Background: One of the most important cause of infertility in men is spinal cord injury (SCI). In our country the incidence of this kind of infertile men raised after the war. Reduced fertility in men with SCI results from inability to ejaculate and poor semen quality. IVF-ICSI technique is one of the most effective methods for treatment of these patients. This study compares the influence of some semen parameters of healthy and SCI men on the rate of successfulness of ICSI method in both groups.Materials & Methods: 71 male with SCI and 44 healthy men (unexplained infertile couples) were treated with ICSI method between 1376 - 1380 in Kowsar Assisted Reproductive center. Routine semen analysis was performed to evaluate semen's parameters including: volume, PH, Viscosity and Liquification in both group.Results: The results show that these paramerters of semen don't influence the rate of fertilization on both groups, except Viscosity (p=0.013) Conclusion: It seems that the best choice of assisted reproduction treatment for couples with spinal cord injured men is IVF - ICSI technique. Of course several parameters can influence The fertility in these couples, so we need more researches in this field.

Introduction: Despite the improvements in assisted reproductive technologies, ART Process is with a low successing rate. There are two major determinants of implantation: embryos and the endometrium. Although progesterone secretion is considered the major hormonal event during the luteal phase, E2 appears to play a crucial role as well.Methods: Patients who were undergoing ICSI with controlled ovarian hyperstimulation using a GnRH analog participated in the study. Patients were prospectively randomized into two groups for luteal phase supplementation. Patient's in-group I did not receive exgenouse E2 supplementation during the luteal phase. Patient's in-group 2 received 2mg of E2 polbid that starting on day 3 after E.T.serum concentrations of E2 and progesterone were measured in all patients on day HCG INJECTION and on day 12 after E. T. pregnancy and implantation rate were documented. Student's ttest and Fisher's exact were used for the statistical analysis of the date.Results: Higher E2 and progesterone levels found during the luteal phase and higher pregnancy rate were recorded in the patients who receive E2 supplementation and were treated with the long GnRH analog protocol.Conclusion (s): The results of this study indicate the patients who are treated with the long GnRH analong protocol for controlled ovarian hyperstimulation, the addition of E2 to the progestin support regime may have a beneficial effect on pregnancy rate.

Background: There has been an increase in number of obese infertile females booked for advanced infertility treatment procedures like in vitro fertilization (IVF) and INTRA CYTOPLASMIC SPERM INJECTION (ICSI). The knowledge of impact of body mass index (BMI) on reproductive outcome can help to counsel these patients.Objective: To compare reproductive outcome in females of different BMI after ICSI.Materials and Methods: Cross-sectional study of 323 females was conducted from June 2010 till August 2011. Females were grouped on the basis of BMI; underweight, (BMI <18 kg/m2), normal weight, (BMI 18-22.9 kg/m2) overweight (BMI 23-25.9 kg/m2) and obese (BMI ≥26 kg/m2). The procedure involved down regulation of ovaries, controlled ovarian stimulation, ovulation induction by hCG, oocyte pickup, in vitro fertilization and embryo transfer of blastocysts. The oocyte yield and embryological data of all BMI groups was compared by ANOVA (analysis of variance). Pregnancy outcome of these was categorized as; no conception bhCG <5 m IU/ml, preclinical abortion with bhCG >5 m IU/ml, no cardiac activity on trans vaginal scan (TVS) and clinical pregnancy with bhCG >5mIU/ml and cardiac activity on trans vaginal scan. Results: Females with BMI 23-25.99 kg/m2 had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI ≥26 kg/m2.Conclusion: A BMI cut off value of above 26 kg/m2 in our study population is associated with a negative impact on pregnancy outcome.

Since the introduction of INTRACYTOPLASMIC SPERM INJECTION (ICSI), the importance of SPERM morphology assessment has been given attention in the assisted reproduction field. It is important to select a good-quality motile SPERMatozoon for giving a better embryo quality in assisted reproduction technique (ART). In ICSI, SPERM morphology evaluation is limited due to its low magnification. However, by using INTRACYTOPLASMIC morphologically selected SPERM INJECTION (IMSI), the selection is done at high magnification of ×6600 using motile SPERM organelle morphology examination (MSOME). Therefore, it becomes possible to select a good quality SPERMatozoon with an intact nucleus that may enhance the pregnancy outcomes. Although all patients can benefit from IMSI, it is important to standardize which techniques (IMSI or ICSI) could be used or which group of patients benefit from IMSI to maximize the efficiency of this advanced technology.

Objective: The present study aimed to simultaneously evaluate the association between expression of three potential factors [post-acrosomal sheath WW domain-binding protein (PAWP), phospholipase Cζ (PLCζ), and truncated form of the kit receptor (TR-KIT)] as candidates of oocyte activation with fertilization rate and early embryonic development.Materials and Methods: In this experimental study, semen samples were collected from 35 INTRA-CYTOPLASMIC SPERM INJECTION (ICSI) candidates and analyzed according to World Health Organization criteria (2010). Each sample was divided into two parts. The first part was processed for insemination by density-gradient centrifugation (DGC) and the second part was prepared for assessment of SPERM morphology (Papanicolaou staining), DNA fragmentation [transferase dUTP nick end labeling (TUNEL)], and three SPERM-borne oocyte-activating factor (s) (SOAFs)-PLCζ, PAWP, and TR-KIT.Results: Significant positive correlations existed between the percentages of PLCζ, PAWP, and TR-KIT with fertilization rate. In addition, significant negative correlations existed between the percentage of DNA fragmentation with the percentages of PLCζ and PAWP. We did not find a relationship between percentages of PLCζ, PAWP, and TR-KIT with embryo quality and pregnancy rate (P>0.05). There was a significant negative correlation between percentage of DNA fragmentation with fertilization and embryo quality.Conclusion: Oocyte activation was associated with the studied SPERM factors (PAWP, PLCζ, and TR-KIT). These factors might hold the potential to be considered as diagnostic factors in the assessment of semen samples to evaluate their potential to induce oocyte activation. In addition, we observed a significant association between DNA fragmentation with fertilization, as well as embryo quality and expression of PAWP and PLCζ, which indicated that men with high degrees of DNA fragmentation might require artificial oocyte activation. Whether such action should take place, and its cost and benefits should be evaluated in the future.

