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Background&Objective: Varicocele represents the most common corrigible surgery in infertile men. The aim of present study was to evaluation the effect of varicocelectomy on heptads semen parameters in patients with abnormal semen parameters. Materials&Methods: This study was conducted on infertile patients who have abnormal semen analysis according to WHO parameters and to an urologist diagnosis, they have varicocele size with grade II, III, they came to infertility clinic of Imam Khomeini Hospital, Sari, Iran, 2004. The Inguinal varicocelectomy was performed over these patients by an urologist. They follow up on the basis of varicocele, post surgery complication, and semen analysis for three months. Results: 67 patients participated in this study with the mean age of 33/6±7/3 and a range of 20-50 years. The patients’s infertility range was 2-20 years, and with the mean 6/5±4/02. %58 has varicocele with grade two and %42 with grade three. In this study, the significant change in total sperm count, sperm motility, sperm morphology (P<0.05), was observed in patients before and after varicocelectomy. It hasn’t also observed any significant association between heptads semen analysis parameters and varicocele grade. Conclusion: Performing varicocelectomy could be useful improvement of semen analysis parameters and in the possible treatment of infertility in men as well.

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Background&Objective: The infertility and its psycological problems can be considered as one of the important difficulties among married couple. Nearlly half of the infertility related to the men. This study was set up to determine the most common risk factors of male infertility in men attending infertility clinics in Shiraz. Materials&Methods: A case – control study was conducted in which 268 men. 161 fertile men were compared with 108 infertile men from the point of risk factors such as smoking habits, drug consumption, hernia, varicocele, job and BMI. Results: Logestic regression analysis, Risk estimate (adds Ratio), and t-test demonstrated that hernia, varicocele, ranitidine consumption, Job and BMI all have statistically significant associations with infertility in men. Odds Ratios of 2.5 for hernia, 4 for varicocele, 2.9 for ranitidine consumption, 2.3 for workers (simple, semiskilled and skilled), t=3.5 (P<0.05). With an increase of one cigarette per day there was decrease 1% in motility of sperm .With an increase of one year of cigarette smoking, the number of sperm was decrease about 800000. The BMI in infertility men was <25. Conclusion: This study showed that the most common factor in men infertility in Shiraz are varicocele and hernia and hard works can cause testicular injury.

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Background and Objective: There are different methods to improve sperm parmeters including swim up.Sperm washing is a basic step in This method during 2007. It seems that two times washing cause bether result especially in high viscosity sample and sample it is not liqufy. The aim of this study is to compare the single and double washing swim up method on sperm parameters.

Materials and Methods: This study was carried out on 50 semen samples referred to Fatemeh-Alzahra infertility center of Babol University of Medical Sciences during 2007. Semen samples had the following characteristics: volume 2-5ml, count>20 million/ml, motility>50% and normal morphology>14%. Sampling condition were completely considered. Sperm parameter analysis carried out after two times washing. Data entered to SPSS-10 and analyzed by repeated measurement and paired T-Test and p-value<0.05 considered statistically significant.

Results: Semen volume mean was 4.050±1.006. Mean sperm motility in one and two times washings increased (P<0.05), but there was not statistically significant differences between one and two times washing. In grading analysis, by increasing the washing, grade III, IV increase and grade I decrease (P<0.05). Sperm morphology mean increased with washing but it is not statistically different between one and two times washing.

Conclusion: This study showed that swim up method is effective method for sperm preparation and two times washing cause recuperation of sperm parameters.

