Disorders of sex development and female reproductive capacity: A literature review.

Disorders of sex development (DSD) are a wide-ranging group of complex conditions that influence chromosomal, gonadal, and phenotypic sex. The prevalence of DSD is very low, but affected patients deserve individualized management to improve psychological, sexual, and reproductive outcomes. This review aims to clarify the fertility potential of DSD patients who can be reared as females and their chance of becoming pregnant, especially using assisted reproductive techniques (ART). Due to the effects of DSD on internal and external genital organs, these conditions result in varying degrees of fertility potential. Fertility rate depends on the phenotype and is inversely related to the severity of the disorder. Reproductive endocrinologists and infertility specialists must be considered active partners of the interdisciplinary treatment team. With current advances in ART, pregnancy is more achievable in patients who were considered infertile at first glance. Due to the complexity of the medical management in DSD patients, more studies should be conducted to conclusively suggest the best choice for improving their fertility potential.Abbreviations: AIS: Androgen Insensitivity Syndrome; AMH: Anti-Müllerian Hormone; ART: Assisted Reproductive Technology; ASRM: American Society for Reproductive Medicine; CAH: Congenital Adrenal Hyperplasia; CAIS: Complete Androgen Insensitivity Syndrome; DHT: Dihydrotestosterone; DSD: Disorders of Sexual Development; FSH: Follicle Stimulating Hormone; GD: Gonadal Dysgenesis; ICSI: Intracytoplasmic Sperm Injection; IUGR: Intrauterine Growth Restriction; IVF: In Vitro Fertilization; IVF-ET: IVF and Embryo Transfer; LH: Luteinizing Hormone; MGD: Mixed Gonadal Dysgenesis; MRI: Magnetic Resonance Imaging; MRKH: Mayer-Rokitansky-Kuster-Hauser; US: Ultrasonography; HSG: Hysterosalpingography; PAIS: Partial Androgen Insensitivity Syndrome; PGD: Preimplantation Genetic Diagnosis; POR: P450 Oxidoreductase; PROM: Premature Rupture of Membranes; TS: Turner Syndrome; 17ß-HSD III: 17ß-Hydroxysteroid Dehydrogenase III; 21-OHD: 21-hydroxylase deficiency; 5α-RD-2: 5α-reductase-2.

Stem cell therapy for lung diseases: From fundamental aspects to clinical applications.

The respiratory system is a complex group of organs in the human body, all of which are necessary in breathing. Due to its special anatomy and composition, after exposure to various damaging factors such as micro particles, carbon granules and toxic gases, the respiratory system can be affected by a variety of damage without return to its original state. Currently, the prevalence of lung diseases, including asthma, and chronic obstructive pulmonary diseases, such as emphysema, has increased remarkably. New therapeutic approaches are desperately needed to discover regenerative medicine approaches, especially cell therapy. This review summarizes the recent advances in stem cell treatments and the research efforts conducted through the application of stem cell therapy for respiratory system diseases. In particular, researchers have used animal models to gather data about treating lung injury by stem cell transplantation. This review concentrated on the findings about route, timing and adjustment of cell transplantation dose, optimum stem cell type selection and potency marker of cells as therapeutic agents. These factors are essential subjects for approval and clinical transplantation. The current clinical trials aiming at treatment of lung diseases by stem cells are mentioned and discussed.

Factors affecting the choice of type of delivery with breast feeding in Iranian mothers.

