Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 1 8 Nauryzbay Imanbayev Department of Oncology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan Yerbolat Iztleuov Department of Radiologists of the NJSC ZKMU named after Marat Ospanov, MC NCJSC Marat Ospanov Western-Kazakhstan Medical University, Aktobe, Kazakhstan Arip K. Koishybaev Department of Oncology of the NJSC ZKMU named after M. Ospanov MC NCJSC Marat Ospanov Western-Kazakhstan Medical University, Aktobe, Kazakhstan Nurgul Kereyeva Department of Oncology ZKMU named after Marat Ospanova, MC NCJSC Marat Ospanov Western-Kazakhstan Medical University, Aktobe, Kazakhstan Anar Tulyayeva Department of Oncology Medical Center of West Kazakhstan Medical University named after Marat Ospanov, Aktobe, Kazakhstan Dinara Zholmukhamedova Department Oncology MC NCJSC Marat Ospanov Western-Kazakhstan Medical University, Aktobe, Kazakhstan Azamat Zharylgapov Department Oncology MC NCJSC Marat Ospanov Western-Kazakhstan Medical University, Aktobe, Kazakhstan 2024 02 20 2024 03 09 Objective: To evaluate the implications and significant role of parenchymal and stromal ratio in colorectal cancer (CRC). Materials and methods: In our review, we involved English studies from common databases such as Web of Science, Scopus, Google Scholar, PubMed, and the Cochrane Library using the following keywords “colorectal cancer”, “tumor stromal ratio”, “tumor parenchymal ratio”, and “prognostic marker” till December 2023. Results: The majority of CRC patients are usually diagnosed at late stages, which may lead to missing out on the chance to get radical therapy. Patients with unfavorable prognosis have epithelial malignant tumors with a high amount of stroma, more than 50% stroma, while tumors with a low amount of stroma, less than 50%, and abundant carcinoma tissue have a better prognosis. Conclusion: Tumor-stromal ratio is a valuable, cheap, and fast modality that provides valuable prognostic data of colorectal carcinoma and other cancers.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2635 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2635/668

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 20 29 EN Jasmina Begum Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhubaneswar, India Subarna Mitra Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhubaneswar, India 2023 10 29 2024 03 18 Objective: A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its frequency has risen in both industrialized and developing nations. Maternal request for cesarean delivery has been explained for the escalating rate along with other factors like anxiety, fear of childbirth, previous cesarean delivery, previous negative vaginal birth experience, maternal age, maternal education, and socioeconomic factors. Hence, this study was undertaken to assess pregnant women's tendency to have a cesarean birth and to investigate the factors associated with the inclination for cesarean delivery. Materials and methods: A hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, a systematic sampling procedure was utilized, and 368 antenatal mothers after 36 weeks of gestation, who do not have any specific medical reasons against vaginal delivery were included in the study. Data collection was done by questionnaire. The information regarding socio-demographic factors, preexisting comorbidities, current obstetric risk factors, emotional factors, previous delivery experience, and their information preference toward the mode of delivery were collected. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery. Results: The preference for cesarean delivery and non-preference for cesarean delivery was 114 (30.9%) and 201 (54.6%), respectively whereas 53 (14.4%) participants remained neutral. The Chi-square analysis revealed a notable connection between the inclination towards a preference for cesarean delivery and factors such as obstetric score, parity, comorbidities, and among obstetric risk factors such as pregnancy after in-vitro fertilization (IVF), with a history of abortion, and having a prior history of cesarean delivery. Nevertheless, no meaningful association was observed between the preference for cesarean delivery and the remaining variables. On multivariate logistic analysis, independent variables like preexisting anxiety or depression, pregnancy through IVF, and having a history of previous cesarean delivery have increased the odds of preferring cesarean delivery. The independent variables like increasing gestational age, graduates, and unemployed have decreased the odds of preferring a cesarean delivery. Conclusion: In conclusion, the prevalence of cesarean delivery is influenced by a complex interplay of medical, cultural, socioeconomic, and healthcare system factors. While cesarean delivery is essential in cases of medical necessity, efforts should be made to avoid unnecessary cesarean delivery that does not provide clear benefits over vaginal delivery. Balancing the risks and benefits of cesarean delivery and promoting evidence-based obstetric practices are crucial for ensuring optimal maternal and infant outcomes. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2513 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2513/670