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Background and Objective: Success rate of IVF depends on infertility factors and its treatment cycle. Different methods of treatment and different centers have reported various rates of success. The aim of this study was to evaluate the fertility outcome after IVF and related factors. Materials and Methods: This descriptive analytic study was performed on 150 infertile couples following IVF in Montaserieh Infertility Center, Mashhad University of Medical Sciences, Mashhad, North – East of Iran during 2001-06. Data was collected by a questionnaire including woman's age, husband's age, infertility factor, spermogram, infertility period, the number of follicles caused by treatment, the number of oocytes, the number of produced and transferred fetus and treatment outcomes. Data was analyzed by SPSS software and Chi-square, t-studen test, One-way ANOVA and logistic regression. Results: The mean age of women was 29.7±5.4. The mean±SD follicles oocytes and transferred fetus were 11±6, 6±3.9 and 2.6±1.5 respectively. There was significant relation between the number of follicles (P<0.05), obtained oocytes (P<0.05) and transfered fetus (P<0.05) with the success rate of IVF. The fertility rate was 24.6%. There was no significant relation between the age groups and fertility rate. Conclusion: This study showed that ovarian response to ovulation stimulation and the number of transferred fetus are the important and effective factors for predicting the outcomes of IVF.

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Background and Objective: Many different factors and problems can cause infertility. This study carried out to compare NK, T and B lymphocyte populations in peripheral blood of fertile and infertile women.

Materials and Methods: In this case - control study 30 infertile women and 15 non pregnant women participated. The non pregnant women had a history of at least two alive children as a control group. The monoclonal antibodies and flowcytometry were used for evaluation of T cell subpopulations (CD3, CD4, CD8), B cells (CD22) and NK cells (CD56) in fertile and infertile women.

Results: NK cells (CD56) significantly increased in infertile women compared with control groups (P=0.009) and T lymphocytes CD3, CD4 significantly reduced in infertile women compared with fertile women (P=0.013, P=0.004, respectively). CD4/CD8 ratio reduced in infertile women compared with fertile women (P=0.05). There was no difference in B cells and CD8 T cells in infertile women compared with controls.

Conclusion: This study showed that NK cells increase and CD4 T lymphocytes reduce in infertile women. Our results suggest the immunological alterations may be related to infertility.

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Background and Objective: Anesthetic agents effect on pregnancy in operating room personnel is a challenge in anesthesiology. This study was carried out to determined pregnancy complications among hospital operating room personals in Fars province – Iran.

Materials and Methods: In this case-control study, 122 women working in operating rooms of governmental Fars province hospitals during their pregnancies with different jobs considered as case group. 122 women working in internal and pediatric wards considered as control group. The history of pregnancy complications including infertility, abortion, preterm labor, fetal death, neonatal death and low birth weight obtained using questionnaire. Data were analyzed using SPSS-15 software and Chi-Square test.

Results: The incidence of abortion was 19.8% and 16% in case and control group respectively, this difference was not statistically significant. Infertility was significantly higher (8.2% versus 2.5%) in case group than control group (P<0.05). No significant differences in incidence of preterm labor, fetal death, neonatal death and low birth weight were seen between two groups.

Conclusion: This study showed that the incidence of pregnancy complications is similar between women working in operating room and those working in other hospital wards but the prevalence of infertility is higher in operating room personnel than those of other wards.

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Background and Objective: The incidence of ectopic pregnancy is increasing due to artificial reproductive technology and increasing rate of sexual transmitted diseases. Ectopic pregnancy is the most common cause of maternal mortality in the first trimester and it reduces the chance of future successful pregnancy. Identifying the risk factors can help to reduce the maternal mortality and morbidity due to early diagnosis and on time treatment. This study was carried out to assess the risk factors in ectopic pregnancy in northern, Iran. Materials and Methods: This case control study was carreid out on 150 patients with ectopic pregnancy as cases and 300 women with normal pregnancy as controls. The subjects were selected from teaching hospital in Babol in northern Iran, during 2005-09. The risk factors include history of tuble surgery, ectopic pregnancy, cesarean section, pregnancy with IUD, infertility, assisted fertility with IUI, multiple partener, pre-eighteen years marriages were recorded for each subject by direct interview and file. Data were analyzed using SPSS-16 and Chi-Square and exat Fisher tests. Results: Theraputic assisted fertility with IUI (95% CI: 3.02-185.09, OR: 23.6, P<0.05), previous ectopic pregnancy (95% CI: 1.90-73.94, OR: 8.19, P<0.05) and cesarean section history (95% CI: 1.1-2.6, OR: 1.7, P<0.05) increased the possibility of ectopic pregnancy. There was not significant differnces between pre- eighteen years marriages, infertility history and multiple partener in cases compared to controls. Conclusion: This study showed that assisted fertility with IUI, previous tubal surgery, pregnancy with IUD, previous ectopic pregnancy and cesarean section are the main risk factors of ectopic pregnancy in northern, Iran.

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Background and Objective: Despite enormous progress in the understanding of human reproductive physiology, the underlying cause of male infertility remains undefined in about 50.0% of cases, which are referred to as idiopathic infertility and affects about 5.0-7.0% of the general male population. Human apurinic/apyrimidinic endonuclease (ApE1) is a multifunctional protein that has an important role in the base excision repair (BER) pathway. ApE1 SNP T>G found in exon 5 led to substitution of Asp>Glu at codon 148. This study was done to evaluate the association of ApE1 Asp148Glu polymorphism and the risk of idiopathic male infertility. Methods: In this case-control study, blood samples were collected from 90 patients diagnosed with idiopathic male infertility and 90 healthy men, genotyped by Allele-Specific PCR (AS-PCR) method by using specific primers that were designed and the association between genotype and allele frequencies in cases and controls were estimated. Results: There was no significant association between ApE1 gene polymorphism at codon 148 in case and control groups. Conclusion: No significant association was found between the Asp148Glu polymorphism and idiopathic male infertility.

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Varicocele is a deficiency of the testicular veins which is recognized by elongation and tortuosity of the pampiniform or cremasteric venous plexus and can lead to impaired spermatogenesis. Varicocele intensity is associated with the reduction of male fertility potential. This review article discusses the effects of varicocele on spermatogenesis process and fertility potential, etiology of varicocele, therapeutic approaches, and the result of treatment. All the published papers from 1975 to 2018 from databases bank such as Science Direct, Google Scholar, Scopus, and PubMed with keywords; infertility, varicocele, varicocelectomy, spermatogenesis, clinical outcome were collected and within these papers, only 74 papers were included for this study. Increased of testicular temperature, backflow of toxic metabolites from the kidney or adrenal glands, hypoxia, hormonal disturbances and oxidative stress are the most prevalent pathogenic cause of varicocele that they can alter testis and sperm functions. Several studies show that varicocelectomy can improve sperm parameters, chromatin statue and fertility potential in infertile men with varicocele. Possibly, treatment of varicocele before assisted reproduction technologies could increase the chance of spontaneous pregnancy in these infertile men.

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Background and Objective: Sperm dysfunction and damage in spermatogenesis are the most common causes of male infertility. Diazepam is also a painkiller for benzodiazepines that can be addictive for a long time. This study was done to determine the effect of Diazepam on testicular tissue parameters and spermatogenesis in Rats.
Methods: In this experimental study, 30 Wistar male rats with a 250-200 gram weight were randomly allocated into 5 groups. Experimental groups were received diazepam with doses of (2, 3, 4, 5 mg/kg/bw) for 14 days, intraperitonally. Serum physiology was injected in control group. The animals were anesthetized and the testes and epididymis ductus defran were removed for examination, sperm motility, and percentage of live sperm.
Results: Weight, large and small testicular diameter, percentage of live sperm and number of sperm moving forward were reduced with injection groups, at a dose of 3 mg / kg in all factors except the number of sperm moving forward in compared to the control group. In other groups, only testicular weight was significantly reduced at a dose of 2 mg/kg (P<0.05).
Conclusion: Diazepam can affect spermatogenesis process in rats.

