Introduction: Infertility is a major stressor in life and can cause disturbances in both sexual and marital relationships. Therefore, the objective of this study was to determine the frequency of sexual dysfunctions among infertile couples, who referred to the infertility center in Babol, Iran, and the identification of the factors associated with these problems.

Method: A cross-sectional study was performed on 236 partners of infertile couples. A standard questionnaire named international classification DSM-IV was used to assess the frequency and the type of sexual dysfunction. The data were analyzed by descriptive statistics and adjusted odds ratios with their 95% CIs.

Results: According to the results, around 58% of men were found to suffer from sexual dysfunction. The most prevalent type of sexual dysfunction was premature ejaculation, (34.7%), orgasm disorder (28.0%), desire sexual disorder (9.2%), delayed ejaculation (8.5%), retrograde ejaculation (6.8%) and erection dysfunction (5.5%). The men with a history of primary infertility had 3.61 fold risk of sexual dysfunction compared to women who had secondary infertility. Male Infertility (odds ratio, 3.61 95% CI, 2.13-4.58) and idiopathic were (odds ratio, 3.43 1.23-4.85) factors significantly associated with sexual dysfunction. There was 4.92 fold risk of sexual dysfunction observed in men whose wives had sexual dysfunction as compared with those whose wives had no sexual dysfunction.

Conclusion: This study shows a high prevalence of sexual dysfunction for male partners of infertile couples in a community in Babol, Iran. It would be beneficial to establish a sexual clinic in infertility centers for the professional staff to monitor infertile couples.

Introduction: It is plausible that pregnancy may result in a decrease in the serum zinc concentration. The concentration of serum zinc is an important determinant of maternal complications. The aim of the current study was to identify serum zinc concentration and evaluate the possible correlation of this concentration with the length of first and second stage of labor in the pregnancy.

Methods: In an observational prospective study, 432 pregnant women, 18 to 35 years of age, from urban primary health care centers in Tehran (Iran) were selected through a multi-stage sampling method and sampling proportionate to size. The blood samples were obtained for the measurement of maternal serum of iron and zinc in healthy singleton pregnancy between 14 to 20 weeks of gestational age, which was accomplished through electro-thermal atomic absorption spectrometry and zinc the standard procedure, respectively. Meanwhile, the length of the stages of labor was also recorded. Serum zinc and serum iron concentrations during early pregnancy, which are associated with prolonged labor, were also analyzed.

Results: Maternal zinc and iron deficiency during pregnancy were found to be around 28.7% and 16.0%, respectively. The overall proportion of prolonged labor was 13.5%. The women with prolonged labor significantly had lower zinc concentration (p=0.03), However, there was no association between prolonged labor and zinc/ iron deficiency after adjusting for confounders.

Conclusion: The findings of the current study indicated that a high prevalence of zinc deficiency was identified among the pregnant women in the second stage of pregnancy. Therefore, it is important to emphasize the need for further research for the evaluation of potential risk factors for maternal complications.

Introduction: The benefits of male involvement in pregnancy have recently gained recognition. The aim of this study was to explore the prevalence of Iranian men’s attendance during pregnancy and its association with socio-demographic factors in Babol, Iran. This study also aimed to improve the male involvement in maternal health in Iran.

Methods: In a cross sectional study, a total number of 600 pregnant women, attending the antenatal clinics in both public and private medical centers from Feb. to Sep. 2015, were selected through a systematic random sampling method. A semi-structured questionnaire comprising 10-item, two-choice questions (Yes-No) elicited information about the men’s attendance at antenatal clinic, their help with household chores, their attendance at counseling sessions, and their paying for the pregnancy service bills.

Results: According to the results, 414 husbands under study (69.0%) accompanied their wives to the antenatal clinic during the pregnancy. Nearly, less than half of the husbands (42.5%) helped their wives with household chores during pregnancy. After adjusting for suspected confounding factors, the OR of Iranian men’s attendance at antenatal clinic for men with special job was  2.76 (95% CI, 1.26 - 6. 05 P = 0.011), and for men with low educational level, it was 0.404 (95% CI, 0.18 - 0.90 P = 0.026). In addition, the OR of Iranian men’s at household chores for men with special job was 2.60 (95% CI, 1.43 - 4. 74 P = 0.002), and for men with educational level between 7 to 12 years, it was 0.404 (95% CI, 0.18 - 0.90 P = 0.002). No significant associations were found between Iranian men’s attendance in pregnancy with the age of men and women, income, residence status, education of women, job of women, birth order, or pregnancy intention.

