Evaluation of risk factors associated with endometriosis in infertile women

Background: Endometriosis affects women's physical and mental wellbeing. Symptoms include dyspareunia, dysmenorrhea, pelvic pain, and infertility. The purpose of this study is to assess the correlation between some relevant factors and symptoms and risk of an endometriosis diagnosis in infertile women

Materials and Methods: A retrospective study of 1282 surgical patients in an infertility Institute, Iran between 2011 and 2013 were evaluated by laparoscopy. Of these, there were 341 infertile women with endometriosis [cases] and 332 infertile women with a normal pelvis [comparison group]. Chi-square and t tests were used to compare these two groups. Logistic regression was done to build a prediction model for an endometriosis diagnosis.

Results: Gravidity [odds ratio [OR]: 0.8, confidence interval [CI]: 0.6-0.9, P=0.01], parity [OR: 0.7, CI: 0.6-0.9, P=0.01], family history of endometriosis [OR: 4.9, CI: 2.1-11.3, P0.001], history of galactorrhea [OR: 2.3, CI: 1.5-3.5, P=0.01], history of pelvic surgery [OR: 1.9, CI: 1.3-2.7, P0.001], and shorter menstrual cycle length [OR: 0.9, CI: 0.9-0.9, P=0.04] were associated with endometriosis. Duration of natural menstruation and age of menarche were not correlated with subsequent risk of endometriosis [P>0.05]. Fatigue, diarrhea, constipation, dysmenorrhea, dyspareunia, pelvic pain and premenstrual spotting were more significant among late-stage endometriosis patients than in those with early-stage endometriosis and more prevalent among patients with endometriosis than that of the comparison group. In the logistic regression model, gravidity, family history of endometriosis, history of galactorrhea, history of pelvic surgery, dysmenorrhoea, pelvic pain, dysparaunia, premenstrual spotting, fatigue, and diarrhea were significantly associated with endometriosis. However, the number of pregnancies was negatively related to endometriosis

Conclusion: Endometriosis is a considerable public health issue because it affects many women and is associated with the significant morbidity. In this study, we built a prediction model which can be used to predict the risk of endometriosis in infertile women

New single nucleotide polymorphism G5508A in the SEPT12 gene may be associated with idiopathic male infertility in Iranian men

Male infertility is a multifactorial disorder, which affects approximately 10% of couples at childbearing age with substantial clinical and social impact. Genetic factors are associated with the susceptibility to spermatogenic impairment in humans. Recently, SEPT12 is reported as a critical gene for spermatogenesis. This gene encodes a testis specific member of Septin proteins, a family of polymerizing GTP-binding proteins. SEPT12 in association with other Septins is an essential annulus component in mature sperm. So, it is hypothesized that genetic alterations of SEPT12 may be concerned in male infertility. The objective of this research is exploration of new single nucleotide polymorphism G5508A in the SEPT12 gene association with idiopathic male infertility in Iranian men. In this case control study, 67 infertile men and 100 normal controls were analyzed for genetic alterations in the active site coding region of SEPT12, using polymerase chain reaction sequencing technique. Fisher exact test was used for statistical analysis and p<0.05 was considered as statistically significant. Genotype analysis indicated that G5508A polymorphic SEPT12 alleles were distributed in three peaks of frequency in both control and diseases groups. Categorization of the alleles into [GG], [GA], [AA] types revealed a significant difference between infertile patients [azoospermic and asthenospermic] and normal controls [p=0.005]. According to our finding we suggest that G5508A polymorphism in SEPT12 gene can affect spermatogenesis in men, the opinion needs more investigation in different populations

Evaluating the effective factors in pregnancy after intrauterine insemination: a retrospective study

