Reproductive Medicine - Semantic Scholar

Iranian Journal of

Reproductive Medicine VOLUME 7

SUPPLEMENT 1

WINTER 2009

ISSN: 1680-6433

ABSTRACT BOOK Published by: Yazd Research & Clinical Center for Infertility. In collaboration with: Iranian Society for Reproductive Medicine.

CHAIRMAN MANAGER Vahidi, Serajedin M.D. EDITOR-IN-CHIEF Aflatoonian, Abbas M.D. MANAGING EDITOR Anvari, Morteza Ph.D. EXCUTIVE BOARD Abdoli, Ali Mohammad M.D. Asadzadeh, Kobra B.S. Khani, Parisa M.D. Mortazavifar, Zahra B.S. Javed, Aisha M.Sc., M.Phil. EDITORIAL BOARD Ahmadi, Ali Ph.D. (USA) Al-Hassani, Safa Ph.D. (GERMANY) Hosseini, Ahmad Ph.D. (IRAN) Hosseini, Seyed Jalil M.D. (IRAN) Kalantar, Seyed Mehdi Ph.D. (IRAN) Karimzadeh Meybodi, Mohammad Ali M.D. (IRAN) Kazemeyni, Seyed Mohammad M.D. (IRAN) Khalili, Mohammad Ali Ph.D. (IRAN) Lenton, Elizabeth Ann Ph.D. (UNITED KINGDOM) Monsees, Thomas Ph.D. (GERMANY) Moini, Ashraf M.D. (IRAN) Nasr-Esfahani, Mohammad Hossein Ph.D. (IRAN) Pour-Reza, Maryam M.D. (IRAN) Pourmand, Gholamreza M.D. (IRAN) Yasini, Seyed Mojtaba M.D. (IRAN) The Iranian Journal of Reproductive Medicine is indexed in Institute for Scientific Information (ISI), Scopus, Chemical Abstract Services, CAB Abstract, Index Copernicus, Index Medicus for the WHO Eastern Mediterranean Region (IMEMR), Directory of Open Access Journals (DOAJ), Magiran, Scientific Information Database (SID), IranMedex, Open J-Gate, Bioline International and approved by Medical Journals Commission of the Ministry of Health and Medical Education. Publication Permission No.13372 IJRM Office, Research & Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. P.O. Box: 89195-999 Yazd, Iran Tel: +98 (351) 8247085–6 Fax: +98 (351) 8247087 E-mail: [email protected] Website: www.ijrm.ir

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Instructions to Authors Aims and Scope The Iranian Journal of Reproductive Medicine (IJRM) is an international scientific quarterly publication of the Research and Clinical Center for Infertility of Shahid Sadoughi University of Medical Sciences and Health Services. Publication of IJRM benefits from copyright protection in accordance with Universal Copyright Convention. All published articles will become the property of the IJRM. The editor and publisher accept no responsibility for the statements expressed by the authors here in. Also they do not guarantee, warrant or endorse any product or service advertised in the journal. This Journal accepts Original Papers, Review Articles, Short Communications and Letters to the Editor in the fields of fertility and infertility, ethical and social issues of assisted reproductive technologies, cellular and molecular biology of reproduction, including the development of gametes and early embryos, assisted reproductive technologies in model system and in a clinical environment, reproductive endocrinology, andrology, epidemiology, pathology, genetics, oncology, surgery, psychology and physiology. Emerging topics including cloning and stem cells are encouraged.

