Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 4 2025 12 31 265 271 Vadivelan Ramachandran Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India Suriya Naarayanan Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India Kavi Kumar Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India Gugan Murugan Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India Biswajyoti Mohanty Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India 2025 09 22 2025 12 30 Objective: This study aims to test how fisetin and dapagliflozin—alone and combined—affect reproductive cycles, blood markers, hormones, oxidative stress, and tissue changes in DHEA-induced PCOS rats. Materials and methods: This study used 30 female rats split into five groups of six animals each: normal controls, PCOS disease controls, fisetin treatment, dapagliflozin treatment, and combination treatment. PCOS was created by giving the rats DHEA injections under the skin for 21 days, followed by 28 days of treatment. The researchers measured body weight, reproductive cycles, organ weights, hormone levels (LH, FSH, testosterone, insulin), cholesterol profiles, oxidative stress markers (MDA, SOD), inflammation markers (TNF-α, IL-6), and examined tissue samples under a microscope. Results: PCOS induction in rats caused estrous cycle disruption (shown through vaginal cytology), weight gain, elevated LH/testosterone/insulin levels, and compromised antioxidant status. Individual fisetin and dapagliflozin treatments significantly ameliorated these abnormalities, but their combination demonstrated the most comprehensive therapeutic benefits, effectively restoring reproductive cycles, hormonal balance, and metabolic parameters while reducing oxidative damage. Conclusion: Fisetin and dapagliflozin, particularly when used together, helped reduce PCOS-related problems by fighting inflammation, protecting against cellular damage, and improving insulin function. This likely works by influencing the PI3K/AKT cellular signaling pathway. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3489 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3489/739

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 4 2025 12 31 247 264 Zahra Shahraki Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran Mohsen Rastkar Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran Elham Rastkar Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Aida Mohamadi Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran Mozhdeh Mohammadghasemi Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran Mahsa Ghajarzadeh Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran 2025 09 19 2025 12 30 Objective: Women with polycystic ovary syndrome (PCO) suffer from a wide range of psychological difficulties such as sexual dysfunction (SD). In different countries, sexual dysfunction has been evaluated in women with PCO, but the results differ between studies. So, we designed this systematic review and meta-analysis to estimate the pooled prevalence of sexual dysfunction and to assess the odds of SD among women with PCO compared with controls. Materials and methods: PubMed, Scopus, EMBASE, Web of Science, Google Scholar were systematically searched by two independent researchers on December 1st, 2023. Data analysis was done using STATA. Results: A literature search revealed 1636 records, 84 full-texts were evaluated, and finally, 37 studies remained for systematic review.  Most studies were published in 2023, followed by 2022.Most studies were from Iran, followed by Turkey. The prevalence of SD in women with PCO ranged between 4% and 99%, and the pooled prevalence was estimated as 73% (95%CI: 72%-74%, fixed-effect model) (I2=0). The odds of SD in women with PCO ranged between 0.42 and 7.29, and pooled OR was estimated as 2.45(95%CI: 1.55-3.86, random-effect model) (I2=79.9%, P<0.001). The SMD of total FSFI (case-control) ranged between -2.83, and 0.46, and the pooled SMD was estimated as -0.48(95% -0.72, -0.25) (I2=94.6%, P<0.001, random-effect model). Conclusion: This meta-analysis demonstrates a significantly higher prevalence of sexual dysfunction in women with PCO, emphasizing the need for routine sexual health assessment and holistic management, including psychological support, hormonal regulation, and lifestyle interventions. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3483 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3483/738

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 4 2025 12 31 272 279 EN Parvathy Sreekumar Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India Anitha Chandrahausan Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research (Deemed to be University), Kanchipuram, Tamil Nadu, India Anthony Josephine Central Research Laboratory, Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India Prabu Dhandapani Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Chennai, Tamil Nadu, India Bobby Joseph Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India Sheeja Mullukalayil Joseph Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India Jiju Jayasree Sasidharan Nair Regional Cancer Centre, Thiruvananthapuram, Kerala, India Dinesh Roy Divakaran Genetika, Centre for Advanced Genetic Studies, Thiruvananthapuram, Kerala, India 2025 10 13 2025 12 30 Objective: Investigating the genetic influence of Protein Tyrosine Phosphatase Non-Receptor Type 22 (PTPN22) on key inflammatory biomarkers-Interleukin-1β, Interleukin-6, and high-sensitivity C-reactive protein (hsCRP) and to evaluate their association with disease progression in endometriosis. Specifically, this study aims to (i) assess differential expression of PTPN22 in cases versus controls, (ii) examine correlations between PTPN22 expression and inflammatory markers, and (iii) determine the predictive value of these biomarkers using ROC curve analysis. Materials and methods: This study involved 150 women with endometriosis and 150 matched controls. Blood samples were analyzed for inflammatory markers (IL-6, IL-1β, hsCRP) using ELISA and PTPN22 gene expression by real-time PCR. Statistical analyses were conducted using Stata 17.0, and ethical approval (01/2022/IECG) and informed consent was obtained. Results: PTPN22 expression was higher in endometriosis cases (p = 0.0001), suggesting a role in disease pathophysiology. ROC analysis showed moderate predictive accuracy (AUC = 0.63). Among the inflammatory markers, hs-CRP was the most diagnostic, followed by IL-6 and IL-1β, with stronger positive correlations observed in the endometriosis group. Conclusion: These findings highlight the translational relevance of PTPN22 and hsCRP as candidate biomarkers for early detection and risk stratification in endometriosis, underscoring the interplay between genetic susceptibility and inflammatory signaling in its pathogenesis.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3525 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3525/740

