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Background: There is growing evidence that damage to spermatozoa by reactive oxygen species (ROS) plays a key role in male infertility. This study was done to review the role of oxidative stress in male infertility. Materials and Methods: In this review article, PubMed, Scopus, and EBSCO-CINAHL databases were used for finding the relevant studies. Results: Under physiological conditions, a certain level of ROS is necessary for normal sperm function. However, an excessive level of ROS produced by leucocytes and immature sperms can cause damages to spermatozoa. Oxidative stress develops when there is an imbalance between ROS production and antioxidant defense system in male reproductive tract. High levels of ROS have been detected in the semen samples of 25-40% of infertile men. Oxidative stress can induce detrimental effects on standard seminal parameters and fertilizing capacity of spermatozoa. Conclusion: Oxidative stress can induce impaired sperm function that results in poor pregnancy rate in natural conditions and assisted reproduction.

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Background: Doxorubicin (DOX) is a widely used anticancer drug, but its use in clinical chemotherapy is limited due to its side effects, including testicular toxicity. The aim of this study was to investigate the protective effect of nano-zinc oxide (nZnO) on DOX-induced reproductive toxicity in male rats.

Materials and Methods: In this experimental study, adult male Wistar rats were randomly divided into four groups, including one control and three experimental groups. They received saline, DOX (6 mg/kg), nZnO (5 mg/kg), and nZnO followed by DOX (i.p), respectively. Treatment was performed for 3 days. After 28 days, post-administration histological changes and reproductive indices were studied.

Results: Administration of DOX induced a significant reduction in seminiferous tubules diameter and thickness of germinal epithelium. Also, fertility and fecundity indices, number of litters and epididymal sperm concentration, decreased, whereas degenerated Leydig cells and deformed Sertoli cells increased.

Conclusion: Coadministration of nZnO significantly improved DOX-induced changes. These findings show the protective role of nZnO in DOX-induced reproductive toxicity.

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Background: Anti-mullerian hormone (AMH) is a reliable marker for ovarian reserve and fertility capacity. The aim of this study was to investigate the differences in AMH between physically active and non-active women.

Materials and Methods: Eighty two reproductive age women (18-50 years) participated (42 active and 40 non-active) in this cross-sectional study. Physical activity level was estimated via the International Physical Activity Questionnaire. Information on fertility parameters were obtained from medical records. Serum AMH was measured using ELISA assay.

Results: There was not a significant difference in mean age between the two groups (P>0.05). There was a significant difference between physically active and non-active women regarding basal concentration of serum exercise AMH (3.90±0.75 ng/ml versus 1.63±0.53 ng/ml, respectively) (P<0.03). Abortion rates differed significantly (P<0.05) between physically active (0.13±0.26) and non-active women (0.40±0.51).

Conclusion: These findings indicated that physical activity may improve fertility capacity in healthy women by maintaining AMH.

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Background: Human &beta-defensin 126 (12kDa) is a small cationic glycoprotein that is highly rich of cysteine. DEFB126 gene is located on the subtelomeric end of 20p1.3 in human. High expression of this protein is reported in epididymis. This polypeptide coats the plasma membrane of sperm during epididy‌mal transit. It is likely that &beta -defensin 126 might have role in unexplained male infertility since it involves in sperm maturation and capacitation. The current research designed to investigate if there is relation between &beta-defensin 126 gene mutation and unexplained male infertility.

Materials and Methods: In this case-control study we followed a two cytosine nucleotides deletion of &beta-defensin 126 gene in 35 Iranian men with unexplained infertility and 40 fertile men with normal spermogeram as control group. Standard PCR, SSCP(Single strand conformational polymorphism), and sequencing were used to detect genetic alteration of &beta-defensin 126. ELISA was performed for the assessment of the protein expression on sperm cells.

Results: Analysis of genetic data revealed 28.6% homozygote deletion in unexplained infertile men while this deletion was detected in 7.5% of controls. The deletion frequency was statistically higher in infertile patients than normal control group (p<0.05). The protein expression was less in men with del/del genotype compare to the other genotypes (p<0.005).