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Style Manuscripts should be written using clear and concise English. The manuscript should include: Title page; the Abstract; Introduction; Materials and Methods; Results; Discussion; Acknowledgement and References. Manuscript format The format of the IJRM manuscripts, including tables, references, and figure legends must be type written, double-spaced, on one side of A4 paper, with margins of 2.5 cm. Pages should be numbered consecutively, beginning with the title page and continuing through the last page of typewritten material. Avoid underlining. Original articles should have the following format: Title page The title page must contain (1) title of article, (2) correct names and highest academic degree of each author, (3) each author’s official academic and/or clinical title and affiliation, (4) name and address of the institution(s), (5) name, address, telephone number, e-mail and fax number of author to whom correspondence should be sent. Running title The author should provide a running title of no more than 50 characters. Abstract All original articles must contain a structured abstract of not more than 250 words. The abstract should include; Background, Objective, Materials and Methods, Results, Conclusions and at least 3 to 5 key words, chosen from the Medical Subject Headings (MeSH) list of index medicus (http://www.nlm.nih.gov/mesh/MBrowser.html ). They should therefore be specific and relevant to the paper. Authors need to be careful that the abstract reflects the content of the article accurately. For Randomized Controlled Trials the method of randomization and primary outcome measure should be stated in the Abstract. Introduction This should summarize the purpose and the rationale for the study. It should neither review the subject extensively nor should it have data or conclusions of the study. Materials and Methods This should include the study design and exact method or observation or experiment, definitions such as for diagnostic criteria, the population or patient samples, and laboratory and statistical methods. If an apparatus is used, its manufacturer’s name and address should be given in parenthesis. If the method is established, give reference but if the method is new, give enough information so that another author is able to perform it. Statistical method must be mentioned and specify any general computer programme used. Results This should include the pertinent findings in a logical sequence with tables and figures as necessary. It must be presented in the form of text, tables and illustrations. The contents of the tables should not be all repeated in the text. Instead, a reference to the table number may be given. Long articles may need sub-headings within some sections (especially the Results and Discussion parts) to clarify their contents. Unnecessary overlap between tables, figures and text should be avoided. III

Discussion The discussion should emphasize the present findings and the variations or similarities with other work done in the field by other workers. Conclusions based on the findings, evidence from the literature that supports the conclusions, applicability of the conclusions, and implications for future research. The detailed data should not be repeated in the discussion again. Emphasize the new and important aspects of the study and the conclusions that follow from them. It must be mentioned whether the hypothesis mentioned in the article is true, false or no conclusions can be derived. Acknowledgements All contributors who do not meet the criteria for authorship should be covered in the acknowledgement section. Financial and material support should also be acknowledged. Personal acknowledgement should precede those of institutions or agencies References All manuscripts should be accompanied by relevant references. The Reference should provide the following information as stated in the presented models as follows: 1.References should be numbered sequentially as they appear in the text according to the Vancouver style. When citing authors in the text, acknowledge only the first author where there are three or more authors, e.g. Williams et al (1) stated that.... Where there are two authors cite both, e.g. Jones and Smith (2) reported that.... Citations in the reference list are to be arranged by number in the following format including punctuation. Journals: Author(s). Title of article. Title of journal (in italics with no full stops) Year; volume number: page numbers. (Abbreviations for journals used in the reference list should conform to Index Medicus.) e.g. Salehnia M, Arianmanesh M, Beigi M. The impact of ovarian stimulation on mouse endometrium: a morphometrical study. Iran J Rep Med 2006; 4:7-11. Books: Author(s). Title: sub-title. Edition. Place of publication: Publisher; Year. e.g. Speroof L, Robert H. Clinical gynecology endocrinology & infertility .6th Ed. Philadelphia; Robert-D; 1999. Chapter in a book: Author(s) of chapter. Title: sub-title of chapter. In: Author(s) (or editors) of the book. Title: sub-title of book. Place of publication: publisher; Year; page numbers. Inclusive page numbers should be given for all references. Print surnames and initials of all authors when there are six or less. In the case of seven or more authors, the names of the first six authors followed by et al should be listed. References to papers accepted for publication, but not yet published, should be cited as such in the reference list e.g. Mohammad Kazem Gharib Naseri M, Mohammadian M, Gharib Naseri Z. Antispasmodic effect of Physalis alkekengi fruit extract on rat uterus, IJRM 2008, in press. The author is responsible for the accuracy and completeness of the references and for their correct textual citation. Tables In limited numbers should be submitted with the captions placed above.Each table should be numbered consecutively with Roman numerals and typed double-spaced, including all headings. Verify tabular statistics to make sure they tally and match data cited in the text. Do not submit tables as photograph. Figures Should be in limited numbers, with high quality art work and mounted on separate pages. The captions should be placed below. The same data should not be presented in tables, figures and text, simultaneously.

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Illustrations Three copies of all figures or photographs should be included with the submitted manuscript. Photographs must be high-contrast, glossy, black and white prints, unmounted and untrimmed, with preferred size of 10 x 15 cm. Color transparencies or photos will be accepted at the discretion of Editorial Board. Figure number, and name of senior author, should be typed on a gummed label and affixed to the back of each illustration. Written permission must accompany any photograph in which the subject can be identified or any illustration that has been previously published. All illustrations must be numbered as cited in the text in consecutive numeric order.