OBJECTIVE: This study assessed the factors affecting the choice of type of delivery with breast feeding in Iranian mothers. METHODS: This Cross section descriptive analytic study was performed using a random sampling technique, using data from 400 pregnant women who attended the maternity centers in Borazjan and Kazerun in Iran in 2014. A questionnaire covering demographic characteristics, mode of delivery and postpartum conditions was completed for each mother. Descriptive analysis and Chi square test were used along with SPSS 23 software to statistically analyze the data and p-value less than 0.05 was considered for statistical significance. RESULTS: In this study, the rate of normal delivery and cesarean operation are considered equal. In the main factors influencing the choice of delivery, mothers' education level (p=0.028) and pregnancy status (p=0.041) showed a significant relationship. Although no significant association between child nutrition with the type of delivery was found, duration of breastfeeding with the type of delivery showed significant association (p=0.046). CONCLUSION: Although cesarean delivery in many cases is life-saving for mother and fetus; in addition to medical indications, parents with higher education and pregnancy status are also important factors in increasing the rate of cesarean section compared to vaginal delivery. Babies of mothers with normal delivery had a longer time of breastfeeding. Further studies in Iran are necessary, regarding the reasons for high cesarean section and their outcomes.

The Relation of Pre and Postnatal Depression and Anxiety with Exclusive Breastfeeding.

INTRODUCTION: Studies on the relationship between prenatal psychosocial risk factors and breastfeeding are disjointed. Maternal health status has a great influence on breastfeeding, growth, and general health of the neonates. The aim of this study was to ascertain the relation between maternal mental health and breastfeeding status of mothers in Kazerun (Fars province, Iran). METHODS: This cross-sectional study was conducted on a total of 92 pregnant women recruited from clinics in Kazerun in 2015. Participants were divided into two groups subject to exclusive breastfeeding. Spielberger Anxiety Inventory, Beck Depression Inventory and Edinburgh Postnatal Depression Scale (EPDS) were used for data collection. Data analysis was performed by the SPSS version 16 using descriptive statistics, Chi-square, and Fisher's exact test. RESULTS: The average of state anxiety score according to Spielberger Anxiety Inventory was 1.97±0.51 in the exclusive breastfeeding group versus 1.77±0.66 in the non-exclusive breastfeeding group (p = 0.229). The mean trait anxiety score according to Spielberger Anxiety Inventory was 1.98±0.44 in the exclusive breastfeeding group versus 2.22±0.44 in the non-exclusive breastfeeding group (p=0.132). An average of Beck Depression Inventory score was 1.35±0.84 totally (1.33±0.81 in the exclusive breastfeeding group vs. 1.33±1.00, P=0.584). An average of EPDS score was 1.65±1.11, 1.64±1.11, and 1.44±0.88 in total, in the exclusive breastfeeding and non-exclusive breastfeeding groups, respectively (p=0.604). CONCLUSIONS: Screening anxiety and depression before and during pregnancy appeared to be necessary.

Effects of fenugreek seed on the severity and systemic symptoms of dysmenorrhea.

BACKGROUND: Primary dysmenorrhea is a prevalent disorder and its unfavorable effects deteriorates the quality of life in many people across the world. Based on some evidence on the characteristics of fenugreek as a medical plant with anti-inflammato-ry and analgesic properties, this double-blind, randomized, placebo controlled trial was conducted. The main purpose of the study was to evaluate the effects of fenugreek seeds on the severity of primary dysmenorrhea among students. METHODS: Unmarried Students were randomly assigned to two groups who received fenugreek (n = 51) or placebo (n = 50). For the first 3 days of menstruation, 2-3 capsules containing fenugreek seed powder (900 mg) were given to the subjects three times daily for two consecutive menstrual cycles. Pain severity was evaluated using a visual analog scale and systemic symptoms were assessed using a multidimensional verbal scale. RESULTS: Pain severity at baseline did not differ significantly between the two groups. Pain severity was significantly reduced in both groups after the intervention; however, the fenugreek group experienced significantly larger pain reduction (p < 0.001). With respect to the duration of pain, there was no meaningful difference between the two cycles in the placebo group (p = 0.07) but in the fenugreek group, the duration of pain decreased between the two cycles (p < 0.001). Systemic symptoms of dysmenorrhea (fatigue, headache, nausea, vomiting, lack of energy, syncope) decreased in the fenugreek seed group (p < 0.05). No side effects were reported in the fenugreek group. CONCLUSION: These data suggest that prescription of fenugreek seed powder during menstruation can reduce the severity of dysmenorrhea.