Is psychosexual therapy a reliable alternative to bupropion extended-release to promote the sexual function in infertile women? An RCT

Background: Various treatment methods are used to deal with sexual problems. Objective: This study was applied to answer the question of whether psychosexual therapy (PST) can be a reliable alternative to bupropion extended-release (BUP ER) to promote sexual function in infertile women. Materials and Methods: In this randomized clinical trial, 105 infertile women with sexual dysfunction were randomly allocated to three groups: PST, BUP ER, and a control group. The PST group participated in a total of eight 2-hr group sessions. In BUP ER group, 150 mg/day Bupropion ER was administered for eight weeks. The control group did not receive any interventions. The female sexual function index (FSFI) and a clinical interview were used to assess their sexual dysfunction. Results: The mean pre-to-post treatment scores of FSFI and its subscales increased significantly in PST and BUP ER groups (except in the subscale of sexual pain) (p = 0.0001, p = 0.0001). The changes in the subjects were not significant in the control group. After adjusting for the baseline values, the results remained significant for the mean FSFI (p = 0.0001), and its subscales between the groups. Compared to the control group, a significant increase was observed in the mean FSFI (p = 0.0001, p = 0.002) and its subscales in the PST group and in the BUP ER group (except in the subscale of sexual pain). Comparison of two intervention methods showed that PST had the better effect on the sexual function improving (p = 0.0001) and its subscales (exempting the subscale of orgasm) than BUP ER. Conclusion: PST can be considered not only a reliable alternative to pharmacotherapy; it also produces better results in terms of improving sexual function in infertile women. Key words: Infertility, Sexual activities, Drug therapy, Psychotherapy, Bupropion

The comparison of insulin resistance frequency in patients with recurrent early pregnancy loss to normal individuals

<p>Abstract</p> <p>Background</p> <p>Patients with ≥ 3 recurrent spontaneous miscarriages are classified as having RSM. Polycystic ovary syndrome (PCOS) is associated with insulin resistance (IR). The purpose of this study is to evaluate the association of IR and RMS.</p> <p>Methods</p> <p>Present case- control prospective study was performed on 100 women in control group (with a history of at a live birth and no history of one more abortion) and study group (with a history of ≥ 3 RMS) who were not diabetes and PCOS. Two groups matched in base of age and body mass index. Blood was withdrawn from the case and control patients for the determination of the fasting blood glucose (FG), fasting insulin (FI) levels and ultrasonography was performed on all the patients.</p> <p>Results</p> <p>The observed differences between age, FG and FG to FI ratio levels in case and control groups were not significant (<it>p </it>> 0.05) but it was significant about fasting insulin (<it>p </it>= 0.0119). FI of < 20 <it>μu/ml </it>or ≥ 20 <it>μu/ml </it>in case and control group was significant (Chi-square: 4.083, p: 0.0433, odds ratio: 4.4386, CI95% = 1.1541 to 17.0701), whereas the difference between absolute and proportional frequency of patients with FG to FI ratio of < 4.5 and ≥ 4.5 in case and control groups was not significant (Chi-square: 2.374, <it>p </it>= 0.123).</p> <p>Conclusion</p> <p>Current study showed that in women with RPL, in Iranian race like Americans, frequency of insulin resistance in high, therefore there is a probability of the degree of insulin resistance in women with RPL.</p

Pharmacological and Non-pharmacological Therapeutic Strategies for Improvement of State-Trait Anxiety: A Randomized Controlled Trial Among Iranian Infertile Women With Sexual Dysfunctions

Objective: To compare the effects of pharmacological and non-pharmacological therapeutic strategies for improvement of state-trait anxiety among Iranian infertile women with sexual dysfunctions (SDs). Material and Methods: In a randomized controlled clinical trial, 105 women with infertility suffering from SDs were randomly assigned to participate in a 2-hour group weekly session of psychosexual therapy (PST) (n = 35), took a tablet of bupropion ER 150 mg/d (BUP ER) (n = 35), or control (n = 35) for 8 weeks during 2014–2015. The Female Sexual Function Index (FSFI) and Spielberger State-Trait Anxiety Inventory (STAI) were completed before and after of the study. Results: State and trait anxiety levels had mean values of 47.80 ± 10.93 and 48.78 ± 11.34, respectively. Mean values of state and trait anxiety levels observed at baseline significantly decreased toward the end of the study in each of the treatment groups (PST, P < 0.0001 and P < 0.0001; BUP, P < 0.005 and P < 0.001, respectively), and the decrease was more significant in the PST group than in the BUP ER group (P < 0.001 and P < 0.007, respectively) and the control group (P < 0.0001) and P < 0.0001, respectively). Significantly high improvement in state and trait anxiety levels was observed in the PST group than the BUP and control groups. However, the decrease in the BUP group was not significant than the control group (P < 0.076 and P < 0.186, respecttively). Conclusion: PST compared to bupropion ER treatment was found to be a more favorable strategy for improvement of state and trait anxiety symptoms