Submission requirements

 Submit only the final version of the manuscript.  The file should be in Microsoft Word.  Provide the printout of the manuscript that exactly matches the disk file. File names must be clearly indicating the contents of each file.  Prepare art as camera-ready copy. Laser prints are accepted. Page charges: There is no page charge for publication in the IJRM. Reprint: Ten reprints will be provided free of charge. The corresponding author will be supplied with 3 free issues.

Ethics of studies involving humans and animals Ethical considerations must be addressed in the Materials and Methods section. 1) Please state that informed consent was obtained from all participants. 2) Include the name of the appropriate institutional review board that approved the project. 3) Indicate in the text that the maintenance and care of experimental animals complies with National Institutes of Health guidelines for the humane use of laboratory animals, or those of your Institute.

Statistics Inadequate or incorrect statistical analyses frequently cause rejection or delays in the review of manuscripts. Where appropriate, authors should seek advice from a professional statistician before the manuscript is submitted.

Ethics of scientific publishing Submission of a paper implies that it reports unpublished work and that it is not under consideration for publication elsewhere. If previously published tables, illustrations or text are to be included, then this should be clearly indicated in the manuscript and the copyright holder's permission must be obtained. Previously published material can be cited in a later review or commentary article, but it must be indicated using quotation marks if necessary. Plagiarism of text from a previously published manuscript by the same or another author is a serious publication offence. Small amounts of text may be used, but only where the source of the material quoted is clearly acknowledged. Fraudulent data or data stolen from other authors is also unethical and will be treated accordingly. Any alleged offence is considered initially by the Editorial Team.

Conflicts of interest Authors must acknowledge and declare any sources of funding and potential conflicting interest, such as receiving funds or fees by, or holding stocks and shares in, an organization that may profit or lose through publication of your paper.

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Copyright The entire contents of IJRM are protected under international copyrights. This Journal is for your personal noncommercial use. You may not modify copy, distribute, transmit, display, or publish any materials contained on the Journal without the prior written permission of it or the appropriate copyright owner.

Review process The submitted manuscripts will be assessed from editorial points of view, at first. Should the manuscript meet the basic editorial requirements; it will enter the peer-review process. The manuscript will then be sent at least to one in-office and two out of office referees for review. The corresponding author will then be informed to the referee’s remark to accept, reject or require modification. Revision: Papers may be returned to authors for modification of the scientific content and/or for language corrections. Revised paper and a letter listing point-for-point response to the reviewers must be submitted to the Editor and must be accompanied by a copy of the original version. Suggestion by the Editor about resubmission does not imply that a revised version will necessary be accepted. If a paper that is returned to the authors for modification is not resubmitted within two months it will be regarded as having been withdrawn and any revised version received subsequently will be treated as a new paper and the date of receipt will be altered accordingly. Authors who resubmit a paper that has previously been rejected must provide the original manuscript and a letter explaining in detail how the paper has been modified. Accepted manuscripts become the property of IJRM. Proofs: A computer print out will be sent to the corresponding author to be checked for only typographical errors and other essential small changes before publication in order to avoid any mistakes. Major alternations to the text cannot be accepted at this stage. Proofs must be returned to the Editor within 3 days of receipt.

Responsibilities of authors The authors are responsible for accuracy of all statements and data contained in the manuscript, accuracy of all references information, and for obtaining and submitting permission from the author and publisher of any previously published material included in the submitted manuscript. The corresponding author will receive an edited manuscript for “final author approval”.

Disposal of material Once published, all copies of the manuscript, correspondence and artwork will be held for 1 years before disposal.

Submit manuscripts to: The Editor in Chief, Iranian Journal of Reproductive Medicine, Research & Clinical Center for Infertility, 2 Bouali Ave, Safayeh, Yazd, Iran. P.O. Box, 89195-999. Telephone: +98 (351) 8247085. Fax: +98 (351) 8247087 E-mail: [email protected] URL: http://www.ijrm.ir

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Iranian Journal of Reproductive Medicine Submission Form Corresponding Author: Manuscript Title: Mailing Address:

Phone: Fax: Cell Phone: E-mail: Check List (Failure to complete will delay processing of the manuscript):              

