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Background: Infertility remains an important problem with a significant negative social impact on infertile couples. intrauterine insemination (IUI) is an assisted method of infertility treatment in couples with unexplained and mild/moderate male factor subfertility. In the present study, we compared infertility-related stress in women undergoing the IUI cycle before and after COVID-19 Pandemic. Materials and Methods: One hundred and sixty women undergoing the IUI cycle participated in the present study. Samples were collected from Jun 2019 to December 2019 and postponed for 6 months because of COVID-19 Pandemic. Afterward, sampling was started again in March 2021. The sampling was divided into two parts, including (I) before and (II) after COVID-19 Pandemic. A socio-demographic form and Fertility Problem Inventory (FPI) questionnaire were completed by participants before starting their treatment. Statistical analyses were performed using Prism software. Results: According to the results of FPI questionnaires, ~95% of all women participating in the study showed medium to very high levels of total infertility stress. The mean total scores of FPI in patients before and after the COVID-19 Pandemic groups were 137.6 ± 24.8 and 134.6 ± 27, respectively. The comparison of FPI scores between the two groups exhibited no significant difference (P˃0.05). Findings also showed that total infertility stress was significantly associated with age, duration of infertility, employment, and educational status. No significant relationship was found between total infertility stress and other data (cause of infertility, type of infertility, and history of previous IUI). Conclusion: According to our study, COVID-19 Pandemic did not affect infertility-related stress in infertile women.

The aim of this study was to investigate the prevalence of insulin resistance (IR) according to the phenotypic subgroups of polycystic ovary syndrome (PCOS) and to determine the associations of TSH levels and body mass index (BMI) with IR in infertile women with PCOS. In this cross-sectional study, we included 400 infertile women with a diagnosis of PCOS according to Rotterdam criteria who were referred to the infertility clinic of amir-al-Momenin University Hospital from April 2018- to January 2020. They were classified into four different phenotypic subgroups according to ESHRE guidelines. The homeostasis model (HOMA-IR) was used to measure IR. The prevalence of insulin resistance was 39.3% in infertile women with PCOS. Among women with PCOS, the commonest phenotype was type I (68%), with type II (18.2%), type III (8.8%), and type IV (5%), respectively. Furthermore, there was no significant difference in the prevalence of IR among different phenotypes of PCOS. Logistic regression analysis showed that the chance of insulin resistance was higher in overweight (OR: 1.76, 95% CI: 1.07, 2.88, P=0.024) and obese PCOS women (OR: 3.25, 95% CI: 1.86, 5.67, P

Background The prognostic value of peripheral natural killer (pNK) cells, as a screening test in women with recur- rent pregnancy loss (RPL) and unexplained infertility, is still a matter for discussion. The purpose of this study was to compare the percentage of circulating CD56+NK cells, CD69 and perforin markers between women with unexplained infertility and RPL with the healthy control group. Materials and Methods In this case-control study, the percentage of CD56+NK cells and activation markers (CD69 and perforin levels) in the peripheral blood were measured in 25 women with unexplained infertility, 24 women with idiopathic RPL and 26 women from the healthy control group, using specific monoclonal antibodies by flow cytometry. Results The percentage of CD56+NK cells was significantly higher in patients with infertility in comparison with the healthy control group (P=0.007). There were not significant differences either in the total number of CD56+cells between the RPL group and the control group (P=0.2) or between the RPL group and the infertile group (P=0.36). The percentage of CD69+lymphocytes in RPL group was significantly higher than in the infertility group (P=0.004). There was a statistically significant difference in Perforin levels between RLP and control (P=0.001) as well as RPL and infertile (P=0.002) groups. Conclusion An increased percentage of CD56+NK cells in patients with unexplained infertility, an elevated expression of CD69 on NK cells in patients with RPL and infertility and a high level of perforin on CD56+cells in the RPL group might be considered as immunological risk factors in these women.

