الفهرس 
ASSISTED REPRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Infertility is common-approximately 10% of couples have difficulty conceiving a child. In young, healthy couples, the probability of conception in one reproductive cycle is typically 20 to 25%, and in 1 year it is approximately 90%.
Several societal factors may contribute to infertility related to aging in women. In the United States, there have been increases over time in the mean maternal age at first birth (25.1 years in 2002 vs. 21.4 years in 1968) and in the mean age of women delivering a child (27.3 years in 2002 vs. 24.9 years in 1968).
Heavy metals exposure has been identified as a factor affecting human fertility. They may induce hormonal disorders, preventing ovulation and pregnancies as well as abnormalities in sperm production.
Maternal blood lead levels of approximately 10 mg/dL have been linked to increased risks of pregnancy hypertension, spontaneous abortion and reduced offspring neurobehavioral development.
Cadmium is highly toxic, and one of the most important environmental pollutants in industrialized countries. It accumulates in the human body during lifetime and can induce renal dysfunction.
It was reported that harmful effects of cigarette smoke components (cadmium, nicotine and cotinine) can disturb the intrafollicular process, leading to infertility.
Mercury and its compounds have a wide spectrum of toxicities, depending on the chemical forms and modes of exposure. There have been numerous studies on the effects of mercury on the immune system, renal system, cardiovascular, reproductive system and the central nervous system.
Mercury resulted in reproductive problems, such as spontaneous abortion, stillbirths, congenital malformations, infertility, disturbances in the menstrual cycle, inhibition of the ovulation and behaviourial effects of the offspring.
The aim of this study was to evaluate the influence of exposure to lead, cadmium and mercury from different sources on IVF treatment outcomes such as pregnancy and fertilization rate.
The present study included all females who had primary or secondary infertility and admitted for IVF or ICSI. The eligible subjects for participating in the study were 100 female. Another 100 pregnant females, selected from the inpatient department, with history of no or minimal exposure, matched for age were used as controls.
All included females were submitted to general evaluation, demographic data and other general conditions were inquired about by a questionnaire. Serum levels of lead, cadmium and mercury were estimated. The women followed up after IVF and the positive cases were evaluated and correlated with serum levels of heavy metals.
It must be mentioned that, this is study is one of the earliest studies to evaluate the correlation between heavy metal serum levels and pregnancy outcome in women undergoing IVF.
The results of the present study revealed that:
1- There was no statistically significant difference between study and control groups as regard demographic characteristics of patients (age, weight, height, BMI, husband age, etc.).
2- There was statistically significant increase in the mean serum levels of lead, cadmium and mercury in the study group when compared to control group.
3- The positive pregnancy tests were achieved in 33% of cases.
4- There was statistically significant increase in the mean serum levels of lead, cadmium and mercury in the negative cases in comparison to positive cases in control group.