One original and 3 copies of the manuscript together with three original figures and photographs are enclosed. A floppy diskette or CD containing the manuscript, tables and figures. Abstract size is not exceeded 250 words. The format of manuscript conforms to the IJRM Instructions to Authors. Entire manuscript (including references and tables) are typed double spaced with margins of at least 2.5 cm for each sides of page on one side of A4 paper. Entire manuscript is typed in a font of at least 12 points in Times New Romans. A legend is provided for each figure on a separate page at the end of the manuscript. All symbols are explained in legends and all symbols in legends appear in figures. References are numbered in the order in which they appear in text in parentheses. References are checked for accuracy against original source and formatted according to the IJRM Instructions to Authors. Contents of the manuscript have not been previously published and are not currently submitted elsewhere. All human and animal studies are approved by an Institutional Review Board. All listed authors have seen and approved of the manuscript. I accept responsibility for the scientific integrity of the work described in this manuscript.

Please refer to the IJRM Instructions to Authors for further information. Signature:

Date:

Note: Neither manuscript nor figures will be returned after review. Mail the manuscript to: Dr. Abbas Aflatoonian, Editor in Chief Iranian Journal of Reproductive Medicine, Research & Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, 2 Bouali Avenue, Safayeh, Yazd, Iran. P.O. Box, 89195-999.

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Assignment of copyright and authorship responsibilities Manuscripts published in the Iranian Journal of Reproductive Medicine become the sole property of, with all right in copyright reserved to, the Yazd Research & Clinical Center for Infertility. The undersigned authors hereby affirm that the manuscript entitled: ................................................................................................................................................................ ................................................................................................................................................................ is original and that all the statements asserted as facts are based on the author(s) investigation and research. The manuscript has not been published in any form and is not being submitted for in the form of scientific presentations. If the above requirements are not fulfilled, justification for duplicate publication and permission to republish copyrighted materials must be declared and accompanied by a covering letter. In signing this form, the authors acknowledge that they have participated in the work in a substantive way and are prepared to take full responsibility for the data presented herein. The author(s) in the event of the acceptance of the above manuscript for publication, does hereby assign and transfer to Iranian Journal of Reproductive Medicine all of the rights and interests with respect to the above copyright either in its current or any other form including revised or electronically disseminated versions. All authors must sign: (Please mark the corresponding author)

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Abstracts of the 15th Congress of Iranian Society for Reproductive Medicine Talash Congress Amphitheater Tehran, Iran 18-20 Feb 2009

President: Parsanezhad ME. Scientific Secretary: Kazemeini M. Iranian Society of Reproductive Medicine Chairman: Nowroozi MR.

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Executive Committee 1. Arman E. 2. Habibi V. 3. Mazaheri Z.

4. Moslem M. 5. Moniri ZA. 6. Saeidi E.

Scientific Committee A-Gynecology, Infertility 1. Abdollahifard S. 2. Aflatoonian A. 3. Aghahosseini M. 4. Aghsa MM. 5. Ahangari R. 6. Ahmadi SM. 7. Akbari Asbagh F. 8. Alborzi S. 9. Ale Yasin A. 10. Ali Akbarian A. 11. Arefi S. 12. Asef Jah H. 13. Asgharnia M. 14. Ashrafi M. 15. Ashrafinia M. 16. Azargon A. 17. Azhar H. 18. Badakhsh MH. 19. Basirat Z. 20. Choobsaz F. 21. Dabir Ashrafi H. 22. Davar R. 23. Dehbashi S. 24. Dehghani Firooz Abadi R. 25. Esmaeilzadeh S. 26. Falahi S. 27. Farazday L. 28. Farimani M. 29. Forouhan B. 30. Forozanfar F. 31. Ghadiri M. 32. Ghafoorizadeh Yazdi M. 33. Ghafourzadeh M. 34. Ghahiri A. 35. Ghasem Zadeh A. 36. Habib Zadeh V. 37. Hossein Rashidi B. 38. Joolaee S. 39. Kalantari A. X

