Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 74 81 Nasibeh Roozbeh Mother and Child Welfare Research Center, Hormozgan Universiy of Medical Sciences, Bandar Abbas, Iran Azam Amirian Department of Midwifery, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran Fatemeh Abdi School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran Simin Haghdoost Department of Midwifery, Urmia Branch, Islamic Azad University, Urmia, Iran 2020 12 29 2021 04 20 Objective: Male infertility is involved in about half of the casess of infertility and the only sole reason for infertility in 20%-30% of the cases. Following the recent interest in the use of medicinal plants, scientists have sought to clarify their effects on male fertility. This review aimed to summarize the results of studies available to determine the effectiveness, safety and mechanism of herbal treatments in the improvement of male fertility. Materials and methods: Medline/PubMed, Scopus, Science Direct, and the Cochrane Central Register of Controlled Trials (Central) databases were searched for randomized controlled trials (RCTs) published during 2000-2020. Studies were only included if they adhered to the CONSORT checklist. The methodological quality of the selected studies was assessed using the Cochrane risk of bias tool. Results: Finally, 20 studies recruiting a total of 1519 individuals were reviewed. These studies compared the effects of eleven different medicinal plants, i.e. ginseng, saffron, Nigella sativa, palm pollen, ADOFON, TOPALAF, sesame, and Mucuna pruriens, on male fertility with those of placebo. All studies (except one) confirmed the beneficial effects of medicinal plants on the improvement of sperm and reproductive parameters and thus male infertility. Conclusion: The existing RCTs indicated the positive effects of medicinal plants on male fertility. Therefore, in order to develop a novel approach to the treatment of male infertility, further clinical trials are warranted to determine the maximum dosage and duration of treatment with herbal medicines and evaluate any potential side effects of such interventions. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1656 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1656/556

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 82 90 EN Ernest Kirui Institute of Tropical and Infectious Diseases, College of Health Sciences, University of Nairobi, Nairobi, Kenya Joseph Mung'atu Department of Statistics and Actuarial Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya Peter Gichangi Department of Human Anatomy, College of Health Sciences University of Nairobi, Kenya Nicholas Onguto Department of Community Health, Kenyatta University, Nairobi, Kenya Davis Kamondo Institute of Tropical and Infectious Diseases, College of Health Sciences, University of Nairobi, Nairobi, Kenya 2020 12 26 2021 04 20 Objective: The recent increase in the uptake of injectable contraceptives has occurred at the expense of the other modern contraceptive methods but the knowledge gap still exists on modeling dynamics and determinants associated with the use of the injectable. This study sought to model for injectable contraceptive usage to bridge the knowledge gap on the use of injectable contraceptives among women of childbearing age in Kenya. Materials and methods: Analytical cross-sectional study design was adopted. Secondary data for women collected during the (Performance Monitoring for Action) PMA2020 survey was used. PMA2020 survey used multistage stratified sampling with urban-rural representation. To establish the factors associated with the uptake of injectable contraceptives, a multiple logistic regression model was fitted using Stata version 13 and R version 3.5.3 statistical software. Hosmer-Lemeshow Test statistic was used to evaluate the goodness of model fit in predicting injectable contraceptive usage. Results: Multivariable analysis showed that women with post-primary/vocational levels of education were 54% less likely to use an injectable contraceptive compared to those who had no education at all. Hosmer-Lemeshow (HL) goodness of fit test statistic indicated that the model was a good fit for prediction. Education, marital status, wealth quintile, place of residence and number of births were significant predictors of the injectable contraceptive uptake among women of reproductive age in Kenya. Conclusion: The findings of this study will inform the design of targeted interventions aimed at addressing the increasing demand for injectable devices among women of reproductive age in Kenya. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1644 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1644/557