Controlled ovarian hyperstimulation [COM] in conjunction with intrau-terine inseminations [IUI] are commonly used to treat infertile couples. In this study we evaluated the relationship between IUI outcome and special causes of infertility. We also aimed to examine parameters that might predict success following IUI. In this cross-sectional study, we included 994 IUI cycles in 803 couples who referred to the infertility Institute. All statistical analyses were performed by using SPSS program, t tests and chi-square. Stepwise multiple linear regression analysis was performed to compare the association between dependent and independent variables. Logistic regression was conducted to build a prediction model of the IUI outcome. Overall pregnancy rate per completed cycle [16.5%] and live birth rate per cycle [14.5%]. The mean age in the pregnant group was significantly lower than that of the non-pregnant group [P=0.01].There was an association between cause of infertility and clinical pregnancies [P=0.001]. Logistic regression identified four significant factors in determining the success of the IUI [menstrual irregularites [OR:2.3, CI: 1.6-3.4, P<0.001], duration of infertility [OR:0.8, CLO.8-0.9, P<0.001], total dose of gonado-tropin [OR:1.02, CL1.003-1.04, P=0.02] and semen volume [ORrl.l, CL1.008-1.2, P=0.03]] which were the most predictive of IUI success. Our study defined prognostic factors for pregnancy in COH+IUI. These variables can be integrated into a mathematical model to predict the chance of pregnancy rate in subsequent COH+IUI cycles

Impact of the endometrioma on ovarian response and pregnancy rate in in vitro fertilization cycles

Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes in in vitro fertilization cycles [IVF]. In this prospective cohort study, we followed 103 patients who underwent intra-cytoplasmic sperm injection [ICSI] procedures over a 24-months period. The study group consisted of 47 infertile women with either unilateral or bilateral ovarian endometrial cysts of less than 3 cm. The control group consisting of 57 patients with mild male factor infertility was candidate for ICSI treatment during the same time period as the study groups. Both groups were compared for number of oocytes retrieved, grades of oocytes, as well as embryo quantity and quality. Our results showed similar follicle numbers, good embryo grades [A or B] and pregnancy rates in the compared groups. However, patients with endometrioma had higher gonadotropin consumption than the control group. The mean number of retrieved oocytes in patients with endometrioma was significantly lower than control group [6.6 +/- 3.74 vs. 10.4 +/- 5.25] [p<0.001]. In addition, patients with endometrioma had significantly lower numbers of metaphase II [MII] oocytes [5 +/- 3.21] than controls [8.2 +/- 5.4] [p<0.001]. In patients with unilateral endometrioma, there were no significant differences in main outcome measures between normal and involved ovaries in the patients with endometrioma. Patients with ovarian endometrioma had poor outcome. They showed poor ovarian response with lower total numbers of retrieved oocytes and lower MII oocytes during the stimulation phase; however, it does not affect the total number of embryos transferred per patient, quality of embryos, and pregnancy rate per patient

ICSI outcome in infertile couples with different causes of infertility: a cross-sectional study

Different success rate of Intracytoplasmic Sperm injection [ICSI] has been observed in various causes of infertility. In this study, we evaluated the relation between ICSI outcome and different causes of infertility. We also aimed to examine parameters that might predict the pregnancy success rate following ICSI. This cross sectional study included1492 infertile women referred to Infertility Center of Royan Institute between 2010 and 2011. We assigned two groups including pregnant [n=504] and non-pregnant [n=988], while all participants underwent ICSI cycles. All statistics were performed by SPSS program. Statistical Analysis was carried out using Chi-square and t test. Logistic regression was done to build a prediction model in ICSI cycles. The overall clinical pregnancy rate in our study was 33.9% [n=1492]. There was a statistically significant difference in mean serum concentration on day 3 after application of luteinizing hormone [LH] between the pregnant and the non-pregnant groups [p<0.05]. However, There were no significant differences between two groups in the serum concentrations on day 3 after application of the following hormones: follicle-stimulating hormone [FSH], thyroid-stimulating hormone [TSH], and metoclopramide-stimulated prolactin [PRL] . We found no association between different causes of infertility and clinical outcomes . The number of metaphase II [MII] oocytes, embryo transfer, number of good embryo [grade A, B, AB], total dose of gonadotropin, endometrial thickness, maternal age, number of previous cycle were statistically significant between two groups [p<0.05]. Our results indicate that ICSI in an effective option in couples with different causes of infertility. These variables were integrated into a statistical model to allow the prediction for the chance of pregnancy following ICSI cycles. It is required that each infertility center gather enough information about the causes of infertility in order to provide more information and better assistance to patients. Therefore, we suggest that physicians prepare adequate training and required information regarding these procedures for infertile couples in order to improve their knowledge