40. Kandi Bidgoli T. 41. Karimi M. 42. Kazerouni T. 43. Keikha F. 44. Madani T. 45. Mansouri tarshizi M. 46. Mehdizadeh A. 47. Mehrafza M. 48. Moayed Mohseni S. 49. Moeini A. 50. Mogharab F. 51. Mohamadzadeh A. 52. Mohamadiyan F. 53. Mohammadbeigi R. 54. Mojibian J. 55. Mojibian M. 56. Moosavifard N. 57. Motazedian SH. 58. Nazari T. 59. Parsanejad MA. 60. Poorreza M. 61. Ramezanzadeh F. 62. Raoufi Z. 63. Raoufi 64. Rostami S. 65. Rasekh jahromi A. 66. Sadri S. 67. Sahand M. 68. Saharkhiz N. 69. Saheb Kashaf H. 70. Saremi AT. 71. Sayyad M. 72. Salehpoor S. 73. Shahrokh Tehrani Nejad E. 74. Shahshahani Z. 75. Sharafi SA. 76. Taheripanah R. 77. Tizro GhR. 78. Vahid Roodsari F.

79. Yavangi M. 80. Zadeh Modares SH. 81. Zafarghandi SH.

82. Ziaei S. 83. Zolghadr J.

B- Embryology 1. Abed F. 2. Abutorabi R. 3. Amanpour S. 4. Amjadi SH. 5. Abolhassani F. 6. Akhoondi MM. 7. Aliabadi E. 8. Amir Arjmand MH. 9. Amiri I. 10. Anvari M. 11. Baharvand H. 12. Bahmanpoor S. 13. Beiki AA. 14. Davari M. 15. Ebrahimzadeh AR. 16. Eftekhari Yazdi P. 17. Eimani H. 18. Esmaeil Nejad Moghadam A. 19. Ghafari M. 20. Golalipour M G. 21. Hashemitabar M. 22. Hassani H. 23. Hosseini A. 24. Jalali M. 25. Joursaraei GhA.

26. Kabir Salmani M. 27. Karimian L. 28. Karimpoor A. 29. Kermani T. 30. Khalili MA. 31. Khazaei M. 32. koshesh L. 33. Movahedin M. 34. Nasr Esfahani MH. 35. Nematollahi N. 36. Niknafs B. 37. Nikzad H. 38. Noori M. 39. Rezazadeh M. 40. Sadeghi MR. 41. Sadrkhanloo R. 42. Saeidi G. 43. Salehnia M. 44. Salsabili N. 45. Shafeei M. 46. Shahverdi AH. 47. Sobhani A. 48. Soleymani M. 49. Talayee T. 50. Yousefi B.

C- Genetics 1. 2. 3. 4. 5. 6.

Biglari AR. Ghafari S. Ghasemi N. Gourabi H. Kalantar SM. Modares MH.

7. Mowla SJ. 8. Mozdarani H. 9. Nowroozinia M. 10. Jafari Poor H. 11. Rezapour S. 12. Sheikhha MH.

D- Urology 1. 2. 3. 4. 5. 6.

Abbasi H. Amir Jannati N. Ayati M. Babolhavaeji H. Fahimi R. Farahi F.

7. Hosseini SJ. 8. Jamshidian H. 9. Kazemeini M. 10. Moin MR. 11. Nowroozi MR. 12. Poormand GhR.

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13. Pooyan O. 14. Radkhah K. 15. Saheb Kashaf S. 16. Sedighi Gilani MA. 17. Shakeri S.

18. Shamsa A. 19. Soofi H. 20. Vahidi SD. 21. Yari H. 22. Ziaei AM.

E- Midwifery 1. Abad M. 2. Ahmadi M. 3. Ebrahimitavani M. 4. Dolatian M. 5. Forohari S. 6. Hadipoor L. 7. Hajizade Z. 8. Jannatiatai P. 9. Jamshidi Manesh M. 10. Jannesari SH. 11. Jokar A. 12. Khodakarami N. 13. Korpi M.

14. Merghati E. 15. Mirmohammad Ali M. 16. Mirmowlayee SH. 17. Modaresi Z. 18. Nahidi F. 19. Ozgoli G. 20. Roosta F. 21. Sheikhan Z. 22. Simbor M. 23. Tehranian N. 24. Torkzahrani SH. 25. Zendezaban N. 26. Valizadeh M. 27. Vaseghrahim Poor SF.

F- Others 1. Dezhkam 2. Haghshenas G.

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3. Kazemi AH.

