ABSTRACT
Background: We sought to compare diagnostic values of two-dimensional transvaginal sonography [2D TVS] and office hysteroscopy [OH] for evaluation of endometrial pathologies in cases with repeated implantation failure [RIF] or recurrent pregnancy loss [RPL]
Materials and Methods: This prospective study was performed at Royan Institute from December 2013 to January 2015. TVS was performed before hysteroscopy as part of the routine diagnostic work-up in 789 patients with RIF or RPL. Uterine biopsy was performed in cases with abnormal diagnosis in TVS and/or hysteroscopy. We compared the diagnostic accuracy values of TVS in detection of uterine abnormalities with OH by receiver operating characteristic [ROC] curve analysis
Results: TVS examination detected 545 [69%] normal cases and 244 [31%] pathologic cases, which included 84 [10.6%] endometrial polyps, 15 [1.6%] uterine fibroids, 10 [1.3%] Asherman's syndrome, 9 [1.1%] endometrial hypertrophy, and 126 [15.9%] septate and arcuate uterus. TVS and OH concurred in 163 pathologic cases, although TVS did not detect some pathology cases [n=120]. OH had 94% sensitivity, 95% specificity, 62% positive predictive value [PPV], and 99% negative predictive value [NPV] for detection of endometrial polyps. In the diagnosis of myoma, sensitivity, specificity, PPV, and NPV were 100%. TVS had a sensitivity of 50% and specificity of 98% for the diagnosis of myoma. For polyps, TVS had a sensitivity of 54% and specificity of 80%. Area under the ROC curve [AUROC] was 70.69% for the accuracy of TVS compared to OH
Conclusion: TVS had high specificity and low sensitivity for detection of uterine pathologies in patients with RIF or RPL compared with OH. OH should be considered as a workup method prior to treatment in patients with normal TVS findings
ABSTRACT
Background: The main purpose of this study is to evaluate the effects of varicocelectomy on serum testosterone levels and semen quality in infertile men who suffer from varicocele
Materials and Methods: This prospective study enrolled 115 subjects with clinical varicocele grades II and III and 240 fertile men as the control group. Total volume of testosterone serum level [ng/dl] and semen quality were com- pared before and after microscopic varicocelectomy. We normalized testosterone serum levels for age, grade, and testis size basis. SPSS 20 software was used to analyze the data. All results of continuous variables were reported as mean +/- SD. Statistical significance was set at a P<0.05
Results: The mean ages of individuals who participated in the treatment [32.2 +/- 5.23] and control [32.8 +/- 5.27] groups were similar. There were similar mean values for adjusted testosterone levels between the varicocele [567 +/- 222 ng/ml] and control [583 +/- 263 ng/ml] groups. In the varicocele group, the adjusted testosterone levels insig- nificantly increased to 594 +/- 243 ng/ml. Among semen parameters, only mean sperm concentration significantly increased after varicocelectomy
Conclusion: Despite increases in sperm concentration, adjusted testosterone levels did not significantly improve after varicocelectomy
ABSTRACT
Background: The most common chromosomal abnormality due to non-obstructive azoospermia [NOA] is Klinefelter syndrome [KS] which occurs in 1-1.72 out of 500-1000 male infants. The probability of retrieving sperm as the outcome could be asymmetrically different between patients with and without KS, therefore logistic regression analysis is not a well-qualified test for this type of data. This study has been designed to evaluate skewed regression model analysis for data collected from microsurgical testicular sperm extraction [micro-TESE] among azoospermic patients with and without non-mosaic KS syndrome
Materials and Methods: This cohort study compared the micro-TESE outcome between 134 men with classic KS and 537 men with NOA and normal karyotype who were referred to Royan Institute between 2009 and 2011. In addition to our main outcome, which was sperm retrieval, we also used logistic and skewed regression analyses to compare the following demographic and hormonal factors: age, level of follicle stimulating hormone [FSH], luteinizing hormone [LH], and testosterone between the two groups
Results: A comparison of the micro-TESE between the KS and control groups showed a success rate of 28.4% [38/134] for the KS group and 22.2% [119/537] for the control group. In the KS group, a significantly difference [P<0.001] existed between testosterone levels for the successful sperm retrieval group [3.4 +/- 0.48 mg/mL] compared to the unsuccessful sperm retrieval group [2.33 +/- 0.23 mg/mL]. The index for quasi Akaike information criterion [QAIC] had a goodness of fit of 74 for the skewed model which was lower than logistic regression [QAIC=85]
Conclusion: According to the results, skewed regression is more efficient in estimating sperm retrieval success when the data from patients with KS are analyzed. This finding should be investigated by conducting additional studies with different data structures
ABSTRACT
To compare the pregnancy outcomes after two embryos versus three embryos transfers [ETs] in women undergoing in vitro fertilization [IVF] intracytoplasmic sperm injection [ICSI] cycles. This retrospective study was performed on three hundred eighty seven women with primary infertility and with at least one fresh embryo in good quality in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients were categorized into two groups according to the number of ET as follows: ET2 and ET3 groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes were compared between ET2 and ET3 groups. Chi square and student t tests were used for data analysis. Clinical pregnancy and live birth rates were similar between two groups. The rates of multiple pregnancies were 27 and 45.2% in ET2 and ETS groups, respectively. The rate of multiple pregnancies in young women was significantly increased when triple instead of double embryos were transferred. Logistic regression analysis indicated two significant prognostic variables for live birth that included number and quality of transferred embryos; it means that the chance of live birth following ICSI treatment increased 3.2-fold when the embryo with top quality [grade A] was transferred, but the number of ET had an inverse relationship with live birth rate; it means that probability of live birth in women with transfer of two embryos was three times greater than those who had three ET. Due to the difficulty of implementation of the elective single-ET technique in some infertility centers in the world, we suggest transfer of double instead of triple embryos when at least one good quality embryo is available for transfer in women aged 39 years or younger. However, to reduce the rate of multiple pregnancies, it is recommended to consider the elective single ET strategy
ABSTRACT
To evaluate predictive factors of successful microdissection-testicular sperm extraction [MD-TESE] in patients with presumed Sertoli cell-only syndrome [SCOS]. In this retrospective analysis, 874 men with non-obstructive azoospermia [NOA], among whom 148 individuals with diagnosis of SCOS in prior biopsy, underwent MD-TESE at Department of Andrology, Royan Institute, Tehran, Iran. The predictive values of follicle stimulating hormone [FSH], luteinizing hormone [LH], and testosterone [T] levels, testicular volume, as well as male age for retrieving testicular sperm by MD-TESE were analyzed by multiple logistic regression analysis. Testicular sperm were successfully retrieved in 23.6% men with presumed SCOS. Using receiver operating characteristic [ROC] curve analysis, it was shown that sperm retrieval rate in the group of men with FSH values >15.25% was 28.9%. This was higher than the group of men with FSH
Subject(s)
Humans , Male , Microdissection , Testis , Spermatozoa , Follicle Stimulating Hormone , Luteinizing Hormone , Sperm Retrieval , Retrospective Studies , AzoospermiaABSTRACT
Electroporation is the most common method used for the transfection of DNA. Although this method has been attributed for various cell using different buffer compositions, the effects of DNA concentration on the transfection efficiency has not yet been studied. Here the correlation between the efficiency of electroporation reaction and increments of DNA concentration has been investigated. Following this investigation, a study was set out to produce a transgenic goat which is capable of secreting recombinant human coagulation factor IX in its milk. In this experimental study, a linearized recombinant vector [pBC1] entailing human coagulation factor IX [5.7 kb] cDNA was introduced into goat fetal fibroblast cells [three sub passages] via electroporation in four separate experiments [while other variables were kept constant], beginning with 10 micro g DNA per pulse in the first experiment and increments of 10 micro g/pulse for the next three reactions. Thereafter, polymerase chain reaction [PCR]-positive cell culture plates were diluted by several factors for further analysis of the transfected wells. Subsequently, positive cells were isolated for fluorescence in situ hybridization. Logistic regression model was used for data analyzing. Significance was defined as p< 0.05. The results showed no significant difference among three first concentrations except for group 1 [10 micro g/pulse] and group 3 [30 micro g/pulse], but there was a significant difference between these groups and the fourth group [p<0.05], as this group [40 micro g/pulse] statistically showed the highest rate of transfection. As the fluorescence in situ hybridization [FISH] results indicated the transgene was integrated in a single position in PCR positive cells. Increasing amount of using the vector 40micro g/pulse efficiently increased the number of transfected cells. Besides of voltage and buffer strength which had been previously shown to play a critical role in electroporation efficiency, our results showed an increase in DNA concentration could affect an exponential surge in the electroporation efficiency
Subject(s)
Animals , Electroporation , Transfection , Fibroblasts , Fetus , Goats , Animals, Genetically Modified , DNA , Polymerase Chain Reaction , MilkABSTRACT
Premature infants undergo painful and stressful procedures during care and treatment. Nurses can help to reduce shortand long-term effects of pain caused by diagnostic and therapeutic procedures using various methods including music therapy. The aim of this study was to assess the effect of music therapy on physiological pain responses of premature infants during and after blood sampling. This was an experimental study with crossover design conducted on 20 premature infants hospitalized in the intensive care unit of a hospital affiliated to the Tehran University of Medical Sciences for a five months period in 2010-11. Infants were randomly allocated in two groups of experiment and/or control. Each infant was considered as its own control. We assessed the physiological pain responses caused by blood sampling such as heart rate and oxygen saturation level. Infants in the experiment group listened to the Transitions music five minutes before until 10 minutes after the blood sampling. The responses were recorded and reviewed ten minutes before until ten minutes after the blood sampling in both groups and physiological changes were detected. Data were analyzed using ANOVA and Chi-square tests in the SAS and SPSS. Results showed significant difference in heart rate between the experiment and control groups during needle exit [P=0.022]. There was also significant difference in heart rate between experiment and control group in the first 5 minutes of blood sampling [P=0.005]. Results showed that music therapy could reduce some physiological responses of pain during and after blood sampling. Music therapy can be used as a beneficial intervention following painful procedures such as blood sampling in the NICU