[Comparison of influential factors affecting survival of patients with colon and rectum cancer using competing risks model]

Colorectal cancer is the most common cancer of digestive system and also fourth cause for death of cancer around the world. Different studies indicate that survival of patients suffering from colorectal cancer has recently developed in some areas of the world. However, it is not clear which factors involve in this improvement. This study aims at investigating some clinical and pathologic factors in prognosis of these patients with colon and rectum cancers separately. Data recorded from 1194 patients with colorectal cancer in Cancer Record Center of Research Center for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences [Tehran, Iran] was used in this study. Data analysis was performed using competing risks model. Software used for data analysis was STATA, 11 version, and significance level was regarded as 0.05. Body mass index, alcohol consumption, tumor site, inflammatory bowel disease, metastasis to lymph nodes and metastasis to other organs had significant effect on death of colon cancer, while body mass index, metastasis to other organs and kind of the first treatment had significant effect [P<0.05] on rectum cancer. Median survival was 7.75 +/- 1.118 and 3.917 +/- 0.26 years for patients with colon cancer and rectum cancer respectively. Also, 1, 2, 3, 4 and 5 years of survival rates for colon cancer were 88.7%, 77.9%, 68.5%, 61.4% and 56.8%, respectively, while they were 89.1%, 74.2%, 60.7%, 47.1% and 41.9% for rectum cancer, respectively. According to the results of this study, some variables may have different impacts on colon and rectum carcinoma; therefore it is needed that the effects of the factors on different parts of the large bowel be considered separately in the future studies

correlation between serum and peritoneal fluid CA125 level in women with pelvic endometriosis

Despite a high prevalence of endometriosis, there still exist many challenges in diagnosing the disease. This study aims to evaluate non-invasive and practical diagnostic methods by measuring serum and peritoneal fluid CA 125 levels in patients with endometriosis. A secondary aim is to determine the correlation between these markers with the stage of disease as well as the relationship of the two markers with each other. This is a cross-sectional study of 60 women who underwent laparoscopy for benign conditions. Based on laparoscopic findings and biopsy results, patients were divided to two groups; one group included patients with pelvic endometriosis [35 patients] and the second enrolled patients free from endometriosis [25 patients]. Serum and peritoneal fluid specimens were provided at the time of laparoscopy and CA125 levels were then assessed by electrochemiluminescence immunoassay. Mean serum and peritoneal fluid CA125 levels were significantly higher in women with endometriosis as compared to the control group [26.42 +/- 24.34 IU/ml versus 12.64 +/- 6.87 IU/ml in serum and 2203.54 + 993.19 IU/ml versus 1583.42 +/- 912.51 IU/ml in peritoneal fluid, p<0.05]. CA 125 levels also varied proportionally with the stage of endometriosis; but showed a significant difference only in higher stages of the disease, both in serum and peritoneal fluid. We calculated the cut-off value suggesting a diagnosis of pelvic endometriosis as 14.70 IU/ml for serum and 1286.5 IU/ml for peritoneal fluid CA125. A linear correlation between CA 125 levels in serum and peritoneal fluid in patients with pelvic endometriosis has also been observed. Serum and peritoneal fluid CA 125 levels are simple and non-surgical tools for diagnosing and staging pelvic endometriosis. These markers are of greater diagnostic value in higher stages of the disease