Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 220 228 EN Fatemeh Modiri Department of Family Studies, National Institute for Population Research, Tehran, Iran Rasoul Sadeghi Department of Family Studies, National Institute for Population Research, Tehran, Iran AND Department of Demography, Faculty of Social Sciences, University of Tehran, Tehran, Iran 2021 03 09 2021 09 11 Objective: Changes in the gendered division of domestic labour are often assumed to influence childbearing intention, but existing evidence is varied and less examined in the Asian context. This paper aims to investigate the association between the gendered division of domestic labour and the intention to have another child. Materials and methods: A cross-sectional survey was conducted in Tehran on 455 married women aged 18-40 years who were selected through a multi-stage cluster sampling. Results: Domestic labour is still a feminine role and the majority of women are satisfied with the division of domestic labour. Women’s satisfaction with the division of domestic labour is a predictor of their tendency to have another child, but the actual division of domestic labour has not a significant effect on women’s desire to childbearing, in the multivariate model. Conclusion: Women’s desire for having another child is positively impacted by their satisfaction with the gendered division of labour in their household. To achieve more fertility, gender equality in the family and identifying the factors affecting women's satisfaction with the division of domestic labour is suggested. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1724 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1724/577

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 258 261 Reza Khadivi Community Medicine Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran Mahshid Nagi Community Medicine Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran Asefe Haddadpoor Information Technology Group, Provincial Health Center, Isfahan, Iran 2021 02 25 2021 06 26 Objective: The present study aimed to determine the prevalence of anti-syphilis antibodies in Iranian pregnant women who attended antenatal care (ANC) in 21 districts affiliated to Isfahan University of Medical Sciences (MUI) from April 2017 to April 2020. Materials and methods: In a cross-sectional study in 2020, the data about anti syphilis antibody were collected from electronic health files of pregnant women. Pregnancy specific health package was delivered to Iranian pregnant women in a horizontally integrated network across the country. The electronic health file was used for every Iranian citizen and all health events were recorded by their health care providers in 2016. All health services, particularly laboratory tests that were performed either in public or private laboratories, that were given to pregnant women needed to be recorded in their electronic health files. According to the pregnancy health package, they were screened initially by Rapid Plasma Reagin (RPR) test. Results: In those years, 70512, 72298, 63272 pregnant women were screened respectively. In these intervals, using the RPR test, no positive cases of anti- syphilis antibody were found. Conclusion: It seems that syphilis infection among Iranian pregnant women who attended ANC in districts affiliated to MUI has reached the elimination phase. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1714 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1714/582

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 262 265 Nahathai Paktinun Bumrungrad International Hospital, Bangkok, Thailand Chartchai Srisombut Bumrungrad International Hospital, Bangkok, Thailand Thidarat Kongwattanasin Bumrungrad International Hospital, Bangkok, Thailand Krit Pongpirul Bumrungrad International Hospital, Bangkok, Thailand AND Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand AND Johns Hopkins Bloomberg School of Public Health, Baltimore, USA 2021 01 07 2021 08 17 Objective: Sperm donation and hormonal therapy with micro-Testicular Epididymal Sperm Extraction (TESE) for infertility from testicular failure might not always be available in some contexts. We report a successful embryo transfer from the patient-by ‘cumulative sperm collection’ strategy. Case report: A 42 year-old male presented with non-obstructive azoospermia from testicular failure. Hormonal treatments were given along with the patient-initiated ‘cumulative sperm collection’ strategy, which eventually resulted in 17 sperms retrieved. Twelve mature oocytes were selected for intracytoplasmic sperm injection (ICSI) with the retrieved sperms, of which 8 oocytes were successfully fertilized but only two reached the early blastocyst stage; the first embryo transfer was not successful. Another five eggs were thawed and fertilized with the remaining 5 sperms and 3 oocytes were successfully fertilized: Seven cells were grade 3, 6 cells were grade 3, and 3 cells were grade 3. The second embryo transfer was successful, and the term female infant was successfully delivered by cesarean section. Conclusion: At a center without micro-TESE availability, successful embryo transfer for testicular failure type IV could be achieved by hormonal therapy plus a ‘cumulative sperm collection’ strategy. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1668 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1668/583

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 229 235 Shokoh Abotorabi Department of Obstetrics and Gynecology, Clinical Research Development Unit, Kosar Hospital, Qazvin University of Medical Sciences, Qazvin, Iran Solmaz Chamanara Department of Obstetrics and Gynecology, Clinical Research Development Unit, Kosar Hospital, Qazvin University of Medical Sciences, Qazvin, Iran Sonia Oveisi Department of Pediatrics, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran Maryam Rafiei Department of Obstetrics and Gynecology, Clinical Research Development Unit, Kosar Hospital, Qazvin University of Medical Sciences, Qazvin, Iran Leila Amini Department of Obstetrics and Gynecology, Clinical Research Development Unit, Kosar Hospital, Qazvin University of Medical Sciences, Qazvin, Iran 2021 04 07 2021 09 01 Objective: Placenta Accreta Spectrum (PAS) affects approximately one in a thousand deliveries. Very few studies evaluated PAS risk factors based on their location. In this study, we have investigated the effects of placenta location on placental adhesion-related complications, its risk factors, and outcomes. Materials and methods: We performed a retrospective cohort study of pathology-confirmed cases of PAS from patients with peripartum hysterectomy, at a large educational hospital in Qazvin, Iran, from 2009 to 2019. Placenta location was found by ultrasound reports and intraoperative evaluation. We measured demographic features, basic characteristics, maternal and neonatal outcomes based on placental location including anterior, posterior, and lateral in Placenta Accreta Spectrum. Chi-square, t-test, and one-way ANOVA were used to examine the relation of complications, risk factors, and outcomes in PAS. Results: A review of 70 cases showed the distribution of placenta location as follows: 57% anterior, 27% posterior, and 16% lateral. The mean gestational age at delivery was 35 (33-39) weeks. In 78.6% (n=55) of the patients, an association with placenta previa and in 94/2% (n=66) of cases a history of cesarean section was found, however, it was not significantly correlated with placenta location (p=0.082). We found that surgery duration was significantly longer in patients with lateral PAS (155±38, vs 129.35±33.8 and 133.15±31.5 for anterior and posterior placenta respectively, p=0.09). Patients with lateral PAS also bled more than the remaining two groups (2836 ml for lateral PAS vs 2002 and 1847 for anterior and posterior placenta respectively, p=0.022). Moreover, women with a history of uterine surgery were more likely to have posterior PAS compared to those with anterior and lateral PAS (p=0.035). Conclusion: Differences in complications, risk factors, and outcomes of PAS based on placenta location may lead to improved diagnosis and decreased morbidity in women. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1751 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1751/578