Abstracts of the 15th Congress of Iranian Society for Reproductive Medicine

Contents

ORAL PRESENTATIONS……………….………………..……………1-38 POSTER PRESENTAIONS…………………………..……...…...…...39-71 AUTHOR’S INDEX……………………………………...……….…..…72-75

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Abstracts of 15th Congress of Iranian Society for Reproductive Medicine

A- Oral Presentations 1- Infertility, Gynecology O-1 Hysteroscopic Direct Endometrial Embryo Delivery (DEED) Kamrava M1, Hall JL2. 1 West Coast IVF Clinic, Beverly Hills, California 90212, USA. 2 LA Center for Embryo Implantation, Beverly Hills, CA 90212, USA. E-mail: [email protected]

Introduction: Prior to the Success of Blastocyst Subendometrial Embryo Delivery (SEED) versus the routine blind transfer technique of catheter, introduction into the uterine cavity has been previously reported. This technique appears to increase pregnancy rates while reducing the side effects. We set out to use a similar technique, which utilized a flexible mini-hysteroscope with a flexible catheter for direct delivery of embryo(s) at the 4-12 cell stage onto the endometrium under direct visualization. Objective: Since the traditional embryo transfer technique is 'blind' and may contribute, in part, to the failure of implantation in many IVF cases, we sought to develop a procedure that allows placement of embryo(s) at the desired location in the uterus under direct visualization". To provide an objective, visually confirmed, replicable technique for embryo transfer. Materials and Methods: 13 consecutive patients, with the infertility of various origins (average age = 37.6 years), underwent hysteroscopic DEED on day 2 or 3 after fertilization. Controlled ovarian hyperstimulation was done using standard protocols. Transvaginal oocyte retrieval was performed under local anesthesia with mild sedation. All women received some type of luteal support, be it progesterone or hCG. Oocytes were fertilized and cultured in a human tubal fluid formulated medium at 37 oC and 5% CO2 in air. Embryos were transferred after 48-74 hours post fertilization. Results: Nine (9) pregnancies were ensued (7 clinical and 2 biochemical). There was no incidence of uterine scratching, bleeding, or ectopic pregnancy. Of note, neither placenta accrete and percreta nor pregnancy-associated-hypertension occurred. There was 1 twin pregnancy.

No. of patients started 13 No. of patients Cancelled 1 No. of Oocytes Retrieved (Average) 8.4 (7-14) No. Embryos Tx (Average) 3.4 (3-4) No. Pt. Pregnant 9 No. Biochem 2 No. Clinical 7 Twins 1 Singletons 6 Conclusion: Together, these preliminary data suggest hysteroscopic early embryo transfer results in a high pregnancy outcome. The accuracy of the procedure is beneficial to patients who have experiences of difficulty in ET. Key words: Embryo, Transfer, Hysteroscopy.

O-2 PCOS, still a debate Salehpour S. IRHRC – Shahid Beheshti University (MC), Tehran, Iran. E-mail: [email protected].

PCOS is a syndrome recognized from half a century, but still there are many points unclear in its clinics and management. What to do with PCOS in adolescence? When does PCOS pathophysiology start? Can we prevent it from childhood or it goes back to the intrauterine life? What is the best way to subside insulin resistance? Where and when is the place of drug therapy to reduce insulin resistance? Is it not better to start with diet and exercise instead of using drugs? Which diet is better? How can we treat the infertility? Which kind of treatment for the ovulation induction is more effective? What to do to prevent metabolic syndrome? What's the place of life style in metabolic syndrome?

O-3 Oxidative stress and antioxidants: exposure and impact on female fertility Akhbardeh M. Boston Medical University, Boston, USA. E-mail: [email protected]

Introduction: Reproductive failure is a significant public health concern. Although, relatively little is known about the factors affecting fertility and early pregnancy loss, but a growing body of literature suggests that environmental factors and lifestyle plays an important role. There is sufficient evidence to hypothesize that diet, particularly its

Iranian Journal of Reproductive Medicine, Vol. 7, Suppl 1, Winter 2009

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constituent antioxidants, and oxidative stress (OS) may influence the timing and maintenance of a viable pregnancy. We hypothesize that conditions leading to OS in the female affect time-topregnancy and early pregnancy loss. Materials and Methods: We review the epidemiology of female infertility related to antioxidant defenses, oxidation and examine the potential sources of OS from the ovarian germ cell through the stages of human pregnancy and its complications related to infertility. Articles were identified through a search of the PubMed database. Results: Female OS is a likely mediator of conception and threshold levels for OS exist, dependent on anatomic location and stage of preconception. Conclusion: Prospective pregnancy studies with dietary assessment and collection of biological samples prior to conception with endpoints of timeto-pregnancy and early pregnancy loss are needed. Key words: Antioxidants, Female Infertility, Oxidative stress.