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 75 79 EN Lajya Goyal Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bathinda, India Priyanka Garg Department of Urology, All India Institute of Medical Sciences, Bathinda, India Suresh Goyal Department of Urology, All India Institute of Medical Sciences, Bathinda, India Surabhi Bansal Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bathinda, India Manjit Rana Department of Pathology, All India Institute of Medical Sciences, Bathinda, India 2024 02 03 2024 03 18 Objective: Aggressive Angiomyxoma (AA) of the vulva is a slow-growing mesenchymal tumour with a tendency to local invasion and recurrence. Case report: We report two cases of vulvoperineal masses that were diagnosed to be Aggressive Angiomyxomas after surgical excision. Both patients presented to the Gynaecology OPD of All India Institute of Medical Sciences, Bathinda, Punjab, India, in 2020 and 2022 with complaints of a mass coming out of introitus of three years duration and 14 years duration, respectively. The first patient was managed by surgical excision of the mass via abdominoperineal approach, while the second patient underwent vaginal hysterectomy along with the removal of the mass. Both patients were given GnRH analogues after the surgery to avoid any further recurrences and have been in remission on follow-ups so far. Conclusion: Due to its rare occurrence, clinicians should consider the possibility of AA while encountering patients with vulvovaginal masses to avoid misdiagnosis and delayed management. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2613 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2613/677

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 9 19 Farangis Sharifi Department of Midwifery, Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran Zahra Hadizadeh Talasaz Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mona Larki Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 2023 08 10 2024 03 18 Objective: Shelters are an important part of a full response to survivors, as stated in many international conventions, such as the 1995 Beijing Declaration and Platform for Action (BDPfA). This study aims to provide a comprehensive perspective on the establishment of shelters for women survivors of violence. Materials and methods: This narrative review was conducted based on the Scale for the Assessment of Narrative Review Articles (SANRA). The MEDLINE, SCOPUS, Web of Science, Embase, Ovid, and EBSCO databases in English and Magiran and Scientific Information Database (SID) in Persian were searched for related documents. Also, WHO, the Joint United Nations Programme on HIV and AIDS (UNAIDS), the Centers for Disease Control and Prevention (CDC), and the United Nations Population Fund's (UNFPA) guidelines and instructions for shelter services for women and girls who have been subjected were searched up to July 31, 2023. A qualitative synthesis was carried out on the 28 eligible articles and instructions out of the 420 retrieved documents. Results: "A "shelter" describes emergency and temporary "safe accommodation for women and children who have been subjected to or are at risk of (typically male) domestic abuse. Types of shelters include emergency shelters or safe homes, second-stage or transitional housing facilities, third-stage housing, and alternative accommodation during (and occasionally after) the period of residence. The shelter delivers a wide range of services, including health services, socio-economic services, and legal services. These principles consisted of a comprehensive perspective, quality of service, organization, funding, and the right issues. Conclusion: Women who are survivors need holistic, interdisciplinary, and specialist care that focuses on safety and needs. The adoption of regulations with robust enforcement guarantees and the facilitation of approvals for the construction of non-governmental shelters and safe houses should be on the agenda setting. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2453 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2453/669

