[Comparison of the percentages of peripheral blood CD4+ CD25+ T lymphocytes in recurrent abortion and normal pregnancy]

Background and Aims: Recent evidences indicate that parts of the immunoregulation system such as CD4+CD25+Tcells [Treg] and Th2 cells and Th1 cells, play very important roles in the maintenance of pregnancy. The deficiency in proper recognition of fetal alloantigen by the maternal immune system is associated with recurrent pregnancy failure. Here, we investigate the proportional changes of CD4+CD25+Tcells in peripheral blood of women with unexplained recurrent spontaneous abortion in comparison to women with normal pregnancy by using flowcytometry

Methods: The case group was comprised of 24 women who had at least three successive miscarriages with unexplained etiology. They had normal karyotypes, anticardiolipin and prolactin and their husbands had normal spermograms. The percentages of TCD4+CD25+cells in peripheral blood of these patients were compared with those of 21 women who had normal pregnancy with no history of pregnancy loss. Anti-CD4, anti-CD25 and anti-CD3 antibodies were added to lymphocytes isolated from peripheral blood. Then samples were incubated, centrifuged and washed. Finally cells were analyzed using FACS Caliber system and data of the two groups were compared

Results: Mean percentage of CD4+CD25+bright T cells in peripheral blood in case group was significantly lower compared to the control group [P=0.000]. Mean percentage of CD4-CD25 bright cells in the CD4+Tcell peripheral blood was significantly higher in case group campared to the control group [P=0.021]

Conclusion: Decrease of CD4+CD25 bright T cells plays a major role in tolerating conceptus antigens and cytokine and might contribute to the maintenance of pregnancy. Inadequate CD4+CD25+Tcells or their functional deficiency may link with miscarriage. Therefore, alteration of CD4+CD25+T cells can be used as an immunologic marker for monitoring of patients with unexplained recurrent spontaneous abortion

[Relationship between number of antral follicle and ovarian volume and responsivness to induction ovulation]

Unresponsiveness of ovaries to different ovulation induction protocols is a major problem in infertility treatment. Recently antral follicle count and ovarian volume have been suggested to predict ovarian response. Objective of this study is to verify the correlation of ovarian responsiveness with ovarian volume or antral follicle count. In this prospective cohort study, 112 infertile patients with 115 IUl induction ovulation cycles were enrolled. All of the patients had their basal FSH measured and an estimation of ovarian volume and antral follicle number count was performed by transvaginal ultrasonography on day 3 of cycle. They were divided into four groups according to ovulation induction protocols. The observation of one or more follicle >/= 16mm during the treatment was interpreted as a positive response. There was a direct linear correlation between average of ovarian volume and antral follicle number, and these two parameters were inversely correlated with age. Considering FSH, there was an inverse correlation with antral follicle count, but no correlation with ovarian volume. Among the different protocols, in HMG group these two parameters correlated directly with ovarian responsiveness. In HMG group, using chi-square for trends, an antral follicle count less than 5 and / or ovarian diameter less than 20mm was associated with cycle cancellation. Therefore, transvaginal ultrasound, measurment of ovarian volume and basal follicle numbers on day 3 of cycle prior to starting gonadotropins adminastration can help to predict the patient's response

[ relationship between total motile sperm count and success of intrauterine insemination]

Incidence of infertility is approximately 10-15% and intrauterin insemination [IUI] is the suitable method in cases of male infertility. This survey is done on 1017 persons among couples that were being treated with 1258 IUI cycles. The aim of this study was to investigate whether total motile functional sperm count [TMFSC] can be predictive of IUl success or not. In all patients after checking and preparing them for ovulation induction, Semen sample was prepared according to WHO with swim-up procedure and 0.8mI of suspension over sperm pellet was used for insemination. The examination of spermogram and motile functional sperm count was done after sperm processing. There was a trend toward an increasing percentage of conception with increasing total motile functional sperm rate count and the least of TMFSC was 20x 10[6] for and with increased TMFSC, success of IUl will increase also. The overall pregnancy rate per cycle was 13.2% and per couple was 16.14% in the infertile couples. This study indicated that the causes of infertility have not any effect on IUl success rate. The duration of infertility has significant difference in pregnant and non pregnant groups