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 125 129 Amrita Talwar Department of Pathology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India Pushpanjali Behera Department of Pathology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India Arvind Ahuja Department of Pathology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India Bani Sarkar Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Sciences, Ram Manohar Lohia Hospital, New Delhi, India Ravi Phulware Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India 2020 12 01 2021 03 13 Objective: Endometrial cancer (EC) is the most commonly diagnosed malignancy and has the second-highest mortality rate among gynecological cancers. Adenomyosis is well-known for abnormal uterine bleeding and is a widely reported entity; however, an EC arising from the adenomyosis is a rare event; even rarer is the occurrence of serous endometrial carcinoma. Case report: A 60-year post-menopausal female presented with post-menopausal bleeding. Subsequently, she underwent a hysterectomy, which showed atrophic and cystic endometrium with extensive adenomyosis and atypical endometrial glands, which are diffusely P53 positive with intervening negative benign and focally positive dysplastic endometrial glands. A final diagnosis of serous endometrial carcinoma arising from adenomyosis was rendered. In a table format, previously reported serous endometrial carcinoma Arising cases from adenomyosis using PubMed search had been described. Conclusion: Serous endometrial carcinoma arising from adenomyosis (<20 cases reported) and has a slightly more dismal prognosis than those deriving from the endometrial cavity. Hence, this case report highlights the occurrence, rarity, and importance of such an entity. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1622 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1622/563

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 91 98 EN Maryam Dehghan Anatomy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Shirin Shahbazi Medical Genetic Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Mojdeh Salehnia Anatomy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 2020 12 31 2021 04 20 Objective: The aim of this study was to evaluate the effect of lysophosphatidic acid (LPA) supplementation during in vitro culture and transplantation of mouse ovaries on the follicular development and expression of vascular endothelial growth factor (VEGF) as an angiogenesis factor at the mRNA and protein levels. Materials and methods: Three weeks old mice ovaries were cultured in the presence and absence of LPA for 24 hours, then they were capsulated in sodium alginate in the presence and absence of LPA as four experimental groups. After transplantation the vaginal smears were performed daily to evaluate the initiation of the estrous cycle. The morphology and follicular distribution were analyzed at the first and fourth estrous cycles using hematoxylin and eosin staining. Then in the groups that showed higher and lower follicular development the immunohistochemistry assay was conducted to identify VEGF protein expression, and the real time RT-PCR was done to analyze the expression of Vegf gene at the first estrus cycle. Results: The large size follicles and also the corpus luteum were prominent in all transplanted groups at fourth estrus cycle in comparison with intact control groups. The statistically lowest percentage of small size follicles and the highest percentages of large size follicles were seen in LPA+/LPA- group (p<0.05). The expression ratio of Vegf to β-actin was significantly higher in this group in comparison with non-LPA treated and intact control groups (p <0.05). Conclusion: LPA as an angiogenesis factor increases the follicular development in transplanted ovaries but it causes early discharge of ovarian reserve. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1657 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1657/558

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 130 135 Laura González- Teshima School of Medicine, Valle University, Cali, Colombia César Payán-Gómez Department of Biology, Faculty of Natural Sciences, Rosario University, Bogotá, Colombia Wilmar Saldarriaga School of Basic Sciences, Valle University, Cali, Colombia AND School of Medicine, Valle Hospital, Valle University, Cali, Colombia 2020 11 05 2021 03 13 Objective: To evidence the need for screening fragile X syndrome (FXS) in egg donors in assisted reproduction protocols. Case report: This is the report of a boy with FXS who inherited the mutated allele from an ovule donated by the mother´s sister through an assisted reproduction protocol. Identifying premutation (PM) carriers of FXS amongst gamete donors isn’t part of the obligatory genetic analysis for donors and is only considered by most of the in vitro fertility societies and guidelines as part of the extension screening tests. Conclusion: It is cost-effective to do pre-conceptional screening for the PM or full mutation (FM) of the FMR1 gene affected in FXS in every woman undergoing assisted reproductive methods, including gamete donors even without a positive family history of intellectual disabilities. This case supports the need of rethinking the guidelines on the necessary gamete donor screening tests in assisted reproduction protocols. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1598 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1598/564

