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   2022| January  | Volume 11 | Issue 1  
    Online since January 21, 2022

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Uptake of in-vitro fertilization among couples attending fertility clinic in a tertiary health institution
Mabel Olubunmi Omobude, Olaolorunpo Olorunfemi, Fidelis Uchendu Okafor
January 2022, 11(1):12-19
Objective: To identify factors that determine the uptake of in-vitro fertilization (IVF), and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at a tertiary health institution in Benin City, Nigeria. Methods: This study adopted a cross-sectional descriptive design. A self-structured questionnaire tested was validated and administered to 250 couples who attended fertility clinic. Data were collected from March 2021 to June 2021 and were analyzed using the Statistical Package for Social Science (SPSS) version 21. Data were presented and interpreted using descriptive statistics and inferential statistics such as Chi-square, univariate statistics and multivariate logistic regression analysis. Results: Among 250 couples, 154 (61.6%) were willing to adopt IVF. The multivariate logistic regression analysis showed that catholic religion [odds ratio (OR) 0.21, 95% confident interval (CI) 0.54-0.73], family income (OR 1.50, 95% CI 1.10-2.00) and age (OR 1.04, 95% CI 1.01-1.10) were the major factors that determined the uptake of IVF, with P-value of <0.001, 0.018 and 0.031, respectively. Conclusions: The uptake of IVF could be sustained or improved on, if the government should improve on the cost of living for families, and religious leaders need to be encouraged to pass on the information about IVF to their members to be well guided about the possibilities of IVF.
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An implementation study of barriers to universal cervical length screening for preterm birth prevention at tertiary hospitals in Thailand: Healthcare managers’ perspectives
Vitaya Titapant, Saifon Chawanpaiboon, Sanitra Anuwutnavin, Attapol Kanjanapongporn, Julaporn Pooliam, Pimolphan Tangwiwat
January 2022, 11(1):1-11
Objective: To identify healthcare managers’ perspectives on the barriers to implementing cervical length screening to prevent preterm births. Methods: In Phase I, 10 healthcare managers were interviewed. Phase II comprised questionnaire development and data validation. In Phase III, the questionnaire was administered to 40 participants, and responses were analyzed. Results: Their average related work experience was (21.0±7.2) years; 39 (97.5%) respondents also had healthcare management responsibilities at their respective hospitals. Most hospitals were reported to have enough obstetricians (31 cases, 77.5%) and to be able to accurately perform cervical length measurements (22 cases, 55.0%). However, no funding was allocated to universal cervical length screening (39 cases, 97.5%). Most respondents believed that implementing universal screening, as per Ministry of Public Health policies, would prevent preterm births (28 cases, 70.0%). Moreover, they suggested that hospital fees for cervical length measurements should be waived (34 cases, 85.0%). Three main perceived barriers to universal screening at tertiary hospitals were identified. They were heavy obstetrician workloads (20 cases, 50.0%); inadequate numbers of medical personnel (24 cases, 60.0%); not believing that the screening test could prevent preterm birth (8 cases, 20%) and lack of free drug support for preterm birth prevention in high-risk cases (29 cases, 72.5%). Conclusions: The main obstacles to universal cervical length screening are heavy staff workloads and inadequate government funding for ultrasound scanning and hormone therapy. The healthcare managers do not believe that the universal cervical length screening can help to reduce preterm birth.
