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15 March 2015, Volume 34 Issue 2
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The Relationship between Single Follicle Volume and IVF-ET/ICSI Outcomes in Natural Cycles and Minimal Stimulation Cycles LI En-fang;MAO Yun-dong;WU Xia-di;QI Xiao-chen;GAO Yan;QIAN Xiao-qiao;WU Wei;FENG Ting;WANG Wei;LIU Jia-yin 2015, 34 (2):  93-97.  Abstract ( 1498 )   PDF (868KB) ( 7611 )   Objective: To study the association between the volume size of single follicular and IVF-ET/ICSI outcomes, in which the ultrasound was used to observe the single follicular developmental state in natural cycles and minimal stimulation cycles. Methods：Clinical data of 1 480 women undergoing IVF-ET/ICSI in our center between April 2007 and May 2012 were retrospectively analyzed. They were divided into 5 groups according to the follicular volume size：group A，≥5.5 mL；group B，4.5-5.0 mL，group C，3.5-4.0 mL，group D，2.5-3.0 mL，group E，1.0-2.0 mL. The clinical outcomes were compared. Results：①Follicular volume was significantly decreased with the mean diameter of single follicle on the day of hCG administration in 5 groups, in both non-stimulation protocol and minimal stimulation protocol（P＜0.001）. ②In natural cycles，the pregnancy rate and live birth rate were relatively low in group A（11.8%），while those rates in other four groups were 20.0%-25.0% and 15.8%-20.0%，but there were not significant differences in groups（P＞0.05）. In group A，the available transplantation embryo rate was high while the non-fertilization rate was low; the zero oocyte retrieval rate（32.6%） was higher than those in group C and group D（P＜0.01）; the available transplantation embryo cycle was merely 39.53%（17/43）. In group B，the 2PN rate was high while the abnormal fertilization and the not-done fertilization rate were low; the non-fertilization rate was relative high while the available transplantation embryo cycle was merely 48.19%（40/83）. The results of other C groups were better than group A generally. ③In minimal stimulation cycles，the pregnancy rates were high in group B and C（24.1% and 21.6%），but there were not significant differences when compared with three other groups（16.7%-17.8%，P＞0.05）. There were significant differences in the rates of fertilization，abnormal fertilization，good embryo and available transplantation embryo among five groups （P＜0.05）. The abnormal fertilization rate in group B was relatively high（15.4%） and the available transplantation embryo rate and the good embryo rate were highest（97.0% and 87.8%，respectively）. The good embryo rate and the available transplantation embryo rate in group E were lowest（58.1% and 75.8%，respectively，P＜0.01）. The fertilization rate in group C was lowest and the abnormal fertilization rate was also lowest（3.0%，P＜0.01）. Conclusions：IVF-ET/ICSI outcomes may be better when the volume of single follicle was 2.5-5.0 mL（15.1-19.6 mm of oocyte diameter）. However, it is necessary to have more well-designed and multicenter studies. Related Articles | Metrics

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Pregnancy Outcomes of Different Hormonal Induced Cycles in Women with Frozen-thawed Embryo Transfer PENG Shu-ming;YANG Fan;LIU Hai-peng;HE Ping;CHEN Yi 2015, 34 (2):  98-100.  Abstract ( 1480 )   PDF (444KB) ( 7611 )   Objective: To compare the pregnancy outcomes of spontaneous natural cycle versus human chorionic gonadotropin（hCG） and gonadotropic releasing hormone agonist （GnRHa） induced cycle in those women with frozen-thawed embryo transfer. Methods：The 273 natural cycles of the frozen-thawed embryo transfer were retrospectively analyzed in our reproductive center from October，2011 to October，2013. Those cycles were divided into three groups according to ovulation inducing methods：group A，spontaneous ovulation（n=181）；group B，triggering with hCG（n=47）；group C，triggering with GnRHa（n=45）. The pregnancy outcome and other clinical parameters were compared among three groups. Results：①There were not significantly differences in age, endometrial thickness on the day of transfer, embryonic number of transfer and the rate of high-quality embryo among three groups（P＞0.05）. ②The clinical pregnancy rate in group A（56.4%） was significantly higher than that in group C（33.3%，P＜0.01），while there was not significantly difference in this rate between group A and group B（P＞0.016 7）. Conclusions：The adverse effect of hCG induced ovulation on the pregnancy outcome was not significant in the frozen-thawed embryo transfer, while GnRHa induced ovulation may affect the pregnancy outcome of the frozen-thawed embryo transfer. Related Articles | Metrics

