Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 1 11 Safaa Al-Hasani Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Lübeck, Germany Khaled Zohni Medical Sciences Division, Reproduction unit, National Research Center, Egypt 2015 10 04 The capability to preserve human oocytes, blastocysts, ovarian tissue and spermatozoa is an important tool in human assisted reproductive techniques. This preservation allows patients undergoing chemotherapy or radiotherapy to preserve their fertility, and helps to attain all benefits from the costly ovarian superovulation therapies prior to ART. The primary goal in establishing an appropriate freezing protocol is to do as little damage as possible while exposing specimens to nonphysiologic ultra low temperatures. Nowadays two techniques are used in cryopreservation: the slow cooling method and the more recent rapid procedure  of vitrification. Vitrification is simple, requires no expensive programmable freezing equipment, efficient and cost effective way to improve cumulative pregnancy rates per cycle. Oocytes, blastocysts, ovarian tissue and spermatozoa could be suitable for vitrification and thus cryopreservation. Vitrification proved to be the future of cryopreservation and important progresses are achieved everyday in this active domain in a trial to set the optimal protocol for cryopreservation of different types of gametes, embryos and tissue. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/21 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/21/21

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 13 16 Zinat Ghanbari Vali-e-Asr Reproductive Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran Tahereh Eftekhar Vali-e-Asr Reproductive Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran Bahareh Hajibaratali Vali-e-Asr Reproductive Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran Maryam Mireshghi Vali-e-Asr Reproductive Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran Mamak Shariat Maternal-Fetal-Neonatal Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran 2015 10 04 Objective: Urogynecologists are constantly looking for simple, safe and effective ways to cure vaginal apex prolapse. The aim of this study was to evaluate the results of posterior intravaginal slingplasty (PIVS). Materials and methods: A total of 38 patients with advanced vaginal apical prolapse underwent posterior intravaginal slingplasty in Vali-e-Asr hospital in Tehran. In this clinical trial (before-after study), demographic, pre-operative, operative details and post-operative follow-up data were collected for all patients. The data were analyzed using SPSS software and Mac Nemar test.  P<0.05 was considered for statistical significance. Results: The mean for patients' age was 67 (50-81) years, for operation time was 35 (25-45) minutes and for blood loss was 125 (70-300) ml. No intraoperative rectal perforation was observed and there was a significant difference in patients' symptoms such as pelvic pain, nocturia, urgency and urinary tract infection before and after the surgery (p < 0.001). Conclusion: PIVS had similar efficacy with other studies in the treatment of vaginal vault prolapse. The procedure reduces the complication rate and shortens the rehabilitation period with a satisfying result. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/22 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/22/22

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 53 57 Alireza Abidi Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Bridgeport University, CT Ali Hamraz Department of Gynecologic Oncology, Yale School of Medicine, New Haven, CT Masoud Azodi Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Bridgeport University, 2015 10 04 Adenocarcinoma in situ is one of the premalignant lesions of the cervix and its incidence is believed to be increasing while the pathogenesis of the disease is not clearly understood. Management of Adenocarcinoma in situ (AIS) unlike carcinoma in situ (CIS) has not been clearly described in the current literature. Here we describe conservative management and serial  olposcopy of two pregnant women with adenocarcinoma in situ of the cervix. Both of the cases were diagnosed initially with abnormal Pap smears and were confirmed by colposcopic directed biopsy. None of the patients agreed with any invasive procedure during pregnancy and both of them were followed with serial colposcopy. None of the lesions showed any evidence of progression. All cases underwent cold knife cone biopsies in their postpartum period. Hysterectomy as the final treatment has been done in both cases with no evidence of progression of the disease during pregnancy. We concluded that adenocarcinoma in situ of the  cervix during pregnancy could be managed conservatively with definite treatment postponed till after delivery. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/30 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/30/30