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Blepharis persica increases testosterone biosynthesis by modulating StAR and 3β-HSD expression in rat testicular tissues
Nilesh Gaikar, Nishit Patel, Samir Patel, Priyal Patel, Piyush Chudasama, Manan Raval
January 2022, 11(1):27-34
Objective: To evaluate the effect of methanolic extract and ethyl acetate fraction of methanol extract prepared from the seeds of Blepharis (B.) persica on testosterone biosynthesis and also to elucidate the underlying mechanism. Methods: Forty-eight male Wistar rats were divided into eight groups (n=6 per group). Group I received 0.3% w/w gum acacia suspension p.o. and served as the normal control group. Group II was administered testosterone propionate in arachis oil i.m. as the positive control group. Group III to V received B. persica methanolic extract p.o. at doses of 50, 100 and 200 mg/kg body weight. Group VI to VIII received B. persica ethyl acetate fraction p.o. at doses of 50, 100 and 200 mg/kg body weight. The testis was used for biochemical estimation and histological studies. The effects of methanolic extract and ethyl acetate fraction of B. persica on testicular testosterone, mRNA expression corresponding to steroidogenic acute regulatory protein (StAR) and 3β-hydroxysteroid dehydrogenase (3β-HSD) along with 3β-HSD enzyme assay were evaluated in testicular tissues and sperm concentration. Ethyl acetate fraction of B. persica was subjected to column chromatography. In-vitro studies were performed using TM3 cell line at three dose levels (50, 100, 200 μg/mL), each for methanolic extract, ethyl acetate fraction and 2-benzoxazolinone for evaluation of their comparative effect on testosterone production. Results: Ethyl acetate fraction and methanolic extract of B. persica could elevate the testicular testosterone content compared to the normal control group. The treatment with methanolic extract and ethyl acetate fraction of B. persica increased the expression of mRNA corresponding to StAR by 6.7 fold and 10.6 fold, respectively, whereas the mRNA expression of 3β-HSD increased by 5.7 fold and 7.3 fold, respectively. Moreover, fraction and extract treatment exhibited increased 3β-HSD activity in the testicular tissues and were found to elevate sperm concentration in seminal fluid. The spermatogenic potential was further ensured by histological observations. 2-benzoxazolinone was isolated from ethyl acetate fraction and identified using spectral studies. It showed the ability to increase the testosterone content in the TM3 Leydig cells. Conclusions: Methanolic extract and ethyl acetate fraction of B. persica are able to increase the testicular testosterone in rats by elevating mRNA expression of StAR and 3β-HSD in testicular tissues, leading to increase the sperm concentration.
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Taurine in semen extender modulates post-thaw semen quality, sperm kinematics and oxidative stress status in mithun (Bos frontalis) spermatozoa
Perumal Ponraj, Kobu Khate, Kezhavituo Vupru
January 2022, 11(1):35-43
Objective: To assess the effect of taurine on post-thaw semen quality parameters, sperm kinematics, antioxidant and oxidative stress profiles and sperm cholesterol efflux in mithun (Bos frontalis). Methods: A total of 50 ejaculates (n=25 samples) were selected based on biophysical parameters. Each sample was split into four equal aliquots after dilution with the Tris-citrate-glycerol extender. Group I, II, III and IV contained 0 mM (the control), 25 mM, 50 mM and 100 mM of taurine, respectively. Frozen-thawed samples were analysed for motility parameters (progressive forward and in bovine cervical mucus penetration test), kinetic and velocity parameters by computer-assisted sperm analyzer, viability, sperm and nuclear abnormalities, acrosome integrity, plasma membrane and nuclear integrities, sperm enzymatic leakage and biochemical (sperm cholesterol and oxidative stress) profiles. Results: The extender containing 50 mM taurine led to a significant enhancement in viability, acrosomal integrity, plasma membrane integrity, motility (progressive and in cervical mucus), and sperm cholesterol content and notably reduced sperm morphological and nuclear abnormalities, and leakage of intracellular enzymes compared to other taurine treated and untreated control groups (P<0.05). Moreover, in addition to significant improvement in kinetic and velocity profiles, 50 mM taurine protected the integrity of acrosome and biochemical membranes than in the untreated control and other taurine treated groups. Inclusion of 50 mM taurine held a clear advantage over the control or 25 mM or 100 mM taurine in cryopreservation of mithun semen. Conclusions: Taurine (50 mM) supplementation in semen extender can be effectively utilized to reduce oxidative stress and improve post-thaw semen quality in mithun.