The diagnosis of polycystic ovary syndrome (PCOS) and metabolic syndrome (MS) in adolescents is clinically challenging. It is on the rise as consistent with the increasing trends in obesity rates. This study aimed to investigate the prevalence of PCOS in adolescents by the National Institutes of Health (NIH) criteria and compare the prevalence of insulin resistance (IR) and metabolic syndrome (MS) between obese (OB) and non-obese (NOB) adolescents with PCOS. This was cross-sectional research with multi-stage cluster random sampling. Participants were 15-18-year-old girls from high schools in Semnan, Iran. The ones who had a history of menstrual dysfunction underwent clinical and hormonal tests. From among a total of 900 participants, 74 girls (8.2%) had a history of menstrual dysfunction. The prevalence of PCOS was 6.44% by NIH criteria. The prevalence of abnormal glucose metabolism, MS, and IR in girls with PCOS were 8(13.7%), 6(10.3%), 24(41.4%), respectively. The OB-PCOS group with a mean BMI of 28.21±1.26 kg/m2 had a significantly greater prevalence of MS, high BP, waist circumference ≥88 cm, and higher IR than NOB-PCOS cases with a mean BMI of 20.54±2.97 kg/m2. Abnormal glucose metabolism was prevalent in adolescents with PCOS and occurred with equal frequency in OB and NOB PCOS groups. Obesity could worsen IR, MS, and some of the components of Mets in PCOS adolescents.

Background: The use of Methotrexate (MTX) is a good and common practice for the treatment of women who were diagnosed early with ectopic pregnancy (EP). The aim of this study is to determine the predictors of treatment failure with a single dose of MTX injection. Methods: In this quasi-experimental research, we studied 70 women with ectopic preg-nancies who were treated with MTX, according to a single dose protocol from 2010 to 2013. EP was diagnosed whenever an intrauterine gestational sac was not identified by transvaginal ultrasonography (TVUS), accompanied by an abnormal rise or plateau in human chorionic gonadotropin (beta-hCG) concentration. Briefly, women with ectopic pregnancies were considered candidates for MTX treatment if they were hemodynami-cally stable; did not desire surgical therapy, agreed to weekly follow-up; and did not have hepatic, hematologic, or renal disease. A Patient was considered a treatment suc-cess (group 1) if her beta-hCG levels decreased ≤10 m IU/ml after the first dose of MTX. Treatment failure (group 2) was defined as the need for a second or a third dose of MTX or surgery. The following risk factors were compared between the two groups: serum beta-hCG on the days 1 and 4, a ≥ 15% decrease in serum beta-hCG between the days 1-4 of the treatment, age, parity, gravidity, the size of the ectopic mass and the endometrial thickness. Results: The success rate of MTX treatment was 77.1%. There were no significant dif-ferences between the two groups in regard to the age, parity, gravidity, the size of ec-topic mass and the endometrial thickness in vaginal sonography, but the mean serum beta-hCG concentration on days 1 and 4 was lower in the success group than the failure group. We also observed a ≥ 15% decrease in serum beta-hCG in 80.9% of the women from the success group and in 38.5% of the cases whose treatment had failed. The presence of fetal heart activity was seen in only one patient and this patient’s treatment failed. Two patients had previous history of ectopic pregnancy and the treatment of both ended in failure. Conclusion: Among women with ectopic pregnancies who were candidates for MTX treatment, a high serum beta-hCG concentration on the days 1-4 and also a ≤ 15% fall in serum beta-hCG between the days 1-4 treatment, are the most important factors associated with the failure of the treatment with a single dose MTX protocol. It is better to use these factors for making decisions about the initiation of the treatment or the continuation of it.

"n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Recurrent miscarriage is defined as the loss of three or more pregnancies. Recurrent Pregnancy Loss (RPL) is traditionally investigated after three or more consecutive losses. Although some believe that the investigation must be launched after two miscarriages, there is not enough compelling evidence to draw conclusion. "n"nMethods : In this cross-sectional study, we studied 58 women with two or more consecutive abortions (37 women with two and 21 women with three or more miscarriages) from 2005 to 2009. The following risk factors were analyzed and compared between the two groups: endocrine dysfunctions, genetic abnormalities, uterine anomalies, infections, thrombophilia, polycystic ovary syndrome, autoimmune disorders, sperm characteristics, and advanced maternal age."n"nResults : We did not find any known factor for pregnancy losses in 18 (31.03%) patients but in the rest, the most common cause of Recurrent pregnancy loss was endocrine disorders (41.4%). The other causes were uterine abnormalities (12.1%), infections (12.1%), maternal age more than 35 years (12.1%), thrombophilia (8.6%), abnormal semen analysis (8.6%), genetic defects (6.9%) and autoimmune disorders (1.7%). There were no significant differences between the two groups in regards with the causes of abortion except uterine abnormality (P=0.039) which was more frequent in women with three or more three miscarriages (23.8%) relative to women with two abortions (5.4%)."n"nConclusion: There were no significant differences between women with two or women with three or more three abortions in regards with the causes of abortion except uterine anomalies. Therefore, it seems quite reasonable and perhaps beneficial to start the investigation in patients with two abortions.