ABSTRACT
Background: understanding the prevalence of menstrual disorders has important implications for both health service planning and risk factor epidemiology
Objective: the aim of this review is to identify and collate studies describing the prevalence of menstrual disorders in Iran
Materials and Methods: studies with original data related to the prevalence of menstrual disorders were identified via searching six electronic databases and reviewing citations. All abstracts or titles found by the electronic searches were independently scrutinized by two reviewers. The Meta-analysis was performed with a random effects model, considering the remarkable heterogeneity among studies. A total of 35 eligible epidemiological studies were included in this review
Results: overall, the pooled prevalence of primary dysmenorrhea was 73.27% [95% CI=65.12-81.42]. The mean proportion of women with oligomenorrhea was 13.11% [95.5%, 95% CI: 10.04-16.19]. We identified 16 studies that reported polymenorrhoea with a random effect of pooled prevalence estimate of 9.94% [95% CI 7.33%-12.56%]. The prevalence estimate of hypermenorrhea was 12.94% [95% CI 9.31%-16.57%]. Overall prevalence of hypomenorrhea was 5.25% [95% CI 3.20%-7.30%], ranging from 0.9- 12.90%. Pooling six studies that reported estimates for menorrhagia, the overall prevalence was 19.24% [95% CI 12.78-25.69]. Overall, 6.04% [95% CI: 1.99-10.08] of the women were shown to have metrorrhagia
Conclusion: this systematic review suggests that the average prevalence of menstrual disorders in Iran is substantial. It has been neglected as a fundamental problem of women's reproductive health. Diagnosis and treatment of these disorders should be included in the primary health care system of reproductive health
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Background: Polycystic ovary syndrome [PCOS] is a frequent condition in reproductive age women with a prevalence rate of 5-10%. This study intends to determine the relationship between PCOS and the outcome of assisted reproductive treatment [ART] in Tehran, Iran
Materials and Methods: In this historical cohort study, we included 996 infertile women who referred to Royan Institute [Tehran, Iran] between January 2012 and December 2013. PCOS, as the main variable, and other potential confounder variables were gathered. Modified Poisson Regression was used for data analysis. Stata software, version 13 was used for all statistical analyses
Results: Unadjusted analysis showed a significantly lower risk for failure in PCOS cases compared to cases without PCOS [risk ratio [RR]: 0.79, 95% confidence intervals [CI]: 0.66-0.95, P=0.014]. After adjusting for the confounder variables, there was no difference between risk of non-pregnancy in women with and without PCOS [RR: 0.87, 95% CI: 0.72-1.05, P=0.15]. Significant predictors of the ART outcome included the treatment protocol type, numbers of embryos transferred [grades A and AB], numbers of injected ampules, and age
Conclusion: The results obtained from this model showed no difference between patients with and without PCOS ac- cording to the risk for non-pregnancy. Therefore, other factors might affect conception in PCOS patients
ABSTRACT
Background: Among the young generation, medical and law students' attitude towards third party reproduction is very important because they will be directly involved in restricting or developing the programs that will support it in the future. The aim of this survey was to investigate attitude of law and medical students to oocyte donation and key aspects of this kind of third party
Materials and Methods: In analytical cross-sectional study, 345 medical and law students were randomly selected using stratified sampling. Data was collected using attitude toward donation- oocyte [ATOD-O] questionnaire. Re- sponses were on a 5-point Likert scale. Data were analyzed according to established statistical approach by Heeren and D'Agostino
Results: The majority of the participants agreed with oocyte donation being the last choice for infertility treatment. There was a significant difference between medical students and law students regarding the acceptance of oocyte donation [3.23 vs. 3.53, P=0.025]. In addition, female participants were more tolerant on receiving donated oocytes from their sisters than male participants [3.01 vs. 2.58, P=0.002] and finally, a higher number of the participants had a positive attitude towards anonymity of the donor and the recipient to one another [3.93 vs. 3.86, P=0.580]. The vast majority of female students believed that the oocyte recipient naturally likes that child [P<0.0001]
Conclusion: In the current study, a great majority of law and medical students support oocyte donation as an alternative way of starting a family. There is an interest among female students in donating oocytes anonymously. The majority believed that the oocyte recipient family will like the donor oocyte child naturally
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
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Background: This study evaluated hope, depression, anxiety, and stress among three groups of infertile couples
Materials and Methods: This cross-sectional study consisted of three groups of infertile couples-candidates for oocyte donation [n=60], embryo donation [n=60], and normal infertile [n=60]. Participants included couples seen at Royan Institute, Tehran, Iran between 2013-2014 who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the Persian version of the Adult Trait Hope Scale [hope, agency and pathway] and Depression, Anxiety, and Stress Scale [DASS]. Data was analyzed by the paired t test, ANOVA, ANCOVA and Pearson correlation tests using SPSS statistical software