Conclusion: Our study shows that this common sequence variation of &beta-defensin 126 takes part in impairment of male reproductive function. Consequently, men with the del/del genotype are significantly less fertile than men who carry the wild type allele.

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Background: Polycystic ovary syndrome (PCOS) is a complex hormonal disorder affecting the reproductive and metabolic systems. The aim of this study was to investigate the effect of 8-week pilates training on anti-mullerian hormone level and cardiometabolic parameters in women with polycystic ovary syndrome.

Materials and Methods: In this semi-experimental study with pretest–posttest design, twenty PCOS patients (aged 28.16±4.29 y) were randomly assigned to pilates training or non-exercising control groups. The training group took part in an eight-week progressive pilates exercise program, three times weekly while the control group were instructed to maintain their normal daily activities throughout the eight-week experimental period. Serum levels of anti-mullerian hormone, body composition and metabolic parameters were assessed before and after the training period.

Results: After an 8 week pilates training, insulin resistance index, total cholesterol, LDL- cholesterol, triglycerides and abdominal fat were significantly decreased (p<0.05). Furthermore, anti-mullerian hormone concentrations decreased significantly in response to pilates training (p<0.05).

Conclusion: These results suggest that pilates training can have beneficial effects on metabolic indices and ovarian reserve in women with polycystic ovary syndrome over a two-month period.

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Background: Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse. Male infertility affecting 15% of couples. Environmental and genetic factors are involved in male infertility. Paraoxonase (PON) is an antioxidant enzyme which plays an important role in various diseases and is associated with oxidative stress and lipid metabolism. The PON gene family consists of 3 genes, PON1, PON2, and PON3, that located on the long arm of chromosome 7. In this study, the association of PON1 gene polymorphism at position 192 Q/R with idiopathic male infertility were investigated.

Materials and Methods: Blood Samples were collected from 120 patients diagnosed with idiopathic male infertility and 124 control subjects, and genotyped by PCR-RFLP method. To estimate the association between genotype and allele frequencies in cases and controls, P-values were assessed by Chi-square (&chi2) analysis.

Results: We observed a significant difference in genotype distributions of PON1 192 Q/R polymorphism between patients and controls (P= 0.0001). Our findings revealed individuals with the variant QR and RR had a significant decrease risk of idiopathic male infertility (RR: OR= 0.057, 95%CI=0.003-1.08, P= 0.05. QR: OR= 0.288, 95%CI= 0.132-0.394, P= 0.0001).

Conclusion: Our data indicate that the PON1 192 Q/R polymorphism maybe associated with decreased risk of idiopathic male infertility. Although more studies should be considered with larger number of patient and control subjects to confirm our results.

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Background: Nowadays, the decline in birth rate is one of the most important social problems in developing societies. Infertility is defined as a failure to conceive in a couple trying to reproduce after one year of regular intercourse without contraception. Leptin have been implicated in maintaining normal female reproductive functions, including lactation, folliculogenesis, ovarian steroidogenesis, the maintenance of mammary gland morphology, the development of dominant follicles and oocytes, the maturation of the uterus endometrium, and menstrual cycle regulation. Sinyle-nucleotide polymorphism T>C found in exon 3 leads to substitution of Arg>Trp at codon 1.5 (R105W). In this case-control study, we aimed to evaluate the association of this polymorphism and the risk of female infertility in the population of Guilan.

Materials and Methods: Blood Samples were collected from 86 patients diagnosed with female infertility and 60 control subjects, and genotyped by allele-specific PCR (AS-PCR). To estimate the association between genotype and allele frequencies in cases and controls, Chi-Square analysis was used.

Results: Analysis revealed no significant differences were found in genotype and allele distributions of LEP Arg105Trp between infertility cases and controls (p=0.21, p=0.2) in this population.

Conclusion: Our findings indicated no significant association between the Arg105Trp polymorphism and female infertility risk (p=0.21). While, more studies are needed to confirm the results.