Objective: Melatonin, the chief secretory product of the pineal gland, regulates dynamic physiological adaptations that occur in seasonally breeding mammals as a response to changes in daylight hours. Because of the presence of melatonin in semen and the membrane melatonin receptor in SPERMatozoa, the impact of melatonin on the regulation of male infertility is still questionable. The aim of this study was to determine the effects of endogenous melatonin on human semen parameters (SPERM concentration, motility and normal morphology), DNA fragmentation (DF) and nuclear maturity.Materials and Methods: In this clinical prospective study, semen samples from 75 infertile men were routinely analyzed and assessed for melatonin and total antioxidant capacity (TAC) levels using the enzyme-linked immunosorbent assay (ELISA) and colorimetric assay kits, respectively. DF was examined by the SPERM chromatin dispersion (SCD) test.Acidic aniline blue staining was used to detect chromatin defects in the SPERM nuclei.Results: There was no significant correlation between seminal plasma melatonin and TAC with SPERM parameters and nuclear maturity. However, we observed a positive significant correlation between DF and melatonin level (r=0.273, P<0.05).Conclusion: Melatonin in seminal plasma is positively correlated with damaged SPERM DNA of infertile patients. The mechanism of this phenomenon needs further study.

Introduction: Implantation of transferred embryos in the uterus after IVF_ICSI cycles is an important process that less information about it is available. Zona hatching method is a suggested approach for this goal. The aim of this research is about performance of zona hatching by laser.Methods: In this study 32 patients that enrolled had IVF/ICSI cycles depend on inclusion criteria of study that they included patients who were more than 35 years old, at least one previous failure of IVF, thickness or hardness of zona pelucida, the laser hatching performed on them. Then the pregnancy test ( b-subunit) was done and patients with a positive result are followed with vaginal ultra sonography.Results: Our successful results belonged to the patients who had more than 35 years old. So 50% of pregnancy was positive and then 20% about the zona pelucida thickness and minimum results were about the previous failure of IVF/ICSI cycles.Conclusion: Laser hatching on the embryos of women more than 35 years old with IVF/ICSI cycle will optimize pregnancy outcomes.

BACKGROUND AND OBJECTIVE: The success rate of INTRA-CYTOPLASMIC SPERM INJECTION (ICSI) is dependent not only on egg and SPERM quality but also is related to endometrial receptivity. Today one of the main obstacles in the treatment of infertility is reduced implantation rates in infertility treatment cycles, despite having some good quality embryos. Therefore, this study was designed to determine the best appropriate level of endometrial thickness on INTRA-CYTOPLASMIC SPERM INJECTION outcome.METHODS: A cross-sectional study was performed on 198 patients in ICSI/ET cycles in Fatemeh-Zahra Infertility center of Babol University of medical science (Babol, Iran) during 2009-2010. Sonography feature of the endometrium (thickness and pattern) and various other variables (maternal age, cause and duration of infertility and number of retrieved oocyte) in pregnant (according to positive B-HCG test and presence of fetal heart beat on vaginal sonography) and non pregnant patients were compared.FINDINGS: A total of 198 cycles were analyzed. Pregnancy rate was 46 (23.2%). Most pregnancy rate (50%) was among patients with an endometrial thickness 9.2-11.7 mm. Duration, type and etiology of infertility, endometrial pattern and number of retrieved oocyte were not correlated to ICSI outcome. Endometrial thickness and maternal age is a predictive factor of success rate in ICSI treatment cycles (p<0.05).CONCLUSION: Endometrial thickness is a good predictive factor for ICSI outcome. We can decide for embryo transfer or freezing if endometrial thickness and pattern are inappropriate.

Background: Endometriosis is one of the most challenging diseases that constitute 20%-40% of women searching for their infertility diagnosis.Objective: This study was undertaken in order to compare the outcome of IVF/ICSI (In Vitro Fertilization/INTRA CYTOPLASMIC SPERM INJECTION) in women with endometriosis, using tubal factor infertility as controls.Materials and Methods: From 2005 to 2006 a retrospective study was carried out in patients with endometriosis (n=80) and tubal infertility (n=57) after treatment with IVF/ICSI. The main outcome measures were ovarian responsiveness, implantation, pregnancy, live birth and twin birth rates. Appropriate statistical analysis was performed using X2 and student t-tests.Results: The mean duration of infertility was significantly lower in women with moderate to severe endometriosis than the tubal factor group (p<0.01). There was also a significant difference in history of ectopic pregnancy between endometriosis and tubal factor groups (p<0.001). However no differences were found in mean number of ampuls of hMG, duration of HMG INJECTION, number of MII oocytes, number of embryo transferred, implantation and pregnancy rates, live birth and twin birth rates between compared groups.Conclusion: Our results suggest that ovarian response and uterine receptivity are not impaired in women with endometriosis versus tubal infertility.