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 4 2025 12 31 280 285 Pushpalatha Marisamy Department of Commerce, Sri Krishna Arts and Science, Coimbatore, India Premkumar Jayapal Department of Food Technology, Nehru Institute of Technology, Coimbatore, India Ramesh Mageswaran Department of Aerospace Technology, SNS College of Technology, Coimbatore, India Mohanraj Krishnan Selvaraj Department of Mechanical Engineering, Erode Sengunthar Engineering College, Erode, India Karthikeyan Arthanari Department of Aeronautical Engineering, Excel Engineering College, Namakkal, India 2025 09 20 2025 12 30 Objective: To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and sperm DNA fragmentation index (DFI), and to identify clinical predictors of elevated DFI among men referred for infertility. Materials and methods: We conducted a cross-sectional study of 783 men referred to a tertiary infertility clinic. Participants underwent semen analysis according to WHO criteria, measurement of serum 25(OH)D by standard immunoassay, and assessment of sperm DNA fragmentation using a validated laboratory method. Demographic and clinical variables (age, BMI, smoking, duration of infertility) were recorded. Associations between 25(OH)D and DFI were evaluated using correlation analysis and multivariable linear and logistic regression models adjusted for potential confounders. Elevated DFI was predefined based on laboratory cutoffs. Results: Among 783 men, vitamin D deficiency was common and a wide range of DFI values was observed. Serum 25(OH)D concentration showed no significant association with sperm DFI after adjustment for age and conventional semen parameters (adjusted effect estimates not significant). In multivariable analyses, older age, lower progressive motility, abnormal morphology and reduced sperm concentration were independently associated with higher DFI (all p < 0.05). These associations persisted when DFI was analyzed as a dichotomous outcome (elevated vs. normal). Conclusion: In this large clinic-based sample, serum 25(OH)D was not independently associated with sperm DNA fragmentation. Conventional semen quality measures and age were stronger and consistent predictors of elevated DFI. These findings suggest that routine assessment of vitamin D status is unlikely to inform sperm DNA integrity beyond established semen parameters; prospective studies are needed to confirm causality. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3486 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3486/741

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 4 2025 12 31 286 292 Zeinab Bahrami Student Research Committee, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran Ali Naghsh Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran Ali Saghebi Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 2025 09 26 2026 01 11 Objective: Dissociative disorders are a range of conditions characterized by a sudden, temporary disruption in a person's consciousness, memory, identity, or perception. This study aimed to determine the prevalence of dissociative disorders among women who had experienced physical domestic violence and were referred to the Department of Forensic Medicine. Materials and methods: This cross-sectional study was conducted at the Mashhad Department of Forensic Medicine in 2024. The primary objectives were to determine the prevalence of dissociative amnesia, dissociative fugue, dissociative identity disorder, and depersonalization /derealization disorder in this population. Data were collected using two instruments: the Dissociative Experiences Scale (DES) and the Structured Clinical Interview for DSM Dissociative Disorders (SCID-D). Results: Among the participants, 22.6% were diagnosed with a dissociative disorder. The prevalence rates for specific disorders were 21.7% for dissociative amnesia, 5.7% for dissociative fugue, 9.9% for dissociative identity disorder, and 12.7% for depersonalization/derealization disorder. A lower level of education (non-university) was significantly associated with a higher prevalence of overall dissociative experiences, dissociative amnesia, and depersonalization/derealization. Conclusion: The findings indicate a relatively high frequency of dissociative disorders among women who experienced physical domestic violence and were referred to the Mashhad Department of Forensic Medicine in 2024. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3494 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3494/742

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 19 4 2025 12 31 293 300 Mitra Alizadeh Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mina Jafarabadi 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 Elahe Rezayof Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2026 01 04 2026 02 03 Objective: Short-term liquid storage of human sperm is frequently required in assisted reproductive technologies, yet storage-related declines in sperm quality remain a challenge. Pentoxifylline (PTX) has been used to enhance sperm motility, but the optimal timing of PTX administration in relation to storage temperature is unclear. Materials and methods: In this experimental laboratory study, semen samples from 30 normozoospermic men were divided into six paired aliquots and stored for 24 hours at room temperature or 4 °C. PTX (3 mmol/L) was administered either before storage, after storage, or not at all. Sperm motility, viability, and morphology were assessed using standard light microscopy. Results: Significant differences were observed across groups for sperm motility parameters and abnormal morphology (p < 0.05), whereas sperm viability remained comparable. Delayed PTX admons, 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 Alireza Mirahmadizadeh Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2024 07 27 2024 09 22 Objective: The widespread utilization of high-resolution computed tomography (HRCT) for diagnosing and management of COVID-19 during the pandemic has prompted worries regarding a potential rise in future breast cancer cases. We aimed to estimate the Life Attributable Risk (LAR) of breast cancer in Shiraz, Iran, linked to HRCT use during the COVID-19 pandemic. Materials and methods: A cross-sectional study was conducted at Namazi Hospital in Shiraz from February 2, 2020, to December 31, 2022.The Imaging Performance Assessment of CT Scanners (ImPACT) patient dosimetry calculator was used to determine organ doses. LAR was computed ut