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Evaluation of Clinical Outcomes by BMI in Infertile Patients with Assisted Reproduction Treatment：A Meta Analysis CAO Jing-yun;LI Ai-bin;NIU Ting;SHEN Lan;CHEN Li 2015, 34 (2):  101-105.  Abstract ( 1424 )   PDF (2518KB) ( 7723 )   Objective: To evaluate the clinical outcomes by BMI in infertile patients with assisted reproductive treatment, so as to guide the reasonable clinical treatment． Methods: We searched CBM，Wanfang，CNKI，VIP，PubMed and FMJS. Those randomized controlled trails(RCTs) or clinical controlled trails（CCT） were identified，which focused on the comparison of clinical outcomes in infertile patients with IVF-ET/ICSI treatment by BMI（between BMI＞25 kg/m2 and BMI≤25 kg/m2）. The duration of search was from January 2000 to June 2014. The extracted data were analyzed by RevMan 5.0. Results: Six literatures with 2 297 cycles were selected for Meta analysis. Meta analysis showed that the pregnancy rate [OR=0.72，95%CI（0.58，0.90），P=0.004]，birth rate [OR=0.65，95%CI（0.47，0.91），P=0.01] in the high BMI group（BMI＞25 kg/m2） were significantly lower than those in the low BMI group（BMI≤25 kg/m2）；and the abortion rate [OR=1.70，95%CI（1.23，2.35），P=0.001] was significantly higher than that in the low BMI group（BMI≤25 kg/m2）. There were not significant differences in the incidence of ectopic pregnancy [OR=1.51，95%CI（0.71，3.22），P=0.28] and the cycle cancellation rate[OR=1.06，95%CI（0.70,1.62），P=0.77] between two groups. Conclusions: It is necessary to ask those infertile women with high BMI to control body weight，and to lower BMI before their ART treatment，so as to improve their clinical outcomes of ART treatment. Related Articles | Metrics

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Expressions of IDO and Foxp3 Genes in Peripheral Blood Mononuclear Cells of Patients with Recurrent Implantation Failure during Midluteal Phase XU Si-juan;ZHANG Hong-hong;NI Ya-li;XIE Guang-mei;GAO Xi-hong;ZHANG Lin;LIU Li-juan 2015, 34 (2):  106-108.  Abstract ( 1412 )   PDF (461KB) ( 7639 )   Objective：To investigate the expressions of IDO and Foxp3 genes in the peripheral blood mononuclear cells（PBMCs) of patients with recurrent implantation failure during midluteal phase. Methods：Fifty patients with recurrent implantation failure（group 1）, 50 women with normal fertility（group 2） and 50 women with IVF-ET and pregnancy in their first cycle（group 3） were recruited with consent. Samples of 2 mL peripheral blood were got at their midluteal phase, and mononuclear cells were isolated. Expressions of Foxp3 and IDO mRNA were detected by real-time quantitative-PCR. Results：There was significant difference in expressions of Foxp3 mRNA and IDO mRNA among three groups（P＜0.05）. Expressions of Foxp3 mRNA and IDO mRNA in group 2 and group 3 were significantly higher than those in group 1（P=0.000），while expressions of two genes in group 2 were significantly higher than those in group 3（P＜0.05）. Conclusions：The lowered expressions of Foxp3 mRNA and IDO mRNA in PBMCs of patients during phase may be related with their recurrent implantation failure. Related Articles | Metrics