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 17 21 Soheila Arefi Endocrinology and Embryology Departement, Avesina Research Institute, Avesina Infertility Clinic, Tehran, Iran Avesina Infertility Clinic, Tehran, Iran Mohammad Mehdi Akhondi Endocrinology and Embryology Departement, Avesina Research Institute, Avesina Infertility Clinic, Tehran, Iran 2 Avesina Infertility Clinic, Tehran, Iran Riehaneh Tokhmechi Avesina Infertility Clinic, Tehran, Iran Ali Sadeghpour Tabaei Shahid Rajaei Hospital, Iran University of Medical Sciences, Tehran, Iran Sepideh Pojhan Avesina Infertility Clinic, Tehran, Iran Hojjat Zeraati Department of Epidemiology and Biostatistics, School of Public Health, Medical Sciences/ University of Tehran, Iran 2015 10 04 Objective: The study aimed to evaluate the effectiveness of laparoscopic ovarian drilling (LOD) on ovulation and restoration of menstrual cycles andpregnancy.  Materials and methods: This cross sectional study was conducted on 81 consecutive Polycystic Ovarian Syndrome (PCO) patients whom were referred to  Avesina Infertility clinic during 2003-2006. Exclusion criteria were tubal and male factor infertility, hyperprolactinemia, thyroid disease and diabetes mellitus. Patients with the age range of  20-35, body mass index of less than 35 kg/m2, failure to ovulate during at least three cycles of Clomiphene Citrate (CC)consumption and more than 12 months of ovulatory factor infertility entered the study. Metformin was used for at least 8 weeks in combination with CC. Forty four PCO women who had not ovulated after medical therapy with combination of CC and Metformin were selected for LOD. The data was analyzed with SPSS software using t- test and logistic regression analysis. P<0.05 was considered statistically significant.  Results: Patients aged 28.9±2.3 years with infertility duration of 4.8±2.3years and BMI of 28±3.3 kg/m2. Effectiveness of medical therapy significantly was related to BMI (P<0.001). After LOD, ovulation occurred in 14 cases (31.8%), restoration of menstrual cycle in 18 women (40.9%), and spontaneous pregnancy in 5 cases (11.3%). Conclusion: LOD is a good method for restoration of ovulatory cycles in anovulatory PCOS women who were resistant to the combination of CC and Metformin. LOD may avoid or reduce the need to gonadotropins for ovulation induction. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/23 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/23/23

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 23 27 Latiffah Latiff Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia Hanachi Parichehr Women Research Center, Alzahra University, Tehran, Iran 2015 10 04 Objective: The objective of this research was to study the sexual perception and practices among people aged 45 years and above and the associated socio-demographic factors. Materials and methods: A cross sectional study was done on 473 middle aged and elderly people living in Klang Valley in 2005. They were married and literate.  Data were collected by means of face to face interview using structured questionnaires and were analyzed using SPSS software. Logistic regression was used and p<0.05 was considered for statistical significance. Results: The mean age of the respondents was 54.36 ± 7.91 years and majority of them were in age group of 50-59yrs (41.25%) and 53.5 % were male. The ethnic distribution was 50.1% Malay, 23.3% Chinese and 26.6% Indians. Most of the  (61 %) reported that they were healthy as compared to 39% who suffered at least from a major medical problem. Only 17.1% of respondents admitted that they had sexual problems and out of these 32% sought various types of treatment. There was a  significant difference between satisfaction with sexual intercourse and gender, ethnicity, age, who initiated the sexual intercourse and presence of sexual problem. Conclusion: The findings indicate that older people present as wide a variety of sexual problem areas as younger individuals. Accurate information about sexuality in later life will enable professionals to better provide a desirable environment. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/24 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/24/24