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 30 35 Smitha Mohan Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College & Re-search Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Pondicherry, India Pallavee P Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College & Re-search Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Pondicherry, India Rupal Samal Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College & Re-search Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Pondicherry, India 2024 01 30 2024 03 18 Objective: Increased subcutaneous fat deposition in abdomen in large for gestational age (LGA) fetuses of mothers with gestational diabetes mellitus can be measured by fetal abdominal subcutaneous tissue thickness (FASTT) using ultrasound. The current study aimed to evaluate the correlation between FASTT and birth weight and compare FASTT and abdominal circumference (AC) for prediction of LGA babies in gestational diabetes. Materials and methods: 150 term GDM women were enrolled into the study. FASTT was measured weekly. Birth weight was measured immediately after delivery and categorized into SGA, AGA and LGA according to International growth charts. The last FASTT and AC values were recorded for analysis. Correlation statistics was used to determine the relation between FASTT with birth weight and ROC curves were used to compare FASTT and AC for prediction of LGA fetuses. Results: There was weak positive correlation between FASTT and birth weight with Pearson’s co-efficient (r) of 0.375. The cut-off value for FASTT to predict LGA fetuses obtained by ROC curve was ≥8.05 mm with sensitivity and specificity of 68.8% and 68.7%. The mean values of FASTT for small for gestational age (SGA), appropriate for gestational age (AGA) and LGA fetuses were significantly different. AUC for FASTT was 0.692 and for AC was 0.755. Conclusion: FASTT had a positive but weak correlation with birth weight. The utility of FASTT as a screening tool may not be impressive. FASTT can discriminate between SGA, AGA and LGA fetuses. AC is a better predictor than FASTT for LGA neonates.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2608 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2608/671

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 36 43 Soudabeh Ershadi Manesh Department of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran Mohammad Javad Bagian Kulemarzi Department of Psychology, University of Razi Kermanshah, Kermanshah, Iran 2024 02 21 2024 03 12 Objective: This study aimed to predict suicide attempts based on behavioral activation and inhibition systems (BAS/BIS) with the mediating role of cognitive emotion regulation (CER) strategies among adolescents of Abyek City. Materials and methods: The research methodology was descriptive-correlational. The cluster sampling method was used, and the resulting sample included 194 adolescents who responded to the BAS/BIS questionnaire (Carver & White, 1994), CER questionnaire, and Beck scale for suicide ideation. Path analysis was employed to evaluate the proposed model using AMOS 24.0 and SPSS 27 softwares. Results: The findings indicate that the proposed model is fitted with the data well. The results of path analysis showed that the BAS/BIS systems explain 27% of the variance of maladaptive CER and 61% of the variance of adaptive CER. In addition, maladaptive CER, BAS, and BIS explain 65% of the variance of suicide attempts. Conclusion: Low levels of BAS, high levels of BIS, and the use of maladaptive CER skills can be considered risk factors for suicide attempts in adolescents.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2639 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2639/672

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 1 2024 05 07 44 52 Mohaddeseh Sadeghi Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran Jamshid Jamali Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran AND Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Farshad Sheybani Department of Psychiatry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2023 12 25 2024 03 18 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Amirali Barkhordarioon Department of Obstetrics and Gynecology, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Azadeh Tarafdari Department of Obstetrics and Gynecology, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2025 03 01 2025 09 30 Objective: To evaluate the efficacy of 50 mg/day intramuscular (IM) progesterone in achieving optimal serum P4 levels during endometrial preparation and investigate the association between serum P4 levels on ET day and subsequent fertility outcomes in hormone replacement therapy (HRT) frozen embryo transfer (FET) cycles. Materials and methods: This prospective cohort study included 121 women (aged 22-45 years) undergoing HRT-FET at Imam Khomeini Hospital Complex from December 2022 to January 2024. Endometrial preparation began with oral estradiol valerate (6 mg/day) on cycle day 2. Once an endometrial thickness of ≥8 mm was achieved, daily IM P4 (50 mg) was initiated. Serum P4 levels were measured on ET day, and oral dydrogesterone (20 mg/day) was added for patients with P4 levels <10.0 ng/mL. Primary outcomes included chemical pregnancy, clinical pregnancy, miscarriage, and ongoing pregnancy rates. Results: The mean serum P4 level on ET day was 22.8 ± 10.1 ng/mL, with 78.5% of participants achieving the target range (10-32.5 ng/mL) following IM P4 administration. Overall chemical pregnancy, clinical pregnancy, and ongoing pregnancy rates were 23.1%, 18.2%, and 14.1%, respectively, with a miscarriage rate of 5.0%. Multivariate analysis revealed that P4 levels >27.8 ng/mL were associated with reduced odds of chemical pregnancy (OR = 0.20; 95% CI: 0.05-0.86; p = 0.03), while no significant differences were observed in other pregnancy outcomes across P4 quartiles. Conclusion: Daily administration of 50 mg IM P4 effectively achieved optimal serum P4 levels in most patients. While higher P4 levels (>27.8 ng/mL) were associated with reduced chemical pregnancy rates, the absence of significant correlations with other pregnancy outcomes highlights the multifactorial nature of embryo implantation success. These findings emphasize the need for further research to refine P4 thresholds and identify additional predictive factors influencing pregnancy outcomes in FET cycles.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3155 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3155/734

