comparison between intrauterine insemination and fallopian tube sperm perfusion Using FAST[registered sign] system in patients with unexplained infertility

Controlled ovarian stimulation [COH] with intrauterine insemination [IUI] is commonly offered to infertile couples with patent fallopian tubes because it is simple, non-invasive and cost-effective technique. Another non-invasive method is fallopian tube sperm perfusion [FSP]. This study was performed to compare the relative efficacy between FSP using fallopian sperm transfer [FAST] system and standard IUI in patients with unexplained infertility. This prospective randomized study was conducted at the IVF Unit, Department of Gynecology and Obstetrics, Mazandaran University of Medical Sciences, Sari, Iran, from March 2011 to February 2012. A total of ninety patients with unexplained infertility underwent ovarian stimulation with clomiphene citrate and human menopausal gonadotropin [HMG]. Patients were then randomly assigned into either group I [n=45] to undergo standard IUI or group II [n=45] to undergo FSP using FAST system. The patients' basic characteristics, including age, primary infertility and duration of infertility, were not significantly different between two study groups. In the group I, there were 9 pregnancies [a pregnancy rate per cycle of 20%], whereas in the group II, 8 pregnancies occurred [a pregnancy rate per cycle of 17.8%, p>0.05]. FSP using FAST system offers no advantage over the standard IUI in order to increase pregnancy rate in patients with unexplained infertility

Infertility in Mazandaran province - north of Iran: an etiological study

The prevalence and etiology of infertility are not similar in different parts of the world. There are only few reports of this topic in Iran. This study was conducted to determine the clinical patterns and major causes of infertility in Mazandaran province in north of Iran. The medical records of 3734 consecutive couples attending two infertility clinics in Mazandaran province, from 2003 to 2008, were reviewed. The couples had not had a viable birth after at least 1 year of unprotected intercourse and were fully investigated. Of the entire samples, 78.7% had primary infertility and 21.3% had secondary infertility. The mean duration of infertility in couples was 5.7 +/- 4 years. The etiology of infertility in couples revealed; male factor in 38.9%, female factor in 34.7%, combined factors in 14.6% and undetermined cause in 11.8%. In this study, delayed attendance of infertile couples to the infertility clinic was found. Therefore, there is a need to revise public health program on infertility to focus on the education and prevention of infertility and its risk factors

Effects of L-carnitine on infertile men's spermogram; a randomized clinical trial

Male infertility is one of the most challenging problems in andrology. The common cause of male infertility is related to disorders in sperm production and its improvement is synonymous with better treatment outcomes. Although, the etiology of infertility is not clear in most cases but different treatment options have been suggested to increase sperm count and motility. L-carnitine, which is found in different food items and it is derived from lysine and methionine, is a substance essential for the oxidation of long-chain fatty acids in the mitochondria and protection of cell membranes from damages caused by free oxygen radicals. This study was done to evaluate the efficacy of L-carnitine in improving sperm quality in infertile men. This double blind randomized cross-over, clinical trial was conducted on 30 infertile men attending Sari Imam Khomeini Hospital's Infertility Clinic during 2005- 2006. Subjects that had at least two abnormal spermograms, based on WHO criteria, with a two-week interval during four weeks and their gonadotropins, testosterone an prolactin concentrations were within normal range were recruited for the study. The exclusion criteria were composed of individuals with medical conditions other than infertility such as grade 3 or 4 varicocele, testicular atrophy, ejaculatory disorders, use of any medications in the past two months prior to the study, azoospermia, endocrinological disorders, ICSI candidacy for severe spermogram abnormalities or other causes of infertility.The patients were randomly allocated to two groups of A and B. Group A and B received L-carnitine and placebo 2g/day for 8 weeks respectively. After a washout period of 8 weeks, the two groups, changed place and received placebo and L-carnitine [2g/dayx8w]. Sperm analyses were done in four stages: Before and after the first intervention, at the end of washout period and after the second intervention. There were significant improvements in mean sperm concentration and progressive sperm motility upon two months of L-carnitine intake [p<0.05] but no significant changes were found in sperm volume or morphology. The aforementioned changes retracted to the primary status after two months. No changes were seen following the intake of placebos in the cases. L-carnitine intake effectively improved the mean sperm count and progressive sperm motility. However, confirmation of these results warrants more thorough clinical trials