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 29 32 Sakine Moaiedmohseni Department of Obstetrics and Gynecology, Shahed University, Tehran, Iran Monir Owje Royan Research center Tehran, Iran 2015 10 04 Objective: This study aimed to assess the value of Chlamydia trachomatis (C.trachomatis) antibodytiter test in prediction of  tubal damage. Materials and Methods: In this case-control study we enrolled50 women with tubal factor infertility (proven by laparoscopy after hysterosalpingography) and 110 women without infertility history. ELISA was performed for all participants, seeking C.trachomatis IgG antibodies. ELISA for IgM was then performed for women with positive test. Statistical package for social science version 11 was used for data entry. Statistical evaluation was performed using student t test, Fisher exact and chi-square tests. Statistical significance was defi ned as P<0.05. Results: In 8(5%) of all women the C.trachomatis IgG antibodywas positive .Five (10%) of the infertilepatients and 3 (2.7%) of pregnant women had positive tests (P < 0.03). All of them had negative results for IgM antibodies. Twenty five percent of women with normal hysterosalpingography and 5.3% of women with abnormal hysterosalpingography had positive antibody test. There was not any correlation between antibody titer and abnormal HSG. Endometriosis was diagnosed in seven women with negative antibody results. Conclusion: The result of C.trachomatis antibody titer was significantly different in women with and without infertility Laparoscopic. Tubalassessment is recommended in infertile women with a positive result of theC. trachomatis antibody titer. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/25 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/25/25

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 33 36 Saeed Reza Ghaffari Vali-e-Asr Reproductive Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran Farzaneh Larti Iranian Fetal Medicine Foundation, Tehran, Iran Tayebeh Sabokbar Vali-e-Asr Reproductive Health Research Center, Medical Sciences/ University of Tehran, Tehran, Iran Maryam Rafati Department of Medical Genetics, Medical Sciences, Medical Sciences/ University of Tehran, Tehran, Iran Jila Dastan Gene Clinic, Tehran, Iran Laleh Eslamian Department of Obstetrics and Gynecology, Medical Sciences/ University of Tehran, Tehran, Iran Fatemeh Rahimi Department of Obstetrics and Gynecology, Medical Sciences/ University of Tehran, Tehran, Iran Sedighe Borna Department of Obstetrics and Gynecology, Medical Sciences/ University of Tehran, Tehran, Iran 2015 10 04 Objective:To investigate the hematologic indices of mothers in non-immune hydrops fetalis pregnancies and identify the possible causative role of Alpha-Thalassemia among them. Material and methods: From 2005 to 2007, 11386 hydrops fetalis cases in three major obstetric hospitals affiliated to Tehran University of Medical Sciences were recorded. Indirect coombs test and hematologic indices of maternal samples were assessed. Results: Among 11386 deliveries, 67 hydrops fetalis cases were detected. Forty-one (62%) cases were immune type and 26 (38%) cases were non-immunehydrops. All the mothers had MCV more than 80 fl and 25 mothers had MCH more than 27 pg, so none of themhad Alpha-Thalassemia carrier criteria. Conclusion: Alpha- Thalassemia is not the major cause of hydrops fetalis in this study and cost-effectiveness of population scaled biochemical and/or molecular screening programs of α-globin gene mutations in Tehran population is under question. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/26 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/26/26

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 1 2008 03 15 37 40 Azizeh Ghaseminejad Mirza Koochak Khan Hospital, Medical Sciences/ University of Tehran, Tehran, Iran Zahra Rezaei Mirza Koochak Khan Hospital, Medical Sciences/ University of Tehran, Tehran, Iran Elham Nikkhah Mirza Koochak Khan Hospital, Medical Sciences/ University of Tehran, Tehran, Iran Mamak Shariat Maternal-Fetal-Neonatal Health Research Center, Medical Sciences/ University of Tehran, Iran 2015 10 04 Sedigheh Esmaeilian Parastarane-Shahed Hospital, Department of Obstetrics & Gynecology, Iran University of Medical Scien 2015 10 04 Objective: To compare the efficacy of ceftriaxone plus Ofloxacin or Azithromycin for cases of pelvic inflammatory disease (PID). Materials and Methods:  This clinical terial was performed on 180 women with PID from March 2005 to March 2007 in Parastarane-Shahed Hospital. Patients with PID were randomly divided to receive injection of Ceftriaxone 250 mg plus Ofloxacin 200 mg per day or Azithromycin 1 g per week for two weeks (90 cases in each group). The degree of pain was assessed on days 7, 14, 30 and clinical cure was assessed on days 14 and 30. Statistical analysis was done based on Fisher exact test, Mann-Whitny and student t-test. Results: From 180 patients eligible for the study, 138 cases were enrolled for protocol analysis. Significant differences were observed regarding the degree of pain between two groups. Clinical cure was 90% (70 of 78) for Azithromycin and 83.3% (50 of 60) for Ofloxacin. Conclusion: Combination of Ceftriaxone plus weekly Azithromycin for two weeks is not only equivalent to Ceftriaxone plus daily Ofloxacin for two weeks but also seems to be better for the treatment of mild PID. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/37 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/37/37