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 3 2025 11 04 226 231 Mohadese Dashtkoohi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mohammad Haddadi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mostafa Saeedinia Shahid Beheshti University of Medical Sciences, Tehran, Iran Fedyeh Haghollahi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Masoumeh Masoumi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Zohreh Heidary Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2025 04 30 2025 09 29 Objective: Infertility is a global health challenge, affecting many couples worldwide. Male infertility contributes to 20–50% of cases. Although semen analysis parameters are widely regarded as key indicators of male fertility, their association with in vitro fertilization (IVF) success remains debated. This study evaluated the relationship between specific semen parameters and grade A embryo formation in IVF among infertile men. Materials and methods: This retrospective cross-sectional study was conducted at a referral infertility center from March 2019 to March 2021, involving 104 men diagnosed with male-factor infertility. Semen parameters, including sperm count, motility, morphology, and volume, were analyzed. The primary outcome was the formation of at least one grade A embryo, defined as a successful IVF outcome. Statistical analyses included chi-square tests and logistic regression. Results: The median age differed significantly between the successful and unsuccessful IVF groups (36 vs. 38 years, p=0.050). No significant differences were observed in semen volume, sperm count, motility, or morphology between groups. Logistic regression revealed that younger age was associated with a higher likelihood of grade A embryo formation (OR=0.935, p=0.012), whereas semen parameters showed no significant association with embryo quality. Conclusion: This study found no significant association between semen parameters and grade A embryo formation in IVF, suggesting that traditional semen analysis has limited predictive value for embryo quality. Although younger age was associated with a higher likelihood of success, the effect size was small (OR=0.935, p=0.012), and its clinical impact may be limited. These findings highlight the potential for successful embryo development despite suboptimal semen parameters and underscore the need for a broader approach to assessing male fertility beyond standard semen analysis. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3233 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3233/735

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 3 2025 11 04 232 239 EN Pantea Nazeri Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Najmeh Hamzavi Zarghani Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada Zhale Tahmasebinejad Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohadese Dashtkoohi Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Mehdi Hedayati Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Parvin Mirmiran Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mamak Shariat Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2025 05 11 2025 09 30 Background: Several bioactive components are present in breast milk, which contribute to enhancing growth and development. Objectives: This study targeted to investigate the potential role of breast milk iodine concentration (BMIC), insulin-like growth factor-1 (IGF-I), and brain-derived neurotrophic factor (BDNF) during the early stage of lactation in child neurocognitive development. Methods: In this secondary analysis, we examined 122 breastfeeding mothers and their healthy children, all of whom were breastfed for at least six months. Levels of BDNF, IGF-1, and BMIC were assessed in breast milk samples obtained between the third and fifth days after lactation began. Three-year-old children were administered the Bayley-III screening test to assess their cognitive, motor, and language development. Results: The median (interquartile range) concentrations of iodine, BDNF, and IGF-1 in breast milk during the starting few days of lactation were 285.0 (181.0-366.0) µg/l, 0.59 (0.52-0.76) ng/ml, and 12.5 (9.6-18.3) ng/ml, respectively. The mean (standard deviation) cognitive, motor, and language scores were 101.0 (10.8), 93.4 (14.6), 100.1 (13.5) and, respectively. Linear regression models revealed a negative relation between breast milk iodine and children’s cognitive development ((β unadjusted = -0.004 (P = 0.010); β adjusted = -0.003 (P = 0.024)). However, no associations were found between breast milk BDNF and IGF-1 and cognitive, language, or motor scores in three-year-olds. Con