Results: Overall, 180 infertile couples participated in the three groups. There was a significant higher mean score for hope in husbands compared to wives in the normal infertile group [P=0.046]. Husbands in the normal infertile group also had a significantly higher mean score for pathway [P=0.032]. The frequency of anxiety significantly differed in female subjects [P=0.028]. In the normal infertile group, the anxiety distribution significantly differed between wives and husbands [P=0.006]. There was a significantly different stress frequency in male subjects [P=0.048]. In the embryo donation group, stress significantly differed between wives and husbands [P=0.002]. In the normal infertile group, stress also significantly differed between wives and husbands [P=0.05]
Conclusion: The results have suggested that hope might be important in reducing psychological symptoms and psychological adjustment in those exposed to infertility problems who follow medical recommendations, which accelerates recovery. It is recommended to hold psychological counseling sessions [hope therapy] during reproduction cycles
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Background: This study compared common psychological symptoms and life satisfaction in husbands and wives according to infertility diagnosis
Materials and Methods: We conducted this cross-sectional study on 248 infertile couples between November 1, 2014 and February 28, 2015 at Royan Institute, Tehran, Iran. Participants answered three questionnaires. First, they completed a demographic questionnaire followed by the Hospital Anxiety and Depression Scale [HADS, 14-item self-report instrument] composed of two sub-scales: anxiety [HADS-A] and depression [HADS-D]. Participants also completed the Satisfaction with Life Scale [SLWS] comprised of 5 items. Both our questionnaires were validated for the Iranian population
Results: In couples with male factor infertility, wives had a significantly higher mean score for anxiety compared to their husbands [P<0.001]. When the cause of infertility was female factor, the wives appeared significantly more anxious [P<0.001] and depressed [P=0.004] than their husbands. Male patients, those with unknown and female factors, expressed greater satisfaction with life compared to other male patients [P=0.022]. Significantly greater depression existed among the couples in which the wives' educational levels was above their husbands [P=0.045]
Conclusion: Our findings showed that when the infertility etiology was male factor, female factors or unexplained, wives showed significantly higher anxiety than their husbands. In couples diagnosed with female factor infertility, wives showed significantly more depression than their husbands
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Background: The multiple pregnancy incidence is increasing worldwide. This increased incidence is concerning to the health care system. This study aims to determine the frequency of multiple pregnancy and identify factors that affect this frequency in Tehran, Iran
Materials and Methods: This cross-sectional study included 5170 mothers in labor between July 6-21, 2015 from 103 hospitals with Obstetrics and Gynecology Wards. The questionnaire used in this study consisted of five parts: demographic characteristics; information related to pregnancy; information related to the infant; information regarding the multiple pregnancy; and information associated with infertility. We recruited 103 trained midwives to collect data related to the questionnaire from eligible participants through an interview and medical records review. Frequencies and odds ratios [OR] for the association between multiple pregnancy and the selected characteristics [maternal age, economic status, history of multiple pregnancy in first-degree relatives, and repro-ductive history] were computed by multiple logistic regression. Stata software, version 13 [Stata Corp, College Station, TX, USA] was used for all statistical analyses
Results: Multiple pregnancy had a prevalence of 1.48% [95% confidence interval [CI]: 1.19-1.85]. After controlling for confounding variables, we observed a significant association between frequency of multiple pregnancy and mother's age [OR=1.04, 95% CI: 1.001-1.09, P=0.044], assisted reproductive technique [ART, OR=6.11, 95% CI: 1.7-21.97, P=0.006], and history of multiple pregnancy in the mother's family [OR=5.49, 95% CI: 3.55-9.93, P=0.001]
Conclusion: The frequency of multiple pregnancy approximated results reported in previous studies in Iran. Based on the results, we observed significantly greater frequency of multiple pregnancy in older women, those with a history of ART, and a history of multiple pregnancy in the mother's family compared to the other variables
ABSTRACT
Background: In order to empower infertile individuals and provide high quality patient-centered infertility care, it is necessary to recognize and meet infertile individuals' educational needs. This study aims to examine infertility patients' knowledge and subsequently their education needs given their attitudinal approach to infertility education in terms of patients who undergo assisted reproduction treatment
Materials and Methods: This descriptive study enrolled 150 subjects by convenience sampling of all patients who received their first assisted reproductive treatment between July and September 2015 at a referral fertility clinic, Royan Institute, Tehran, Iran. We used a questionnaire that measured fertility and infertility information [8 questions] as well as attitude toward education on the causes and treatment of infertility [5 questions]. Chi-square, independent sample t test, and one way ANOVA analyses were conducted to examine differences by sex. P<0.05 was considered statistically significant
