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Background: Endometrial scratch injury is considered controversial in increasing the success rate of assisted reproductive technology. Objective: To compare the pregnancy outcomes in women undergoing intrauterine insemination with and without an endometrial scratch. Materials and Methods: In this randomized clinical trial, 150 women referred to the Fatemieh Hospital, Hamadan, Iran who were candidates for IUI between December 2017 and December 2018 were randomly assigned into two groups (n = 75/each) with or without an endometrial scratch (as case and control groups, respectively). Women in both groups were in proper and identical protocol for IUI. Chemical and clinical pregnancies, abortion, and live birth rate, also pregnancy complications were compared between the groups. Results: Chemical and clinical pregnancy rates were higher in the case than the control group (p = 0.25, p = 0.54, respectively). In the case group, the abortion and multiple gestation rates were 14.3% and 4.3%, respectively, while it was 5% in the control group (p = 0.60, p = 0.54 respectively). The endometrium thickness on day 21 was higher in the case group than the control (p = 0.01). Conclusion: Endometrial scratching in intrauterine insemination women is not associated with an increase in both clinical and clinical pregnancy rates, however, studies with a larger sample size are recommended to evaluate this intervention. [ABSTRACT FROM AUTHOR]

Background: During the month of Ramadan, millions of Muslims abstain from food and drink daily from dawn to sunset and people actually experience repeated cycles of fasting and refeeding. Menstruation is a normal physiological process that its regularity is controlled by hypothalamic-pituitary-ovarian axis. Etiology of menstrual dysfunction includes weight loss, hypoleptinemia, abnormal eating behaviors, exercise, and psychological stressors. Objective: To investigate the effects of Ramadan fasting on menstrual cycles. Materials and Methods: This analytic cross-sectional study was performed on 80 female college students resident in a dormitory of Hamedan University of Medical Sciences. A questionnaire including demographic characteristics and menstrual calendar was filled by all participants. All analyses were performed using the statistical software SPSS for Windows version 11.5. Results: We found 11.3%, 30%, and 16.3% of participates had abnormal menstrual pattern three months before, during and three months after Ramadan, respectively. In participates who fast more than 15 days, menstrual period had significantly more abnormality than participants who fast less than 15 days. Considering our results we demonstrated that menstrual abnormalities during Ramadan month reach to their peak and three months after Ramadan reduce but do not return to previous condition. Conclusion: This study confirms that menstrual abnormalities including oligomenorrhea, polymenorrhea and hypermenorrhea increased during Ramadan especially in participates with more than 15 days of fasting. [ABSTRACT FROM AUTHOR]

Background: The most frequent physical finding in infertile men is varicocele, in which one of the mechanisms that can affect seminal parameters is oxidative stress. Objective: Our study aimed, for the first time, to compare the efficacy of recombinant human follicle-stimulating hormone (rhFSH), human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) on sperm parameters and fertility after varicocelectomy. Materials and Methods: 113 infertile men with varicocele were divided into four groups. Group A received HCG 5000 IU weekly, group B received HMG 75 IU three times a week, group C received rhFSH 75 IU three times a week and group D received no medical treatment after varicocelectomy. Results: After three months, in group A sperm morphology improved (p=0.007), causing a 32% pregnancy rate. In group B, sperm motility (p=0.023) and morphology (p=0.014) improved, causing a 57% pregnancy rate. In group C, all of the investigated semen parameters increased (p<0.05), causing a 62.5% pregnancy rate. Only rhFSH improved sperm concentrations to >20x106 mL (p=0.027). In group D, sperm morphology increased (p=0.038), but other parameters remained unchanged and no pregnancies occurred. Conclusion: It can be concluded that drugs can reduce induction time for spermatogenesis and fertility in comparison with varicocelectomy alone. For these purposes, rhFSH is more effective than other drugs. [ABSTRACT FROM AUTHOR]

Background: Methylenetetrahydrofolate reductase enzyme (MTHFR) plays a key role in regulating folate balance, converting homocysteine to methionine, and producing s-adenosylmethionine (SAM) that plays a role in the methylation process. Objective: This study aimed to determine MTHFR activity and SAM level in men with normozoospermia and oligozoospermia. Materials and Methods: 30 oligozoospermic and 30 normozoospermic men as controls were enrolled in this case-control study. Semen analysis was conducted according to the world health organization criteria. All semen samples were collected after 3-5 days of sexual abstinence. The sperms were evaluated by sperm test video software. All subjects SAM level was measured by enzyme-linked immunosorbent assay kit, and MTHFR were measured manually. Results: 2 groups had a significant difference in sperm morphology (p = 0.02), concentration (p = 0.02) and motility (p = 0.03). The MTHFR activity in normozoospermic and oligozoospermic groups had significantly differences (p = 0.01). The level of SAM in the semen of oligozoospermic men was statistically lower than normozoospermic men (p = 0.03). Also, there was a positive association between MTHFR enzyme activity and SAM level in the normozoospermia group (p = 0.02, ß = 0.67) and oligozoospermia group (p = 0.03, ß = 0.54). Conclusion: MTHFR activity and SAM concentration were statistically lower in oligozoospermia men. It seems they can affect sperm concentration, morphology, and motility. [ABSTRACT FROM AUTHOR]

Background: Infertility is considered as a major health care problem of different communities. The high prevalence of this issue doubled its importance. A significant proportion of infertility have been related to environmental conditions and also acquired risk factors. Different environmental conditions emphasized the need to study the different causes of infertility in each area. Objective: The aim of this study was to determine the frequency causes of infertility in infertile couples. Materials and Methods: In this cross sectional descriptive study 1200 infertile men and women that were referred to infertility clinic of Fatemieh Hospital during 2010 to 2011, were examined. This center is the only governmental center for infertility in Hamadan. Sampling was based on census method. Information about the patients was obtained from medical examinations and laboratory findings. To analyze the data, descriptive statistics such as frequencies and the mean were used. Results: The prevalence of primary and secondary infertility was 69.5% and 30.5% respectively. Among the various causes of infertility women factors (88.6%) had the highest regard. In the causes of female infertility, menstrual disorders, diseases (obesity, thyroid diseases, and diabetes), ovulation dysfunction, uterine factor, fallopian tubes and cervical factor had the highest prevalence respectively. The causes of male infertility based on their frequency included semen fluid abnormalities, genetic factors, vascular abnormalities, and anti-spermatogenesis factors, respectively. Conclusion: Etiology pattern of infertility in our study is similar with the many other patterns that have been reported by the World Health Organization. However, frequency of menstrual disorders is much higher than other studies that require further consideration. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the impact of the cervical mucus aspiration before the transplantation of embryo on pregnancy rate.