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 2 2008 06 15 95 98 Soosan Alimohammadzadeh Taher Imam Reza (501 Army) Hospital, Army University of Medical Sciences, Tehran, Iran Zahra Rezasoltani Imam Reza (501 Army) Hospital, Army University of Medical Sciences, Tehran, Iran 2015 10 04 Objective: The study evaluated the efficacy of oral calcium carbonate supplement on leg pain in pregnancy and nursing period. Materials and methods: A total number of 176 women at third trimester of pregnancy or nursing period till to one year after delivery with complaint of leg pain, low back pain (LBP), and posterior pelvic pain (PPP) were evaluated for distinct primary causes and were excluded, then 58 patients randomized into calcium group (n=27) treated with 500 mg calcium carbonate orally per day just for one week, and control group (n=31) received no drug. Incidence of days with leg, low back, and posterior pelvic pain per week were evaluated and compared between the two groups at 3 different weeks before, during, and after discontinuation of drug. Statistical significance was defined as P<0.05.  Results: Mean number of days with leg pain per week during calcium carbonate intake was significantly different between the study and control groups (P<0.05). Mean number of days with LBP and PPP was not significantly different between two groups. Conclusion: The use of oral calcium supplement was associated with lower episodes of leg pain but failed to reduce the incidence of LBP and PPP in pregnancy and nursery period. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/38 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/38/38

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 2 2 2008 06 15 99 102 Katayon Berjis Obstetrics and Gynecology Department, Azad University of Medical Sciences, Tehran, Iran Abotaleb Sarem Obstetrics and Gynecology Department, Azad University of Medical Sciences, Tehran, Iran Mansoureh Moaya Obstetrics and Gynecology Department, Azad University of Medical Sciences, Tehran, Iran Nahid Mohamad Alaiha Obstetrics and Gynecology Department, Azad University of Medical Sciences, Tehran, Iran 2015 10 04 Objective: This research was designed to compare the effectiveness of intramuscular progesterone and vaginal progesterone to support luteal phase in IVF cycles. Materials and Methods: In this randomized clinical trial 182 infertile patients between 20-40 years old were selected for rapid ZIFT cycles. In order to support luteal phase Cyclogest suppository (400 mg BID) was used for 77 cases and the rest used intramuscular progesterone (100 mg daily). Pregnancy and abortion rates were compared between two groups. Results: Chemical pregnancy rate (positive ß-HCG) was %27.3 in Cyclogest group and %30.6 in intramuscular progestrone group (P = 0.7). Clinical pregnancy (gestational sac visible by transvaginal ultrasound) was observed in %22.1 of cases in Cyclogest group and %27.1 of cases in intramuscular progestrone group (P = 0.4). Ongoing pregnancy rate (fetal heart action visible by transvaginal ultrasound) was %15.6 in Cyclogest group and %18.8 in intramuscular progesterone group (P = 0.6). Conclusion: Chemical pregnancy, clinical pregnancy and ongoing pregnancy rates were similar in vaginal and intramuscular progestrone groups. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/39 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/39/39