Conclusion: The findings of this study indicated that the Iranian men’s attendance in pregnancy is low. The Iranian Ministry of Health should strive to provide adequate guidelines for the development of male involvement in pregnancy.

Introduction: Chronic diseases, diabetes in particular, are globally epidemic, and are regarded as a major public health problem for reproductive health. Diabetes may influence maternal health, pregnancy outcomes, and also mental health.  The aim of the current study was to identify the prevalence of mental health disorders in type 2 diabetic women and to evaluate the possible correlation of the subscales of mental disorders with coexisting diabetic complications.

Methods: In this cross-sectional study, a total number of 400 women with type 2 diabetes were selected from the outpatient clinic of diabetic care center in Amol, Iran. The General Health Questionnaire (GHQ–28) was used as a screening tool for the detection of mental disorders.  The questionnaire, which contained 28 items, comprised four domains: somatic symptoms, anxiety /insomnia, social dysfunction, and severe depression. The diabetic complications were obtained from their documents.

Results: The mean age of the participants, with a mean diagnosed 8.9±0.3 years, was 48.8±0.5 years. The prevalence of mental disorder among Type 2 diabetic women was found to be 73.7%. The most prevalent mental health disorder was social dysfunction (78.8), somatic symptoms (51.7%), anxiety/ insomnia (33.3%), and severe depression (11.3%) among type 2 diabetic women.   The prevalence of mental health disorder was higher in women with coexisting diabetic complications&ge3 than those <3 complications (p <0.05).  Significant differences was found between somatic symptoms, anxiety/ insomnia with coexisting diabetic complications (p <0.05). There were no significant differences between social dysfunction, severe depression with coexisting diabetic complications.

Conclusion: The study demonstrated the importance and the effect of diabetes on mental health disorders. Therefore, it is necessary to put emphasis on the benefits of psychological screening at outpatient clinic of diabetic care center in Iran, particularly for those with co-morbid medical complications. 

Introduction: Many women nowadays postpone their first pregnancy to the fourth or fifth decades of their lives, which could emanate from social, economic and educational factors. This study was an attempt to evaluate the pregnancy and neonatal outcomes in women at 40 years of age or above.

Methods: In this retrospective study, we compared the pregnancy outcomes for women over the aged 40 with those of age group under the age of 40 years. The maternal and obstetrical data, from August 2009 to August 2013, were all obtained from hospitals obstetrical documents. The Chi-square test and the T-Test were used to determine the relationship between the qualitative and the quantitative variables.

Results: During the four years, a total number of 160 women, aged 40 or above gave birth, among which 25% was nulliparous. The mean age at delivery for the elderly group was 42.4 ± 2.1, which can be compared with the mean age of women (26.7± 4.7) under the age of 40. The gestational diabetes (p= 0.0001), gestational hypertension (p = 0.022), and polyhydramnios (p=0.010) occurred more often in women aged 40 or above. It is worth mentioning that the occurrence of anemia in the third trimester in the elderly group was lower than that of the younger group (8.8% vs. 23.1%) (p= 0.024). The preeclampsia, preterm labor, low birth weight, oligohydramnios, bleeding, emergency Cesarean section, and urinary tract infection were all similar in the two age groups.

Conclusion: This study showed that the adverse pregnancy outcomes were significantly higher in the women aged 40 years or above when compared with those of younger women. Therefore, there is an urgent need to provide more frequent prenatal care for the elderly women in primary health care centers.

Introduction: Nausea and vomiting in early pregnancy is a common complaint, affecting approximately 50-80% of pregnant women. The aim of this study was to determine the effect of the severity of nausea and vomiting from pregnancy on the quality of life during the first trimester of pregnancy.

Methods: An analytical study was conducted on pregnant women with nausea and vomiting from pregnancy (NVP) during their first 12 weeks. These pregnant women were receiving prenatal care at the prenatalogy ward of Rouhani Hospital, which is affiliated to Babol University of Medical Sciences. The women were asked to complete a visual analogue scale questionnaire to report their intensity of nausea within the last 24 hours. The severity of NVP was measured by a structured questionnaire. A Health-Related Quality of Life for Nausea and Vomiting during Pregnancy (NVPQOL) questionnaire was also used to measure the quality of Life of pregnant women with NVP. Low scores in all domains of NVPQOL and the overall quality of life evaluation mean better quality of life. A total number of 80 women with NVP, who were within the age range between 18 to 35, were randomly selected for the purpose of this study.