Results: Total mean knowledge was 3.08 +/- 0.99. Clients' responses indicated that the highest mean knowledge scores related to knowledge of factors that affected pregnancy [3.97 +/- 1.11] and infertility treatment [3.97 +/- 1.16]. The lowest mean knowledge scores related to knowledge of the natural reproductive cycle [2.96 +/- 1.12] and anatomy of the genital organs [2.94 +/- 1.16]. Most females [92.1%] and males [83.3%] were of the opinion that infertility education programs should include causes of infertility and types of treatment associated with diagnostic and laboratory procedures. No statistically significant difference existed between male and female participants [P=0.245]
Conclusion: Most participants in this study expressed awareness of factors that affect pregnancy and infertility treatment. It is imperative to educate and empower infertile individuals who seek reproduction treatment in terms of infertility causes and types of treatment, as well as diagnostic and laboratory procedures to enable them to make informed decisions about their assisted reproductive procedures
Subject(s)
Adult , Adolescent , Aged , Female , Humans , Male , Middle Aged , Young Adult , Health Knowledge, Attitudes, Practice , Reproductive Techniques, Assisted , Infertility , Patient Education as Topic , IranABSTRACT
Background: In 1993, Muller developed the Prenatal Attachment Inventory [PAI] which has been used widely in many studies and translated into several languages. The current study aimed to translate the PAI into Persian, assess the underlying structure of the PAI, and the appropriateness of the one-factor solution proposed by Muller
Materials and Methods: In this cross-sectional study, we recruited a total of 322 primigravidae in their 27th to 34th gestational weeks that referred to private and governmental prenatal clinics in Tehran, Iran. All participants completed the Persian versions of the PAI and a demographic questionnaire. Participants were re-tested 2 weeks after the initial testing The following psychometric properties of the PAI were investigated: construct validity by confirmatory factor analysis [CFA], internal consistency reliability with Cronbach's alpha, and test-retest reliability according to the intraclass correlation coefficient [ICC]
Results: The CFA results indicated that a single-factor model provided good fit to the data, which confirmed the original model by its developer. The Cronbach's alpha coefficient for PAI was 0.856 and the test-retest reliability with ICC was 0.784. Considering the duration between marriage and pregnancy, women with low duration scored significantly higher than women with high duration on PAI [P=0.043]
Conclusion: The Persian version of the PAI showed that one factor structure was ad- equate and could be used for measuring psychological affectionate attachment between Iranian mothers and their fetuses
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Background: Few studies have been conducted on the infertility problems in Iran. This study aimed to investigate the prevalence of infertility problems and related factors in Iranian infertile patients
Materials and Methods: In this cross sectional study, 405 infertile patients referred to Royan Institute, Tehran, Iran, between 2014 and 2015, were selected by simple random sampling. Participants completed the Fertility Problem Inventory [FPI] including 46 questions in five domains [social concern, sexual concern, relationship concern, rejection of parenthood, and need for parenthood]. Mean difference between male and female was verified using independent-samples Student's t test. A generalized linear model [GLM] was also used for testing the effect of variables on the fertility problems. Data was analyzed using Stata software version 13
Results: The mean age [SD] of participants was 31.28 [5.42]. Our results showed that 160 infertile men [95.23%] were classified as very high prevalence of infertility problems. Among infertile women, 83 patients [35.02%] were as very high prevalence of infertility problems, and 154 patients [64.98%] were as high prevalence. Age [P<0.001], sex [P<0.001], a history of abortion [P=0.009], failure of previous treatment [P<0.001], and education [P=0.014] had a significant relationship with FPI scores
Conclusion: Bases on the results of current study, an younger male with lower education level, history of abortion and history of previous treatments failure experienced more infertility problems
ABSTRACT
To our knowledge, there is no valid and comprehensive questionnaire that considers attitude toward oocyte donation [OD]. Therefore this study has aimed to design and develop a tool entitled attitude toward donation-oocyte [ATOD-O] to measure attitude toward OD. This methodological, qualitative research was undertaken on 15 infertile cases. In addition, we performed a literature review and search of various databases. Validity of this questionnaire was conducted by knowledgeable experts who determined indices such as relevancy, clarity, and comprehensiveness. Reliability of the questionnaire was assessed based on the opinions of experts and infertile couples referred to Royan Institute. ATOD-O was designed in 52 statements that covered various issues such as the OD process, donor and recipient characteristics, as well as family, emotional, psychological, legal, religious, and socio-economic dimensions. Results were scored as five points: 1 [strongly disagree], 2 [disagree], 3 [somewhat], 4 [agree], and 5 [strongly agree]. The overall relevancy of the questionnaire was 97% and clarity was 96%. Overall comprehensiveness was 100%.The findings from this preliminary validation study have indicated that ATOD-O is a valid measure for measuring and assessing attitude toward donated oocytes. This questionnaire can be used in studies regarding different groups of a society