O-4 Study of the risk factors of premature ovarian failure Ghasemzadeh A, Beyhaghi E, Farzadi L. Department of Obstetrics and Gynecology, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail: alghasemzadeh@ yahoo.co.uk

Introduction: Premature ovarian failure (POF) is a disorder characterized by cessation of menstruation before the age of 40 years. The causes of POF are extremely heterogeneous. Acquired forms such as those occurring after treatments for neoplastic diseases or autoimmune diseases account for many cases. POF has a strong genetic component with X chromosome abnormalities. It has been proposed that some environmental factors and dietary habits may play a role in this regards. This study was aimed to evaluate the probable risk factors of POF. Materials and Methods: In a cross-sectional, analytically-descriptive setting, 80 women with amenorrhea and/or infertility age of 40 years or less were recruited in Tabriz Alzahra Hospital and infertility clinics during a 13-month period. Two separate measurements of serum FSH confirmed the diagnosis of POF in these patients (FSH>30IU/L). Eighty other women, without amenorrhea or infertility, enrolled as healthy controls. Probable risk factors were compared between the two groups.

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Results: A positive history of previous operation on ovaries, presence of similar signs and symptoms in patient's sister, lower age of maternal menopause and red or fish meat-insufficient diets were independently related to POF comparing with the healthy counterparts. In multivariate study, red or fish meat-insufficient diets were the sole independent predictors of POF. There were no significant differences regarding the location of inhabitance, smoking, living around high-pressure electricity poles or industrious areas and the use of cell-phones between the POF and the healthy groups. Conclusion: To our knowledge, the current study is the first one to focus on the environmental and dietary risk factors related to POF. Furthermore, controlled studies are recommended to be carried out. Key words: Premature ovarian failure, Diet, Environment.

O-5 Survey of relative frequency of pathological results of endometrial biopsy of infertile women undergoing laparoscopy at AlZahra Hospital, Rasht Asgharnia M, Mirblook F, Esmailzadeh Y. Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran. E-mail: [email protected]

Introduction: Infertility has been defined as the failure to undergo pregnancy followed by sexual intercourse without the prevention methods for one year that involves nearly 10-15% of couples. Gynaecology and Obstetrics laparoscopy is used for direct observation of pelvic and peritoneal cavity. Endometrial biopsy is relatively cheap, performed with a curette in the time of laparoscopy and evaluates response of endometrium to ovarian activity and uterine caues of infertility such as inflammation, polyp, fibroma and malignancy. Objective: The aim of this study was to determine the endometrial biopsy results in infertile women who underwent laparoscopy and biopsy during the study period. Materials and Methods: The files of all women underwent laparoscopy and biopsy, hospitalized in this center from April 2005 –to September 2006, were studied. Necessery data including: pathological results of endometrial biopsy, demographic data, history of obstetrics and surgery, etc. were elicited from the files and recorded. Finally, collected data were analyzed by SPSS software.



Results: Biopsy results of 143 infertile women were: 72 cases (50.3%) proliferative endometrium; 40 cases (28%) luteal endometer; 5 cases (3.5%) malignancy; 5 cases (3.5%) polyp; 5 cases (3.5%) liomyoma; 4 cases (2.8%) hypoplastic endometrium; 1 case (0.7%) endometritis and 11 cases (7.7%) insufficient samples. 52 cases of infertile women had polycystic ovary syndrome (36.4%). Conclusion: According to the results of this study, performing endometrial curettage should be regarded as a part of infertility evaluations during laparoscopy. The chance of pregnancy is increased by diagnosis of the cases such as polyp and liomyoma; furthermore, the discovery of malignancy cases results in on-time treatment of patient. Key words: Pathology, Endometrial biopsy, Female infertility.