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 99 105 Ziba Mosayebi Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Setareh Sagheb Department of Neonatology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahsa Mirzendedel Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran Amir Hossein Movahedian Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran 2020 11 07 2021 04 04 Objective: Vitamin D deficiency is a major health problem in all age groups. In the present study, we aimed to determine the prevalence of vitamin D deficiency in neonates hospitalized in an intensive care unit (NICU) and its association with clinical neonatal outcomes. Materials and methods: A prospective cross-sectional study was carried out on all neonates hospitalized in the NICU of Children's Medical Center over a period of one year (January–December 2018). Immediately on admission, a serum sample for vitamin D measurement was obtained with another routine blood sampling. Demographic and clinical data including sex, gestational age, the season of birth, serum levels of vitamin D and calcium, the causes of hospitalization, age at admission and neonatal outcomes including length of hospital stay and mortality during hospitalization were assessed. Results: One hundred neonates entered the study. Vitamin D deficiency and insufficiency were present in 95% of neonates. There was a significant association between vitamin D status and birth during winter (p=0.014); hypocalcemia (p=0.025) and older age at NICU admission (p<0.001). The mean value of vitamin D in term neonates was significantly lower than in preterm neonates (p=0.031). There were no correlations between length of hospital stay and neonatal mortality rate with vitamin D status (p=0.876). Conclusion: Vitamin D deficiency and insufficiency were highly prevalent among NICU patients. Maternal vitamin D supplementation during pregnancy may prevent or reduce the risk of low levels of vitamin D in neonates. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1600 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1600/559

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 136 140 Lajya Goyal Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bathinda, India Priyanka Garg Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bathinda, India Manmeet Kaur Department of Pathology, All India Institute of Medical Sciences, Bathinda, India Diksha Sharma Guru Gobind Singh Medical College, Faridkot, Punjab, India 2021 01 13 2021 05 01 Objective: Dermatofibrosarcoma protuberans (DFSP) of the vulva is an uncommon soft tissue tumor with fewer than 60 cases reported previously. Distant metastasis is rare with a high propensity for local invasion. Surgical management is the gold standard with adequate margin excision to prevent future recurrences. We report a case of vulvar DFSP requiring three resections to achieve primary clearance. To the best of our knowledge, this is the first case report from India. Case report: A 35-years-old female, presented with nodular vulvar mass for the third time arising from the upper part of right labia majora for the last year. She had a history of two similar episodes in the paons, support from healthcare professionals, and family backing emerging as predominant themes. Conclusion: This study revealed profound physical and mental health challenges compounded by societal stigma and limited resources. Strengthening social support networks, reducing stigma, and promoting patient-centered care are imperative. Targeted interventions are also essential to enhance health outcomes for these young mothers and their children. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2905 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2905/703

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 4 2024 12 22 253 260 EN Maria Nascimento Department of General and Specialized Surgery, Professional Master's Program in Maternal and Child Health, Faculty of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil Lara Marchesi Faculty of Medicine, Department of Clinical Medicine, Universidade Federal Fluminense – UFF, Niterói, RJ, Brazil Wender Soares Faculty of Medicine, Department of Clinical Medicine, Universidade Federal Fluminense – UFF, Niterói, RJ, Brazil Jenaine Rosa Emiliano Faculty of Medicine, Department of Clinical Medicine, Universidade Federal Fluminense – UFF, Niterói, RJ, Brazil Maria Auxiliadora Saad Faculty of Medicine, Department of Clinical Medicine, Universidade Federal Fluminense – UFF, Niterói, RJ, Brazil Glaucimara Hacar Maternity Ward, Rede D’Or São Luiz, Oeste D’Or Hospital, Rio de Janeiro (RJ)- Brazil Gabriel Chiracava Faculty of Medicine, Department of Clinical Medicine, Universidade Federal Fluminense – UFF, Niterói, RJ, Brazil 2024 09 14 2024 11 27 Objective: Stillbirth is a neglected problem that needs to be given a greater visibility, especially in developing countries. This study aimed to describe temporal trends of stillbirth rates disaggregated by maternal and gestational age. Materials and methods: This is an ecological study conducted in Brazil. Stillbirth rates and temporal trends were calculated using data from 2011-2021, considering variables such as gestational age (≥ 22 weeks) and maternal age (10-19, 20-34, and ≥ 35 years old). Stillbirth rates were presented per 1,000 births, and trends were assessed via autoregressive models. Results: There were 228,386 stillbirths in Brazil, corresponding to 1 event per 133 live births at ≥ 22 gestational weeks in singleton pregnancies. At ≥28 weeks, the average stillbirth rates were 139.46 per 1,000 births (28-31 weeks), 36.59 per 1,000 births (28-36 weeks), 6.07 per 1,000 births (28-41 weeks), and 5.94 per 1,000 births (28-42 weeks and more). Data disaggregation by maternal age showed that average stillbirth rates were 7.69 per 1,000 births (mothers aged 10-19 years), 6.90 per 1,000 births (mothers aged 20-34 years), and 10.34 per 1,000 births (mothers aged ≥ 35 years). The temporal trends showed statistically significant increase in stillbirth rates in almost all gestational age strata among adolescent mothers, but not among older women. Conclusion: Older women experienced the highest stillbirth rates in Brazil but with a clear declining trend. The upward stillbirth trends revealed among adolescent mothers suggest that the fetal death prevention must be prioritized in the Brazilian adolescent health policy agenda. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2914 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2914/704