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Effects of enzymatic and non-enzymatic antioxidants in diluents on cryopreserved bull epididymal sperm
Hasan Sakhdary, Abbas Farshad, Jalal Rostamzadeh, Fateme Bahri Binabaj, Keyvan Sobhani
January 2022, 11(1):44-50
Objective: To evaluate the supplementation effects of vitamin E, vitamin C, superoxide dismutase (SOD), and catalase to diluents on bull cryopreserved epididymal sperm. Methods: Sperm were retrieved from 20 bull testes and were then supplemented with 0.1 mM vitamin E, 5.0 mM vitamin C, 100.0 IU/mL SOD, and 100.0 μg/mL catalase alone, or in a combination. The control treatment contained no addition. After supplementation, samples were frozen and stored in liquid nitrogen. The sperm parameters including motility, progressive motility, viability, acrosome integrity, plasma membrane integrity, kinematics and DNA damage were evaluated following the thawing process. Results: Vitamin E alone significantly increased the parameters of acrosome and membrane integrity compared to the control treatment (P<0.05). While compared to the control treatment, vitamin C had no improvement effect on sperm characteristics except for membrane integrity. Treatment of vitamin E+vitamin C had a significant improvement in total motility, progressive motility, viability, membrane and acrosome integrity compared to the control and other treatments (P<0.05). Compared to the control treatment, addition of SOD or catalase alone significantly improved the percentages of total motility, progressive motility, viability, membrane and acrosome integrity (P<0.05). Furthermore, SOD+catalase significantly increased total motility, progressive motility, viability, acrosome and membrane integrity characteristics compared to the catalase treatment (P<0.05). Vitamin E alone, vitamin E+vitamin C, and SOD in diluents decreased DNA damages and thereby improved the rate of intact sperm heads. Conclusions: Addition of 100.0 IU/mL SOD alone and 0.1 mM vitamin E+5.0 mM vitamin C, and also 5.0 mM vitamin C+100 μg/mL catalase in a combination improves the quality of cryopreserved bull epididymal sperm and could be used for cryopreservation.
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Recurrent ovarian endometrioma after conservative surgery: A retrospective study
Kuntima Kantawee, Woraluk Somboonporn
January 2022, 11(1):20-26
Objective: To study the prevalence and associated factors of recurrent ovarian endometrioma after ovarian cystectomy. Methods: This retrospective study analyzed 303 patients who underwent cystectomy for ovarian endometrioma and had at least a 2-year follow-up at Srinagarind Hospital from January 2013 to December 2018. The patients were divided into the recurrent and nonrecurrent groups according to the findings from postoperative transvaginal ultrasonography 6 months after undergoing surgery. Nineteen factors were collected for risk evaluation. The prevalence of recurrent ovarian endometrioma and its 95% confident interval (CI) were calculated. Univariate and multivariable logistic regression analyses were performed to determine the association between factors and recurrence. Results: Recurrent ovarian endometrioma occurred in 33% (95% CI 27.7%-38.3%) patients. The median duration of follow-up was 36 months. during the median follow-up period of 36 months. Preoperative history of parity, preoperative infertility history, endometriosis surgery, moderate to severe dysmenorrhea, dyspareunia, intraoperative stage 4 according to revised American Society for Reproductive Medicine classification, presence of adenomyosis, and postoperative pain relief were associated factors based on univariate analysis. In contrast, infertility [odds ratio (OR) 2.22, 95% CI 1.14-4.33], moderate to severe dysmenorrhea (OR 2.13, 95% CI 1.09-4.15), and postoperative pelvic pain relief (OR 0.22, 95% CI 0.12-0.42) were independently associated factors based on multivariable logistic regression analysis. Conclusions: In our setting, preoperative infertility history and moderate to severe dysmenorrhea were associated with a higher recurrent ovarian endometrioma risk. In contrast, postoperative pain relief was significantly associated with lower recurrence risk.
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Successful live birth after intracytoplasmic sperm injection using testicular sperm in non-mosaic Klinefelter syndrome
Sonia Jellad, Ramzi Arfaoui, Nesrine Souayah, Fatma Hammami
January 2022, 11(1):51-52
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