Results: Numbers of mature follicles (9.5 ± 6.88 in Letrozole vs. 8.79 ± 5.53 in Clomiphene), size of dominant follicles (16.09 ± 2.86 vs. 15.27 ± 1.77), easy performance of IUI (90.5 vs. 89.7), incidence of OHSS (19% vs. 13.8%), pregnancy rate (14.28% vs. 6.9%), endometrial thickness (8.64 ± 1.72 vs. 7.82 ± 1.82) and rate of miscarriage (6.9% vs. 4.76%). Conclusion: At first step of examination, it seems rate of pregnancy is higher in Letrozole group. Rate of miscarriage also seems higher in Clomiphene group but based on statistical outcomes, there is no difference between two groups and variations are insignificant. Recently published studies imply that Letrozole may have teratogenic effects so it is better to wait for the results of more studies about its effectiveness. Therefore, clomiphene citrate stays as first choice treatment of anovulatory infertility and PCOS.

O-6 Comparison of Letrozole and Clomiphene citrate in women with polycycstic ovarian syndrome undergoing ovarian stimulation and intrauterine insemination

Key words: PCOS, Letrozole, Clomiphene citrate.

Erfanian Ahmadpoor M1, Mansoori Torshizi M2 .

Refahi S, Mashoufi M, Dadashi L, Jabbarzadeh T.

1 Shahinfar School of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran. 2 Novin Infertility Centre, Mashhad, Iran.

Tabriz University of Medical Sciences, Tabriz, Iran.

E-mail: [email protected]

Introduction: Hysterosalpingography is a radiographic examination of endocervical canals, uterine cavity and fallopian tubes with the use of a radiographic contrast medium. The goal of this study was to evaluate the hysterosalpingographic features of women with infertility. Materials and Methods: The study included hystosalpingograms of 100 infertile women who were referred to the hospitals affiliated to Tabriz University of Medical Sciences, Iran, from January 2007 to June 2008. Results: The obtained findings were abnormal in 42% of cases. 79% had primary infertility. Abnormal uterus was seen in 25% and abnormal fallopian tubes in 21%. Abnormal uterine shape and tubal blockage were the commonest abnormal findings regarding uterine and fallopian tubes. Conclusion: In sum, the uterine abnormalities were more than tubal abnormalities and pelvic inflammation disease was the most common cause of abnormality.

Introduction: Polycycstic ovarian syndrome is one of frequent causes of infertility. In PCOS, the overies start secreting slightly more androgens. This may cause to stop ovulation, irregular menstrual periods and infertility. Materials and Methods: To compare effects of two ovulatory agents (Letrozole and Clomiphene citrate), sixty infertile women with PCOS, eligible for ovulation induction and IUI, were divided randomly in two groups. First group received two Letrozole tablets (5mg) between cycle days 3 and 7 and second group was administered by two Clomiphene citrate (100 mg) betweens cycle days 3 and 7. All patients were administered two ampoules of HMG (350 IU) per day between cycle days 8 and 11. Transvaginal sonography was done for them at 11th day of cycle and the number of mature follicles, size of dominant follicles and endometrial thickness was measured. Two hCG ampoules (10000 IU) were administered on appropriate times and IUI was performed 36 hours later.

O-7 Hysterosalpingography study uterine and tubal abnormalities in infertile women

E-mail: [email protected]

Key words: Hysterisalpingography, ART, Congenital uterine anomaly.


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O-8 Comparison of the oral estrogen and later dose injection of Depomedroxy progesterone acetate (DMPA) in the treatment of abnormal uterine bleeding after the use of DMPA Sakhavar N, Teimoori B, Mirteimoori M. Department of Obstetrics and Gynecology, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. E-mail: [email protected]

Introduction: Depomedroxyprogestron Acetate (DMPA) is one of the long-acting methods of Contraception. It is usually administered intramuscularly (150 mg) after every 3 months. Its efficacy is the same as IUD and sterilization, but problems of spotting and amenorrhea have been seen after dosage. During the first 6 months of use, it often leads the women to discontinue the treatment. So, we take a decision to find an absolute way of treatment of these problems to prevent the discontinuation of this contraception effective method. Materials and Methods: This clinical trial study was excersiced, in 2006-2007 in Zahedan, on the women in reproductive ages who were referred to obstetric clinics and had regular menstruation before receiving DMPA and abnormal uterine bleeding (AUB) such as; spotting or metrorrhagia after its use, selected and divided in two equal groups randomly. In first group, we prescribed oral conjugated estrogen 1/25 mg daily, and in second group, 150 mg intramuscular DMPA (its later dose) and work up our patients for two weeks. We used SPSS software and analyzed data by Chi square and t-test and considered significant differentiations if P-value was (p