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Background and Objective: The increasing usage of cell phones, have raised concerns about the potential effects of these waves on the health of individuals. In the present research the effect of mobile phone radiation on the expression of DAZL gene in BALB/c mice were studied.
Methods: 18 male mice were divided into three groups: Control, sham-exposed and experimental. Experimental mice were exposed to mobile waves for 2 hours daily, during 3 weeks. After 3 weeks, the testes were excised and RNA extraction and Real-Time PCR were performed. Sperm counts in deferen channel and the study of sperm motility in epididymis were done.
Results: The percentage of non-progressive sperm motility significantly increased in experimental group in compared to control group (P<0.05).The level of DAZL gene expression in the experimental group was significantly lower than the control group (P<0.05). Weight of the testis, percentage of live sperm, percentage of rapid progressive sperm motility and percentage of slow progressive sperm motility non-significantly reduced in experimental group in comparison with controls.
Conclusion: Exposure to cell phone waves for 21 days and 2 hours a day impairs spermatogenesis by reducing the quality and motility of sperm and also reduction of expression of DAZL gene.

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Background and Objective: Infertility is one of the issues that affect many aspects of infertile couples. In this study current infertility in Tehran province is estimated based on clinical, epidemiological and demographic definitions.
Methods: This descriptive-analytical study was performed on 669 women with a spouse aged 15-49 in Tehran, Iran during 2020. Data were collected by using a valid researcher-made questionnaire.
Results: Prevalence of current infertility by clinical, epidemiological and demographic definitions was 9.6%, 8.1% and 5.8%, respectively. As expected, primary infertility is lower (2%-4%) than secondary infertility (1.8%-6.4%). Some couples become infertile after their first pregnancy and the birth of their first child. Infertility has a significant relationship with age (P<0.05), age in the first marriage (P<0.05) and socio-economic statuse (P<0.05).
Conclusion: Current primary infertility is relatively low and normal, but secondary infertility is high. Focus on lifetime infertility shows higher rates of infertility than current infertility in Tehran, Iran.

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One of the main spermatogenesis events is the replacement of histones with small proteins called protamines, which leads to chromatin's condensation in the sperm nucleus and protects it against possible damage. Today, tests such as aniline blue (AB), toluidine blue (TB), and chromomycin A3 (CMA3) staining are used based on different characteristics to evaluate sperm chromatin compaction. For the assessment of DNA fragmentation in sperm, several tests such as 8-hydroxy-2-deoxyguanosine (8-OHdG), TUNEL, Comet, sperm chromatin structure assay (SCSA), sperm chromatic dispersion (SCD), and acridine orange have been introduced that directly and indirectly assay DNA damage. The articles in PubMed and Google Scholar, as well as related books, from 2007 to 2022, were collected and reviewed based on keywords 8-OHdG, TUNEL, Comet, SCD, and acridine orange. So far, many studies have been conducted at the treatment level and on sperm chromatin tests, but the number of cases published so far is limited. Various sperm samples have been used in different studies, with different threshold limits in the tests. The sixth edition of the World Health Organization (WHO) book notes that each laboratory has its threshold limit. Therefore, in this review study, common methods of evaluating chromatin packaging and DNA damage are introduced, and the advantages and disadvantages of each test are discussed based on the latest achievements related to infertility.

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Background and Objective: A basic factor in the reduction of fertility levels is delayed fertility. This research was carried out in Khorramabad, Lorestan Province, Iran.
Methods: This descriptive-analytical study was conducted on 535 married women aged 15-49 years in Khorramabad. The data were collected face-to-face through a cross-sectional survey in 2020 using a researcher-made questionnaire between September and December 2019. This study used the Kaplan-Meier test to determine the childlessness survival time. A logistic parametric model with the gamma shared frailty distributions was employed to analyze its determinants.
Results: The mean of childlessness survival time was 31.76 months, with a median of 24 months. Women in the age group of 15 to 30 years, women with university education, women who married at the age of less than 25 years, and women with a higher sense of socioeconomic insecurity had a longer childlessness survival time (P<0.05).
Conclusion: Childlessness was evaluated as low in Khorramabad. Only 2% of the women remained childless after 10 years of marriage.