Mental and personality disorders in infertile women with polycystic ovary: a case-control study

Background: Polycystic Ovarian Syndrome (PCOS) is one of the most common causes of infertility in women. Objective: The current study investigated mental and personality disorders in infertile women with and without PCOS. Methods: This case-control study evaluated 400 infertile women who referred to the Infertility Center in Babol city (North of Iran). Participants were categorized into the case group (201 PCOS) and the control group (199 without PCOS). All of the participants completed the Millon Clinical Multi-axial Inventory-III (MCMI-III). Results: The mean scores for clinical personality patterns were significantly higher for six personality disorders (schizoid, avoidant, antisocial, depressive, sadistic, and negativistic) and for three classes of severe personality disorder patterns (schizotypal, borderline, and paranoid) in infertile women with PCOS than in women without PCOS. The mean scores for eight clinical disorders (somatoform, manic disorder, dysthymia, alcohol-dependence, drug-dependence, post-trauma stress disorder, major depression, and delusion disorder) were also higher in infertile women with PCOS than in women without PCOS. Conclusion: The scores of many mental and personality disorders are higher in infertile women with PCOS than in women without PCOS. Thus, clinicians should prioritize recognizing and treating psychological problems of infertile women with PCOS

Vaginal wall cysts in a prepubertal girl: a case report

A vaginal cyst is an encapsulated sac, situated on or under the lining of vagina, and contains liquid or semi liquid substance. Vaginal cysts have rarely proved to be more troublesome than causing a bit of discomfort and slight pain, but in some cases, they can develop into tumors. A 5-year-old girl, who was complaining about a weird pain in her lower abdomen, was referred to the gynecology center of the hospital. Ultrasonography revealed a vague large cyst in her uterus and vagina. Surgical procedure was necessary to remove it. The patient was followed up for 6 months, and no sign of recurrence of the cyst was observed

Age of women and the number of antral follicles in predicting ovarian response in intrauterine insemination (IUI)

Background: Fertility specialists assess ovarian responses prior to estimating the prognosis for women who are suffering from anovulation. To diagnose the inconsistencies between chronological and biological age of ovaries and predict ovarian response, transvaginal sonography (TVS) ovarian act as an operant method. The aim of the current study was to assess the correlation between the number of antral follicles in both ovaries and the age of women in predicting the ovarian response in intrauterine insemination (IUI).  Methods: The research design of the present study was a cross-sectional. A total of 171 individuals, who were non-smoker patients and had already undergone a standard regimen of ovarian stimulation for IUI, were selected as participants of this study from the Infertility and Reproductive Health Research Center in Babol (Iran). On the third day of the cycle, TVS was conducted to measure the mean of every ovary and also to count the number of antral follicles on the both ovaries.  Results: The mean age of our patients was 27.7. The increased aged of women is significantly associated with lower total number of antral follicles. (P = 0.001). The mean ovarian diameter was significantly correlated with high number of antral follicles (p = 0.0001).  Conclusion: The findings of the present study indicated that the age of women and the ovarian diameter are leading factors to help determine ovarian response as well as basal antral follicle counts

Evaluation of Nutritional Status of Quince Trees (Cydonia oblonga Mill.) by Compositional Nutrient Diagnosis Method (CND) in Isfahan Province