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  Background: Approximately, 50% of male infertility causes have remained unknown. It seems that genetic disorders may lead to many cases of idiopathic infertility. XRCC1 ( X-ray Repair Cross Complementing group 1) acts as a scaffolding protein in the base excision repair (BER) and single strand break repair (SSBR). Single nucleotide polymorphisms (SNP) of XRCC1 may influence DNA repair capacity. Thus, they had been considered as a risk factor for infertility. XRCC1 Arg399Gln polymorphism was located on p rotected domain , BRCT1 . The aim of this study was to explore the p ossibility of association between XRCC1 Arg399Gln polymorphism and susceptibility to idiopathic male infertility.

  Materials and Methods: In this case-control study, the genotype and allele frequencies of Arg399Gln polymorphism were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on a Guilanian population consisting of 144 men with idiopathic infertility and 166 healthy men. Statistical analysis was performed using the MedCalc 12 software.

  Results: According to our results, compared with Arg/Arg genotype, the Arg/Gln , Gln/Gln and Arg/Gln + Gln/Gln genotypes showed a significant association with an increased risk of idiopathic male infertility ( OR=4.19 95%CI 2.37-7.41, p<0.0001 ), (OR=3.42 95%CI 1.50-7.81, p<0.0034), (OR=4.06 95%CI 2.32-7.09, P<0.0001) , respectively. In addition, the Gln allele frequency in patients was significantly higher than that in controls(p=0.0004).

  Conclusion: In total, Arg399Gln polymorphism of XRCC1 gene can be associated with male infertility and Gln allele might be a risk factor of idiopathic male infertility in in this sample population. Larger population and different ethnicities should be studied to achieve a definitive conclusion.

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Background: Infertility is a multifactorial disorder with genetic and non-genomic factors. It is estimated that female infertility factors accounts for more than 40%. Estrogen is one of the effective hormons  in fertility. Its crucial actions on target tissues are mediated via binding to estrogen receptors(ESR). The ESR1 gene is located on chromosome 6q25.1 and encodes α estrogen receptor. The aim of this study was to analysis of ESR1 rs104893956 polymorphism in female infertility.

Materials and Methods: In this case-control study, of 60 infertiles and 55 healthy controls, blood samples were attained. After the extraction of genomic DNA from peripheral blood leukocytes, Allele Specific-PCR (AS-PCR) method was applied for determining the codon polymorphism. Statistical analysis was performed using the MedCalc software (Version 12.1).

Results: The frecuency of T allele was significantly higher in patients (58%) than the controls (44%). There was higher frequency of TT genotype of the polymorphism in patients (18.33%) compared with controls (1.8%). Our findings revealed that the patients carrying the TT genotype had a significant increased risk of infertility.

Conclusion: The results of this study suggests that ESR1 rs104893956 polymorphism may affect the increased susceptibility to female infertility in Guilan province. The results may be different in other genetic pools or large-studied population.

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Background: Adoption has a significant role for strengthening families without children and also resolution of psychological confilicts of unsupervised children. The goal of this study is to assess the psychological status of adoption applicant couples.

Materials and Methods: This is a descriptive- analytic study that is done with cooperation of welfare organization and Arak University of Medical Sciences in 2014. All adoption applicant couples referred to welfare organization for 1 year participated in the study. Data were gathered by using demographic questionnaire and MMPI-II. Data were showed by descriptive statistic and were analyzed by using mean, average and covariance analysis indices.

Results: Mean and standard deviation of all clinical scales and reliability of MMPI-II in all samples and also different subgroups of statistical population were under 65. All applicants had good mental health and psychologically were eligible for adoption. A group of applicants have pretended themselves better than what they are because of the fear of rejection that led to significant difference in k scale(p=0.019).

Conclusion: According to the findings of this study, applicants had good mental health and didn’t have any psychopathologic damage, but sometimes they have pretended themselves better than what they are. Investigation of other diagnostic tools in future studies is recommended.

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Background: The prediction models for infertility treatment success have presented since 25 years ago. There are scientific principles for designing and applying the prediction models that is also used to predict the success rate of infertility treatment. The purpose of this study is to provide basic principles for designing the model to predic infertility treatment success.