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 266 270 Ganbayar Batmunkh Division of Medical Genetics, National Center of Maternal and Child Health, Ulaanbaatar, Mongolia Purevtogtokh Myagmartseren Infertility clinic, National Center of Maternal and Child Health, Ulaanbaatar, Mongolia Tuul Bayarsaikhan Division of Medical Genetics, National Center of Maternal and Child Health, Ulaanbaatar, Mongolia Tserendagva Dalkh International School of Mongolian Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia Munkhtuya Tumurkhuu Department of Chemistry, North Carolina State University, North Carolina, USA 2021 02 17 2021 08 17 Objective: This study aimed to investigate the cause of primary infertility in a rare case with unilateral absence of vas deferens. Case report: A 35-year-old man was presented to the Infertility Clinic at the National Center of Maternal and Child Health (NCMCH) with an eight-year history of primary infertility. Clinical examination showed a normal intelligence with a coarse facial appearance and small testicles. Hormonal tests detected elevated levels of prolactin (PRL), follicle stimulating hormone (FSH), and luteinizing hormone (LH), and low levels of testosterone. Chromosomal analysis with fluorescence in situ hybridization (FISH) revealed a 46XX with SRY (sex-determining region Y) positive karyotype with translocation of the SRY gene (46XX der(X)t(X:Y)(p11.1:p11.3)(SRY+)). Magnetic resonance imaging (MRI) revealed bilateral seminal vesicles atrophy and agenesis of the vas deferens on the right side, which is rarely found in 46, XX male syndrome. Conclusion: Although 46XX testicular disorder of sexual development (DSD) cases are rare, multiple aspects of the clinical examinations are important to make an accurate diagnosis and to provide proper genetic counseling and guidance to patients in their long-term management https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1701 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1701/584

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 236 241 Sara Peña-Lizola Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Dr. José Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Luis Sordia-Hernandez Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Dr. José Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Selene Garcia-Luna Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Dr. José Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Otto Valdes-Martinez Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Dr. José Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Cassandra Skinner-Taylor Rheumatology and Immunology Service, Dr. Jose Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Mario Garza-Elizondo Rheumatology and Immunology Service, Dr. Jose Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico OScar Vidal-Gutierrez Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Dr. José Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Jesus Villarreal-Perez Department of Endocrinology, Dr. Jose Eleuterio González University Hospital, Autonomous University of Nuevo Leon. Monterrey, Mexico Miryam Eguia-Bernal Rheumatology and Immunology Service, Dr. Jose Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico Felipe Morales-Martinez Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Dr. José Eleuterio Gonzalez University Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico 2021 04 08 2021 08 22 Objective: Subfertility is commonly observed in patients with rheumatoid arthritis (RA). Although the causes are not well established, the alteration of the ovarian reserve is thought to contribute to the lower chances of pregnancy. This cross-sectional study aimed to evaluate the ovarian reserve in patients with RA. Materials and methods: Two parameters associated with ovarian reserves such as the antral follicle count (AFC) and the anti-müllerian hormone (AMH) were assessed in 38 patients with RA. We also analyzed the correlation of these parameters with the medication used to treat this pathology and with the illness severity. Results: The AMH levels in women with RA were comparable to those found on healthy individuals although the RA patients were more likely to have a low AFC. Ovarian reserve and RA were neither influenced by parameters of disease activity nor by the use of medication. Conclusion: The ovarian reserve in women with RA was similar to that found in healthy individuals. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1752 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1752/579

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 4 2021 11 28 271 274 Maryam Abiri Department of Medical Genetics, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran AND Shahid Akbarabadi Clinical Research Development Unit, Iran University of Medical Sciences, Tehran, Iran Maryam Hassanlou Faculty of Biology, Women’s University of Semnan (Farzanegan), Semnan, Iran ons, 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 or amniocentesis in twin pregnancies was 3.7%, which was not associated with the study variables. Conclusion: The results of the present study showed that the rate of miscarriage following amniocentesis and CVS in twin pregnancies is 3.7%. Therefore, reassuring the parents about the benefits of amniocentesis or CVS rather than their rare complications is necessary. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2716 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2716/706

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 4 2024 12 22 274 280 Roya Sahebi Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Jafar Hassanzadeh Department of Epidemiology, Research Center for Health Sciences, Institute of Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran Rezvan Haghighi Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Mehrzad Lotfi Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran