papers, the full texts of 27 articles were reviewed and finally, 9 were eligible for evalu...
Polycystic ovary syndrome (PCOS) is characterized by various reproductive and cardiometabolic dis... more Polycystic ovary syndrome (PCOS) is characterized by various reproductive and cardiometabolic disorders. Asymmetric dimethylarginine (ADMA) is associated with cardiovascular, metabolic, and hormonal status. Selenium, a micronutrient with antioxidant properties, could affect multiple physiological pathways. This study aimed to investigate the effect of selenium supplementation on ADMA, cardiometabolic risk factors, and hormonal status in women with PCOS. In this randomized, double-blind, placebo-controlled clinical trial, 66 women with PCOS, aged 18-45 years, were randomly assigned to receive either 200 μg/day selenium or placebo, for 12 weeks. Circulating concentrations of ADMA, testosterone, sex hormone-binding globulin (SHBG), lipid profiles, and glycemic parameters were assessed at baseline and following supplementation. ADMA concentration decreased significantly compared to baseline values (85.14 ± 75 to 56.4 ± 38.64 ng/l, p = 0.02) in the selenium group. This change was marginally significant compared with the placebo group (28.74 ± 68.63 vs. − 1.77 ± 52.88 ng/l, p = 0.056). Serum testosterone levels declined significantly in the intervention compared to the placebo group (0.01 ± 0.17 vs. − 0.08 ± 0.18 ng/ml, p = 0.038). Pre-to post-Apo-B100/Apo-A1 ratio declined considerably in the intervention group (0.72 ± 0.16 to 0.65 ± 0.16, p = 0.003). No further differences were observed in SHBG, lipid profiles, Apo-A1, Apo-B100, Apo-B100/Apo-A1 ratio, and glycemic control between the two groups at the end of the study. Selenium supplementation for 12 weeks had beneficial effects on reduction of circulating ADMA and total testosterone levels in women with PCOS. No significant improvements were seen in other cardiometabolic risk factors. The effects of selenium supplementation on hormonal, reproductive, and cardiometabolic disorders, considering the potential mediating role of ADMA, should be further investigated.
Background and Aim: Over 200 million pregnancies occur worldwide annually; one third are unwanted... more Background and Aim: Over 200 million pregnancies occur worldwide annually; one third are unwanted and half end up in abortion. This study aimed to determine the prevalence of unwanted pregnancies and induced abortions during women's childbearing age over a period of 30 years (divided into 5-year intervals) in Tehran, Iran. Materials and Methods: This cross-sectional study was conducted in 2014 on 518 married women 15 to 55 years old living in Tehran with a history of at least one pregnancy. A questionnaire containing two sets of questions on individual and demographic characteristics and women's abortion history was used to collect the data for a period of 30 years (divided into 5-year intervals). The data collected were analyzed using SPSS 16 (the significance level was a p-value of <0.05). Results: Of the 966 pregnancies among the 518 women studied, 665 (68.4%) were planned and 307 (31.6%) unwanted. There were 249 abortions, 108 (43.4%) of which were miscarriages, 41 cases (16.5%) for medical reasons, and 100 cases (40.2%) induced (deliberate). The proportion of induced abortions in unwanted pregnancies increased from 0.0% in 1981-1986 to 41.7% in 2011-2014. Conclusion: Based on the findings it can be concluded that due to changes in family planning program effectiveness and accessibility of contraception methods in Iran unwanted pregnancies and the subsequent abortions have become more common.
Endometriosis is a debilitating disorder, defined as the presence of endometrial gland and stroma... more Endometriosis is a debilitating disorder, defined as the presence of endometrial gland and stroma outside of the uterus. It may affect angiogenesis and vascular endothelial growth factor (VEGF) is one of the angiogenic factors that plays an important role in both physiological and pathological angiogenesis. The present study aimed to evaluate the association of VEGF -2549 insertion/deletion (I/D) polymorphism with endometriosis. This case-control study enrolled 244 (100 cases and 144 controls) women who were admitted for laparoscopy or laparotomy for gynecological procedures. Genomic DNA was separated from peripheral blood leukocytes and polymerase chain reaction (PCR) amplification was performed for genotyping of the VEGF gene Insertion/Deletion (I/D) polymorphism. The frequency of the II, ID, and DD genotype was 14%, 52% and 34% in patients versus 18.8%, 47.8% and 34% in controls. The results did not provide any evidence supporting the endometriosis risk related to the VEGF polymorphism in a group of Iranian women population.
Background: The aim of this study was to identify the appropriateness of cesarean sections, perfo... more Background: The aim of this study was to identify the appropriateness of cesarean sections, performed in Tehran hospitals using standardized Rand Appropriateness Method (RAM) criteria. Methods: In this study we used the RAM criteria. In order to prepare the list of cesarean scenarios, clinical guidelines were selected, and the Appraisal of Guidelines for Research and Evaluation was used to choose the most appropriate. Two panels were held with the participation of related specialists. The scenarios derived through this method were compared with data existing in the medical records of 250 women who underwent cesarean sections in selected hospitals affiliated with Tehran University of Medical Sciences. The appropriateness rate of the cesarean sections was calculated. Results: Out of 250 cases of cesarean sections performed, 91 (36.4%) were inappropriate, 41 (16.4%) were equivocal and 118 (47.2%) were considered to be appropriate. Appropriateness differed between public and private hospitals, which were statistically significant. Conclusion: This study shows that as with many other health services, cesarean section has many scenarios that there are different opinions about them and no decision about presenting these scenarios as yet. Moreover the result of study showed the rate of inappropriate cesarean sections in this study is one of the highest reported rates from different communities.
The study assessed the efficacy of low dose ketoconazole in addition to clomiphene citrate (CC) a... more The study assessed the efficacy of low dose ketoconazole in addition to clomiphene citrate (CC) and hMG on ovulation induction. Materials and methods:A double blind, randomized, clinical trial was performed on fifty infertile patients with PCOS who had failed to respond to a daily dose of hMG and 100 mg CC for controlled ovarian hyperstimulation in Vali-e-Asr Reproductive Health Research Center.These patients were randomly divided into two equal groups receiving ketoconazole or placebo.All patients received CC and hMG for controlled ovarian hyperstimulation.Number of mature follicles, estradiol and progesterone levels at the time of hCG adminstration, endometrial thickness, ovarian hyperstimulation syndrome(OHSS), pregnancy rate, abortion, multiple pregnancies were measured. SPSS 11 software was used for statistical analysis. Statistical significance was defined as P < 0.05. Results: No significant statistical differences existed in the number of mature follicles, estradiol and progesterone levels prior to hCG administration ,endometrial thickness, OHSS and pregnancy rate between two groups. Estradiol level was lower among those receiving ketoconazole. No abortion and multiple pregnancy were found. Conclusion: Ketoconazole may suppress steroid production in resistant PCOS patients undergoing CC and hMG induction. But it has no effects on follicular maturation and OHSS prevention.
Journal of Trace Elements in Medicine and Biology, Mar 1, 2016
Objective: To our knowledge, no reports are available indicating the effects of selenium suppleme... more Objective: To our knowledge, no reports are available indicating the effects of selenium supplementation on metabolic parameters, inflammatory factors and oxidative stress in gestational diabetes (GDM). This study was designed to assess the effects of selenium supplementation on metabolic status among pregnant women with GDM who were not on oral hypoglycemic agents. Methods: This randomized double-blind placebo-controlled clinical trial was performed among 70 women with GDM. Patients were randomly assigned to receive either 200 µg selenium supplements as tablet (n=35) or placebo (n=35) for 6 weeks from week 24-28 of gestation. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify related variables. Results: Selenium supplementation resulted in a significant reduction in fasting plasma glucose (FPG) (-10.5±11.9 vs. +4.5±12.9 mg/dL, P<0.001), serum insulin levels (-1.98±11.25 vs. +5.26±9.33 µIU/mL, P=0.005), homeostasis model of assessment-insulin resistance (HOMA-IR) (-0.84±2.76 vs. +1.47±2.46, P<0.001) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0.008±0.03 vs.-0.01±0.01, P=0.009) compared with placebo. In addition, a significant decrease in serum high sensitivity C-reactive protein (hs-CRP) levels (-791.8±2271.8 vs. +500.5±2563.3 ng/mL, P=0.02) was seen after the administration of selenium supplements compared with placebo. Additionally, we observed a significant elevation in plasma glutathione (GSH) (+52.14±58.31 vs.-39.93±153.52 µmol/L, P=0.002) and a significant reduction in plasma malondialdehyde (MDA) levels (-0.01±0.36 vs. +0.67±1.90 µmol/L, P=0.04) following the consumption of selenium supplements compared with placebo. We did not find any significant effect of taking selenium supplements on homeostatic model assessment
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Middle East Fertility Society Journal, Feb 23, 2023
Background Endometriosis is a chronic deliberating disease with devastating effects on reproducti... more Background Endometriosis is a chronic deliberating disease with devastating effects on reproductive health. The present study aimed to investigate the impact of education based on the theory of planned behavior (TPB) on the reproductive health of women with endometriosis. This research was a randomized controlled trial performed on 71 women with endometriosis (35 intervention and 36 control groups) referred to the infertility clinic of Imam Khomeini Hospital in Tehran, Iran. The educational intervention based on the structures of the TPB was performed in the intervention group in 4 sessions, weekly for 90-120 min. The demographic questionnaire, model constructs questionnaire, and endometriosis reproductive health questionnaire (ERHQ) in both groups were completed in 3 stages (before intervention, 4, and 8 weeks after the intervention). Data were analyzed using SPSS software version 24. Results After the educational intervention, TPB values and overall reproductive health of women with endometriosis improved significantly in the intervention group (p < 0.05), while changes were not significant in the control group. Conclusion The study results showed that education based on the TPB had positive effects on the reproductive health of patients.
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