Objective: To summarize whether the supplementation of L-arginine in pregnant women helps in management of preeclampsia and its impact on maternal and neonatal outcomes. Methods: Studies conducted from the past 17 years (1999 to 2016). were referred from database like Cochrane Central Registry of Controlled Trials (CENTRAL), Scopus, Google Scholar and PubMed. Out of 134 studies, 7 studies were included. L-arginine versus placebo was considered for quantitative analysis. Modified Cochrane data extraction form was used to collect the data. The risk of bias was assessed using Cochrane’s risk of bias assessment tool in RevMan 5.4 and the summary of findings was determined using GradePro software. Results: L-arginine showed a significant reduction of preeclampsia [odds ratio (OR) 0.38; 95% confidence interval (CI) 0.25, 0.58)]. There was a significant reduction in systolic blood pressure [mean difference (MD) -2.47; 95% CI -4.53, -0.42] and diastolic blood pressure (MD -0.97; 95% CI -3.83, 1.89). The effects of L-arginine on secondary outcomes like maternal gestational age, latency, neonatal weight, and appearance, pulse, grimace, activity, respiration (APGAR) score at 1st and 5th minute were not statistically significant. Conclusions: L-arginine supplementation is effective in lowering systolic and diastolic blood pressure of preeclamptic patients. However, it has no noticeable effects on maternal and neonatal outcomes.

Pregnancy associated diseases/disorders are associated with significant maternal and neonatal morbidities and mortalities. Devising/validating cost effective and easily accessible predictive, diagnostic and risk stratification markers are critical to the management and improved outcome in these diseases. Inflammation forms the backbone of most of the routinely encountered maternal complications of pregnancy. Hematological markers can be considered as a direct reflection of the systemic inflammatory milieu. Recently, the neutrophil lymphocyte ratio has been explored for its potential to assess the severity of inflammation and thus the severity of the underlying disorder. The neutrophil-lymphocyte ratio has gained scientific attention as a potential prognostic/predictive marker of acute as well as chronic inflammatory diseases including gynecological and reproductive disorders. This present study reviews the mechanistic role of neutrophils and lymphocytes in fueling or propagating the inflammatory cascades in the three most common maternal complications of pregnancy and the evidence of clinical importance of the neutrophil to lymphocyte ratio in predicting, diagnosing, and prognosticating pregnancy-associated complications.

Objective: To investigate the quality of life of infertile couples who seek in vitro fertilizations (IVFs) by gender in the Gaza Strip, Palestine. Methods: A cross-sectional study was conducted, from February 2019 to November 2019, among 383 infertile couples selected through convenient sampling. A valid and reliable Arabic version of the fertility quality of life questionnaire (FertiQoL) was used in data collection. One way analysis of variance and independent t-test were applied to compare between males and females. Results: The mean age of males and females was (34.54±8.54) years and (29.28±6.71) years, respectively. More than half of them had university degree (64% and 60%, respectively). The mean duration of infertility was (5.66±3.54) years. The mean males’ scores of FertiQoL and its subscales (emotion, mind/body, social, core, tolerability, and treatment) were significantly higher than females’ scores (P<0.05). Conclusions: Males have higher scores of FertiQoL and its subscales than females. The mean score of FertiQoL increases with better education, but decreases with increase of age, duration of marriage, duration of infertility and number of IVF attempts. Routine psychological assessment and counseling are necessary for infertile women taking into considerations factors affecting their quality of life.

Objective: To investigate the frequency of -786T>C variant in endothelial nitric oxide synthase (eNOS) gene promoter in Iranian women with recurrent pregnancy loss. Methods: Blood samples were obtained from 100 unrelated women affected by recurrent pregnancy loss and 100 unaffected women as the controls. Genomic DNA was extracted and -786T>C polymorphism in eNOS gene promoter was investigated by PCR-RFLP method. Statistical analyses and Hardy-Weinberg equilibrium in the groups of patients and controls were performed by Chi-square test and SPSS standard software (Version 21). Results: The frequency of homozygous TT was 40% in cases and 46% in the control group; the frequency of CC was 7% in cases and 5% in the control group; frequency heterozygote TC was 53% in cases and 49% in the control group. Genotype frequencies between the two groups showed no significant differences (P>0.05). Conclusions: The -786T>C polymorphism is not more frequent in recurrent pregnancy loss in this population.

Objective: To investigate the effects of folic acid on testicular oxidative damage in sodium fluoride-induced male Wistar rats. Methods: A total of 24 male Wistar rats were divided into 4 groups: the control, sodium fluoride (fed with 100 mg/L sodium fluoride through drinking water orally for 21 days), folic acid (36 μg/kg body weight/day, orally), and sodium fluoride plus folic acid (received similar dose orally) groups. At the end of 21 days, epididymal sperm parameters, biochemical analysis of testicular tissue, and serum hormonal levels were performed along with histopathological studies. Results: Sodium fluoride intoxication resulted in marked reduction in gonado somatic index, serum luteinizing hormone, and testosterone level along with 3 β -hydroxysteroid dehydrogenase and 17 β -hydroxysteroid dehydrogenase activities. In addition, reduction in sperm density, as well as loss of sperm motility and sperm viability, were also observed. Besides, increased levels of testicular malondialdehyde, nitrite, interleukin-6 and tumor necrosis factor- α as well as decreased levels of superoxide dismutase and catalase activities and reduced glutathione content were found to be associated with this toxicity. Folic acid co-treatment, on the other hand, could prevent all the sodium fluoride-induced testicular pathophysiology and oxidative stress related parameters. Histological examinations of testicular sections from the experimental rats supported these results. Conclusions: Combining all, this study suggests that being an antioxidant, folic acid plays a beneficial role against fluoride-induced adverse effects on the male reproductive system.

Objective: To evaluate the protective effects of honey compound syrup on sperm count and testis tissue in rats. Methods: Thirty rats were randomly assigned to five groups. The control group received 1 mL normal saline with dimethyl sulfoxide intraperitoneally; the busulfan group received busulfan 10 mg/kg body weight at the first and twenty-first days of the experiment via intraperitoneal injection; the last three groups received busulfan 10 mg/kg body weight to induce azoospermia, and then received 1.0, 1.5, or 2.0 mg/kg honey compound syrup, respectively, after induction of azoospermia. After administration, the testis and epididymis of all rats were removed. Then, reproductive organ weight and sperm parameters (sperm concentration, epididymal sperm reserve and daily sperm production) were measured. After hematoxylin-eosin staining, seminiferous tubule cells and diameters were assessed. Results: Busulfan damaged the testis tissue and impaired spermatogenesis. Administration of honey compound syrup in three doses improved testis tissue and spermatogenesis. The protective effects of honey compound syrup may relate to the antioxidant properties of honey and other compounds in this syrup. Conclusions: Administration of honey compound syrup could be an ameliorative agent for the side effects of chemotherapy drugs such as busulfan on the male reproductive system.