Materials and Methods: In this paper, the principles for developing predictive models are explained and then the design of such models in infertility treatments is described in more details by explaining one sample.

Results: The important principles for models that firstly are described are: identifying and defining the purpose, expected function of model, input data that will be used to develop a model: type of intervention or diagnostic procedures that can lead to changes in the samples and output definition or expected result of model function. Further, characteristics of predictive factors in final model, drawing the information flowchart, internal and external validation and attention to the analysis programme of results are the important subjects that have been described.

Conclusion: If predictive models are used properly, can help treatment team and patients to achive best treatment in ART.

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Background and Aim: Recently, there is increasing concern about the declining of male reproductive health. Oxidative stress has been proposed as a possible mechanism contributed in reproductive system failure. Dorema aucheri that is being used in Persian folk medicine has been supposed to have male fertility-enhancing properties. Present study was done to evaluate the impacts of Dorema aucheri on oxidative status and reproductive parameters in male rats. Materials and Methods: In this experimental study, healthy adult male Wistar rats were treated with 100, 200 and 400 mg/kg of ethanolic D. aucheri leaves extract via gavage for 70 days. Blood samples were collected for analysis of testosterone, LH and FSH serum levels. Reproductive organs weight, density, motility and morphology of spermatozoa, seminiferous tubules diameter, germinal epithelium height and also testicular levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GPx) were evaluated. Findings: Significant (p<0.05) increases were seen in the testis and epididymis weights of male rats treated with 200 and 400 mg/kg D. aucheri extract. In rats treated with D. aucheri extract sperm density and percent of morphologically normal sperm were significantly (p<0.05) higher. No significant differences were seen in serum testosterone, FSH and LH levels between D. aucheri extract-treated groups and controls. D. aucheri significantly (p<0.05) reduced malondialdehyde (MDA) levels and also increased superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity in testicular tissue of rats. Conclusion: Present study indicates that D. aucheri leaves extract has beneficial effects on reproductive parameters in male rats which might be a consequence of its antioxidant properties.

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Background and Aim: Reducing the fertility rates in Iran and use of multiple contraceptive methods in recent decades have been affected by many social, economic and demographic factors. Therefore, this study was conducted to study the fertility pattern and common preventive fertility methods at Arak city in 2017 year. Materials and Methods: This cross-sectional study was conducted on 384 married women referred to Arak remedial centers in 2017 year. The participants were randomly selected from Vali Asr, Taleghani and Amir Kabir hospitals. The participants information was collected using questionnaire and  subsequently analyzed using Stata software version 12. Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.1396.4 has been approved by research ethics committee at Arak University of Medical Sciences. Findings: Our results showed that the mean age and average duration of marriage of women were 40.03 ± 11.19 and 21.08 ± 12.73 respectively, as well, 281 (73.2%) of women used the natural fertility prevention methods. Most of the participated women were post-graduate diploma with lacked income and housekeeping. Other contraceptive methods such as pills, condoms, IUDs, one-month menses and three-month injections were 8.9, 3.28, 6.38, 1.7 and 2.6, respectively. Conclusion: The most common method for preventing fertility is natural method. Condoms and pills are used more than the other contraceptive methods. There is a lack of awareness of modern contraceptive methods. Therefore, it is recommended that married women be educated about educational materials and counseling for familiarizing them with contraceptives.

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Background and Aim: Fertility pattern is one of the most important determinants of population fluctuations. Various individual and social factors affect this pattern. This study aimed to determine the factors affecting the fertility pattern using the structural equation model.
Methods & Materials: In this cross-sectional study, 384 women were randomly selected from married women of childbearing age who referred to Taleghani, Valiasr, and Amir Al-Momenin hospitals in Arak as patients. After obtaining verbal consent to participate in the study, a researcher-made and valid questionnaire was completed for them. Structural equation modeling was used to measure the effect of important individual and social variables on fertility patterns. Data analysis and analysis were performed with AMOUS software version 11 and SPSS V. 22.
Ethical Considerations: This study was registered with the ethics code IR.ARAKMU.REC.1396.4 by the Research Ethics Committee of Arak University of Medical Sciences.
Results: The Mean±SD age of the participants in the study was 40.03±11.19. The variables affecting the fertility pattern using the structural equation model included, respectively, the type of individual exercise, the method of contraception, the type of infertility treatment, and the duration of use of the contraceptive method.
Conclusion: The results showed that physical activity, contraceptive method, and duration of use of this method and the type of infertility treatment were related to fertility pattern. By recognizing the factors affecting the fertility pattern and increasing the awareness of young couples, it is possible to help improve the fertility pattern.

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Background & Aim: Infertility is defined as inability to become pregnant with regular sexual intercourse for more than one year without using preventive methods. Infertility has negative effects on the quality of life of infertile couples. this thesis was done with the purpose of investigating the effecte of infertility counseling to improve the quality of life among infertile couples
Materials and Methods: This randomized clinical trial was carried out on sixty infertile couples with primary infertility in2017. Samples were allocated to an intervention (30 couples) and a control group (30 couples) by simple randomization. Even days of the first week, the intervention group and in the odd days, control group samples were selected, and the opposite was done in the following week. The intervention group received infertility counseling for six forty-five-minute sessions twice a week. However, control group received routine care. FertiQoL questionnaire was completed before and after intervention. For data analysis SPSS 19 software and Paired T-Test statistical tests , Mann-Whitney and Chi-Square Test, were used.
Ethical Considerations: Ethical code is IR.KMU.REC.1395.678  in Kerman University of Medical Sciences
Findings: Comparison of the differences between the mean of quality of life in the intervention and control groups before counseling and after counseling indicated  that infertility counseling increased Meaningful quality of life in the intervention group (p <0.0001) 
Conclusion: The results indicated infertility counseling can improve the quality of life among infertile couples. Therefore, it can lead to more satisfaction and cooperation in infertility treatment.

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Background and Aim Physical activity has multiple health benefits, but its association with fertility in women is still unknown. Considering the critical effects of lifestyle on reproductive health, this study aims to compare the physical activity and body composition of fertile and infertile women.
Methods & Materials This is a case-control study that was performed on 100 fertile and 100 infertile women aged 20-40 years referred to the infertility treatment centers in Arak, Iran. they completed self-reported questionnaires surveying sociodemographic characteristics and lifestyle, and the International Physical Activity Questionnaire (IPAQ) assessing physical activity and sedentary behavior. Anthropometric characteristics and body composition were also measured. Multiple logistic regression analysis was used to analyze the association of fertility with physical activity level, sedentary behavior, and body composition.
Ethical Considerations This study was approved by the Ethics Committee of the University of Arak University of Medical Sciences  (Code: IR.ARAKMU.REC.1400.050).
Results The level of physical activity (P=0.001) was lower and the body mass index (P=0.03) was higher in infertile women than in fertile women. In women with moderate level of physical activity, the risk of infertility was lower (OR=4.42, 95% CI: 1.60-12.99, P=0.004). Women who spent the time sitting for more than 300 minutes a day were 2.07 times more likely to have fertility than women who were physically active (OR=2.07, 95% CI: 1.36-3.14, P=0.001).
Conclusion Low physical activity, sedentary lifestyle and obesity are independent risk factors of infertility. To prevent infertility, more attention should be paid to the lifestyle of women.