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 4 2024 12 22 261 268 Hery Bemanana Regional Directorate of Public Health Atsinanana, Toamasina, Madagascar AND University of Toamasina, Madagascar AND Sylababa Association Madagascar 2024 09 25 2024 11 27 Objective: This study aims to analyze the association between the likelihood of giving birth in a healthcare facility and various sociodemographic characteristics in Madagascar. Materials and methods: This study utilized data from the 2021 Madagascar Demographic and Health Survey which included a representative sample of women of reproductive age (15-49 years). The sociodemographic variables analyzed included age, birth order, education level, region residence and economic status with the place of delivery being the primary dependent variable. Data analysis was conducted using R software. A chi-square test was applied to assess associations between variables, with a significance threshold set at 5%. Results: The prevalence of institutional childbirth services usage in Madagascar was 37.4% (35.1-39.7). The results showed that women under 20 years had an assistance rate of 36.7% (33.9-39.4), while the rate for primiparas reached 49.9% (48.5-51.3). Prenatal visits, mother’s age, birth order, region, residence, education level, and economic quintile significantly influenced access to care, with p-values < 0.0001. Only 17.5% (15.6-19.4) of women in the lowest quintile received qualified assistance at childbirth. Conclusion: The results highlight the impact of age, birth order, residence, education level, region and socioeconomic status on access to childbirth services, necessitating a multisectoral approach to improve equity. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2928 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2928/705

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 4 2024 12 22 269 273 EN Fatemeh Golshahi Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Rahimi-Sharbaf Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mahbobeh Shirazi Maternal, Fetal and Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Sara Saeedi Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Athar Abdolrazagh Nejad Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Sahar Garfami Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Nafise Saedi Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Jafar Golshahi Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran Zeynab Amiriarya Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Narjes Tavakolikia Vice-Chancellor for Health, Tehran University of Medical Sciences, Tehran, Iran Behrokh Sahebdel Department of Perinatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2024 06 09 2024 09 22 Objective: Amniocentesis and chorionic villus sampling (CVS) are the most widely used prenatal diagnostic methods. Despite their benefits, they can be associated with adverse pregnancy effects, but the exact prevalence of these complications especially in twin pregnancies is not exactly known. Therefore, the present study was conducted to determine post-amniocentesis or CVS complications in twin pregnancies. Materials and methods: This retrospective observational study was conducted on 187 pregnant women who underwent amniocentesis or CVS in the perinatology department of Yas Hospital affiliated with Tehran University of Medical Sciences from January 2011 to March 2020. All participants were evaluated with amniocentesis or CVS by an expert perinatologist. The study outcomes were considered as the occurrence of vaginal bleeding, rupture of the membranes, chorioamnionitis, and abortion. Results: The mean age of women was 33.5 ± 6.5 years. About 90 % of pregnant women underwent amniocentesis and the others underwent CVS. In 132 (70.6%) pregnant women, the most common indication for diagnostic prenatal tests was having high-risk first/second-trimester screening followed by abnormal ultrasound anomaly scan in 31 (16.6%) cases. It was also found that in 80 (42.8%) patients, the placenta site was in the anterior part and 65 (34.8%) in the posterior part. The diagnostic test results were normal in 170 (90.4%) cases, while trisomy 21 was detected in 13 (7%) cases and trisomy 13 in 4 (2.1%) cases. The rate of abortion following CVS o