Results: The mean total score of NVPQOL was 95.5±15.69. The total quality of life score in women with severe nausea (p = 0.003) and sever vomiting (p = 0.029) was higher than that of the mild/moderate group. A statistically significant result was found in the mean scores of the fatigue domains between the women with mild/moderate and severe nausea groups (P = 0.001). The women with severe vomiting also had significantly higher mean scores of the physical symptoms (P = 0.027) and limitation (P = 0.027) domains compared with those with low/moderate vomiting.

Conclusion: The finding showed that the NVPQOL score was correlated with the severity of NVP symptoms. It is, therefore, very important that we, in our clinical practices, consider the impact of NVP on Iranian woman's quality of life in order to provide them with optimal management in case the need arises.

Introduction: Ovarian cancer is the most common cause of cancer death from gynecological tumors in Iran. Despite the fact that intra-operative frozen section, which is widely used in diagnosis of ovarian tumors, there are problems associated with the diagnostic procedure in this setting. The aim of this study was to compare the intra-operative frozen section with the permanent histo-pathological sections in the diagnosis of ovarian cancer at Rouhani Hospital in north of Iran.

Methods:  The intra-operative frozen section diagnosis was conducted on 126 women with ovarian masses, who underwent surgery between January 2006 and July 2011. The results of the intra-operative frozen section were compared with those of the past histopathological diagnoses of permanent sections as the gold standard.

Results: The overall accuracy of intra-operative frozen section diagnosis was 94.4%. There were 0.9% cases with false-positive as well as 1.8% cases with false-negative. The sensitivity and specificity values were 66.7% and 100% for malignant tumors, 80.0% and 95.9 % for borderline tumors, and 99.1% and 90.0% for benign tumors, respectively. All inaccurate diagnoses were for the epithelial tumors.

Conclusion: The intra-operative frozen section diagnosis is a reliable method for the surgical management of the patients with an ovarian mass. Diagnostic problems can occur during the intra-operative frozen section examination. The clinicians and pathologists must be aware of the pitfalls of this method therefore, there is an urgent need to establish a good communication among them in order to obtain more accurate results.

Background: Azoospermia is the most challenging issue associated with infertility treatment. The aim of this study was to re-examine the relationship between plasma levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) with testicular pathology in azoospermic infertile men visiting the infertility clinic in north of Iran.

Methods: Fifty eligible azoospermic infertile men who had the medical indication of testicular biopsy for sperm retrieval in infertility clinic were included in the study. Plasma FSH and LH were measured by immunoassay. Then a bilateral testicular biopsy using Bouin’s solution as a fixative was performed under local anesthesia. The One-way analysis of variance was used to assess the differences between the groups.

Results: The plasma levels of FSH (p=0.0001) and LH (p=0.044) among infertile men with Sertoli-cell-only syndrome was significantly higher than those with hypospermatogenesis. Also, the plasma levels of FSH among infertile men with maturation arrest was significantly higher than those with hypospermatogenesis (p=0.003). There were no statistically significant differences in plasma LH levels between hypospermatogenesis and maturation arrest.

Conclusions: The findings of the present study indicated that the plasma levels of FSH and LH among infertile men with azoospermia testis correlated with the histopathological features. Therefore, it is necessary to emphasize the fact that azoospermic cases with highly-elevated plasma FSH and LH levels could be excluded from separate testicular biopsy as they are not suitable cases for conventional treatments.

Iatrogenic vas deferens injuries (IVDIs) as inadvertently medical conditions are critical complications of surgical operations in the inguinal region of children and adults. It is well documented that any scant disturbance in vas deferens tunica muscularis or mucosa will endanger fertility and unintentionally manipulations during inguinal hernia repair can cause perforation and/or obstruction of damaged vas deferens resulting in male fertility reduction. It has also been suggested that IVDIs can play crucial roles in formation of anti-sperm autoantibodies and sympathetic vasospasm leading to bilateral testicular deterioration as well as sperm motility and capacitation impairments. In line with that, it seems that non-recognized IVDIs may have destructive effects on spermatogenesis resulting in fertility problems and careful attention to surgical detail should be considered during inguinal region surgical procedures to prevent IVDIs. However, recent progresses in urological microsurgeries and assisted reproductive technologies provide remarkable improvements in fertility outcomes of patients even with serious iatrogenic reduction in fertility.