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Introduction: Physical activity is one of the important lifestyle factors that can have positive or negative effects on the reproductive system, and more research is needed to reflect the effect of inactivity on fertility in order to provide safe lifestyle recommendations to help couples achieve pregnancy is required. Therefore, this study was conducted with the aim of describing and comparing the physical activity status of fertile and infertile men in Arak city in 2022.
Methods: The present study is a case-control study that was conducted on 220 fertile and infertile men (22 to 40 years old) referred to Arak University Jihad infertility centers that were selected through available sampling. Participants completed self-test questionnaires on socio-demographic characteristics, lifestyle, physical activity, and sedentary behaviors. Anthropometric characteristics and body composition were also measured. Multivariate logistic regression was used to analyze the association of infertility with physical activity level, sedentary behavior, and body composition.
Ethical Considerations: This study was approved by the Ethics Committee of the University of Arak University (Code: IR.ARAKMU.REC.1401.046).
Ethical Considerations: The present research has been registered with the code IR.ARAKU.REC.1401.015 in the Ethics Committee of Arak University.
Results: In this study, it was observed that the amount of physical activity (P=0.02) and body composition (P=0.001) in fertile men is more favorable than infertile men. In men with a low level of physical activity, the risk of infertility increases 2.97 times (odds ratio 2.97 and 95% CI: 1.03, 8.61, and P=0.04). On the other hand, in men with moderate level of physical activity, the risk of infertility decreases (odds ratio 0.27 and 95% CI: 0.08, 0.92, and P=0.03). Also, in men who sit for more than 6 hours a day, the chance of infertility increases by 3.02 times (odds ratio 3.02 and 95% CI: 1.28, 7.10, and P=0.01). An increase in body mass index increases the risk of infertility by 1.61 times in men (odds ratio 1.61 and 95% CI: 1.23 and 2.11 and P=0.001).
Conclusions: Since obesity, physical inactivity and infertility in Iranian men are increasing at the same time, so there should be more focus and seriousness on the issue of lifestyle modification and especially physical activity regarding reproductive health.

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Introduction: For many people, infertility is a prominent crisis and cause of mental stress that causes many unfavorable psychological reactions. The purpose of the research is to design a cognitive-behavioral coping training package with the stress of infertility and its effectiveness on the hope of infertile women.
Methods: The present study was conducted using a mixed method using the qualitative part, content analysis type, and the quantitative part, semi-experimental, in the pre-test-post-test-two-month follow-up design with the control group. The statistical population of this research was infertile women referring to infertility centers and gynecology and infertility specialists in Kermanshah in 2022. A sample of forty women was selected as a sample using the purposeful sampling method and replaced in two groups (experimental and control) in a simple random manner. Data were collected from Newton et al.'s infertility stress questionnaire (1999) and Schneider's Hope (1991). The data was analyzed using a content validity test and repeated measurement variance analysis tests.
Results: The designed educational package was valid and adequate. The findings showed a significant difference between pre-test, post-test, and follow-up in the component of hope, and this difference continued until the follow-up stage.
Conclusions: The educational package on cognitive-behavioral coping with the stress of infertility of infertile women can be used to reduce the stress and increase the hope of infertile women.

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Introduction: The present study was conducted to investigate the effectiveness of acceptance and commitment-based therapy on the lifestyle of improving the health and emotional distress of women undergoing infertility treatment with the in vitro fertilization (IVF) method.
Methods: The method of this study was semi-experimental with a pre-test-post-test design with a control group and a follow-up stage. The statistical population of the study included women undergoing infertility treatment with the IVF method referring to the infertility center of Imam Khomeini Hospital in Tehran in the first six months of 2012. In this research, 27 women undergoing infertility treatment with IVF method were selected by voluntary sampling method and replaced by random method in test and control groups. The experimental group underwent acceptance and commitment therapy (10 sessions) for two and a half months. A health-promoting lifestyle questionnaire (HPLP) and an emotional distress questionnaire (Lavibond and Lavibond, 1995) were used as research tools. The data were analyzed using a mixed analysis of variance and Bonferroni post hoc test.
Results: It showed that the treatment based on acceptance and commitment to the lifestyle level improves health (Eta = 0.56, F = 19.74) and has a significant effect on the dimensions of emotional disorders such as depression (P < 0.0001, Eta = 0.58, F = 0.58). F = 34), anxiety (P > 0001; Eta = 0.59; F = 35.69), and stress (P > 0.0001; Eta = 0.61; F = 40.12) of women undergoing infertility treatment with the IVF, and has been able to lead to increase a healthy lifestyle, reduce depression, anxiety, and stress in these individuals.
Conclusions: Acceptance and commitment therapy, utilizing six psychological acceptance processes, cognitive breakdown, self under context, interaction with the present, specified values, and committed behavior, can be used as an effective treatment to reduce emotional distress in women undergoing IVF infertility treatment.