Introduction Quince with the scientific name "Cydonia oblonga Mill." is one of the most important horticultural products in the word including Iran. According to the average production from 1994 to 2020, Iran was the fourth largest quince producer in the world. Isfahan province is one of the most important centers of high quality quince production with 2432 hectares of cultivated area and annual production of 25986 tons. Most of the quince orchards are located in the cities of Natanz and Isfahan. Plant nutrition as an important factor in growth, is a function of nutrients and environmental conditions interactions. Assessing the nutritional status of plants is based on precise determination of nutrients and appropriate application method to diagnosis and interpret the results. Various methods have been used to evaluate the nutritional status of the plant, such as the Critical Value Approach (CVA), the Deviation from Optimum Percentage (DOP), the Diagnosis and Recommendation Integrated System (DRIS) and the Compositional Nutrient Diagnosis (CND). The CND method expresses interactions by considering the ratio of one element to the geometric mean of all elements. Then high and low functional groups are separated, by using mathematical and statistical methods and application of cumulative function of the variance ratio of nutrients and the chi-square distribution function. Finally, CND nutrients norms and indices such balance index are calculated step by step. Therefore, considering the importance of the quince production in the country and the lack of sufficient knowledge to determine its nutritional status, the present study was conducted with the aim of investigating the nutritional status of quince trees using the CND method and determining the nutrients norms for this product. Materials and Methods  In order to evaluate the nutritional status of quince trees using the CND method, 28 orchards were selected in the cities of Isfahan and Natanz. The orchards were selected such a way that they had different ranges of yield. The geographical location was recorded for each orchard. Then random and composite sampling of leaves was done from branches without fruit in July 2018. Concentration of nitrogen phosphorous, potassium, calcium, magnesium, iron, manganese, zinc, copper and boron was measured in quince leaves. At the end of season, the yield was determined for each orchard. The orchards divided into two groups based on high and low yields. The CND norms, CND nutritional index and nutritional balance index (r2) were computed based on steps of Parent and Dafir. The balance index of nutritional elements (r2) was calculated by Keith-Nilson method based on the Chi-square statistical distribution function (K2) in Excel software.   Results and Discussion According to results of cumulative distribution function of nutrient variance and considering the yield of 23 tons per hectare as the intermediate yield, 25% of the studied orchards were in the high yield group and 75% of the orchards were in the low yield group. After solving the third– rank cumulative function equations of the studied nutrients, the highest yield was obtained for potassium Fci (VK) = 21.98 and the lowest value was for nitrogen Fci (VN) = 15.37. CND standard norms of nutrients and residual value were described as: V*N= 2.91, V*P= 1.39, V*K= 2.91, V*Ca= 2.13, V*Mg= 1.35, V*Fe= -2.01, V*Mn= -3.12, V*Zn= -3.97, V*Cu= -4.85, V*B= -3.51 and V*Rd= 6.78. The CND nutrient index revealed that potassium and nitrogen had the most negative index among macronutrients in the low-yield orchard group. The low amount of soil organic matter and the high presence of sand can contribute to the negative nitrogen index. Among the micronutrients, the iron index was negative in 67.7% of the low-yield orchards. Zinc and copper had the next highest nutritional requirements in most orchards. The presence of calcareous conditions in the soil of the studied orchards may be one of the reasons for this observation. The estimation of the nutritional balance index indicated that the r2 value in orchards with low yield was 60.3% higher than that in high-yield orchards. Conclusion  CND nutritional balance index (r2), specially in orchards with low yield was more than zero (20.85), indicating nutritional imbalance in these orchards. Proper management and balanced application of chemical fertilizers should be considered. This can increase the yield and quality of quince production

Impact of dexamethason

Objective: Infertile women with polycystic ovary (PCOs) involve with anovulatory cycles. Various adjuvant treatments have been suggested to improve ovarian response in these patients. In this study, we aimed to evaluate the role of dexamethasone in the outcome of IVF/ICSI in PCOs infertile women. Study design: 129 PCOs infertile women undergone IVF/ICSI were enrolled for this single blind clinical trial study in 2012–2013. Setting: Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran. Method: 43 patients who underwent IVF received dexamethasone (0.5 mg, 4 tab/day) in the treatment group and 74 patients were considered as the placebo group. Main outcome measure: Pregnancy rate was compared between the two groups. In addition, number of dominant follicle, oocytes retrieved, embryos transferred, and number of gonadotropin ampoule were evaluated. Results: The pregnancy rate in the group receiving dexamethasone was 17.5% significantly higher versus 4.3% in the placebo group (P < 0.05). The mean number of embryos in the patients received dexamethasone was 6.7 ± 4.3, significantly greater than placebo which was 4.9 ± 4.9 (P < 0.05). The mean number of gonadotropin ampoules used in the group received dexamethasone was 3.5 ± 1.6, significantly lower versus the placebo which was 5.3 ± 2.5 (P < 0.05). The mean number of oocytes in the group received dexamethasone was 11.8 ± 8 and in the placebo group was 9.6 ± 5.8 that was not significant. Conclusion: Dexamethasone enhances embryos and pregnancy rate; in addition, it reduces gonadotropines ampoule used for stimulation, hence, and we recommend using of dexamethasone in women with PCOs undertreatment of IVF/ICSI