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Construction of Dual Referral System for Infertility Treatment in Jiangsu Province SU Feng-jin;CHAI De-chun;MAO Yun-dong;WANG Wei;DING Wei;CUI Yu-gui;XU Hao-qin;LIU Jia-yin;HU Zhi-bin 2015, 34 (2):  109-111.  Abstract ( 1644 )   PDF (506KB) ( 7683 )   Objective：To retrospect the construction and application of the dual referral system for infertility treatment in Jiangsu Province, China. With the standard procedure to screen infertile pathogeny, those doctors of reproductive medicine with formal training can diagnose and treat patients step by step, and smoothly transfer treatment between superior and subordinate reproductive centers. Methods：The standardized diagnosis and treatment procedure of infertility and sterility and the clinical pathway of preliminary screening on the pathogeny were established. The database system, CCRM, was upgraded in the practice in our center. The advanced training course of 3 months was designed for doctors. The expert out-calls and lecture tours were scheduled in Jiangsu Province. The clinical shortcut service system, so called the Green Channel，and the demonstration clinics were well developed. Results：There were 271 309 patients undergone the preliminary screening system from January 2005 to October 2013 in our center. 27 hospitals joined the program. 7 149 patients underwent the transfer treatment, the referral rate is 2.6% （7 149/271 309）. The cost of the preliminary screening on pathogeny was 1 176.4 RMB. Times of the expert out-call were 74，and 1 785 patients were diagnosed in those expert out-calls. 236 trainees finished their three-months′ advanced training program; 2 529 participants finished training in 28 courses. 40 outpatient clinics of infertility were set up and 56 hospitals joined in the training of the database system. Conclusions：It is concluded from our practice that the infertility dual referral system was effectively developed in Jiangsu Province, China, and that the standardized infertility diagnosis and treatment procedure was also successfully developed. With above system and procedure and the clinical pathway of preliminary screening on the pathogeny of infertility，it is feasible to reduce the medical cost for patients, and to provide the high-quality medical service in the limited times of visiting doctors. Related Articles | Metrics

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Hysteroscopic and Pathological Characteristics of Endometrial Polypoid Lesion in 1 372 Infertile Patients: A Retrospective Study FENG Miao;LI Su-chun;PAN Ping;WU Sui-mei;LI Lei-lei;LI Qian;WANG Yong-xia 2015, 34 (2):  112-115.  Abstract ( 1549 )   PDF (715KB) ( 7684 )   Objective：To analyze retrospectively the hysteroscopic and morphological characteristics of endometrial polypoid (EP) lesion in infertile patients, so as to improve the diagnostic coincidence rate of hysteroscopy and histopathology. Methods：Those infertile patients performed hysteroscopy were analyzed retrospectively from February 2005 through July 2014. Hysteroscopic characteristics were then compared with histopathologic characteristics in those patients with EP. Results：17.4% (1 372/7 884) of infertile patients were diagnosed with EP lesion by hysteroscopy. The morphological manifestation of EP lesion under hysteroscopy were as follows: endometrial neoplasm (88.0%, 1 207/1 372), endometrial local uplift (6.7%, 92/1 372), and endometrial coarse and fragment (5.3%, 73/1 372). The three most prevalent diagnoses by histopathology were endometrial polyp (83.0%, 1 139/1 372), endometrial polypoid hyperplasia (9.3%, 128/1 372) and hysteromyoma (2.2%, 31/1 372). The diagnostic coincidence rate in those patients with typical polypoid neoplasm under hysteroscopy was significantly higher than that in those patients without typical lesion (P＜0.05). Multiple polypoid neoplasm accounted for 77.8% (1 068/1 372) of endometrial polypoid lesion diagnosed by hysteroscopy, while the coincidence rate in those patients was 98.0% (1 047/1 068). Conclusions：The diagnostic coincidence rate of hysteroscopy and histopathology is high in those patients with typical endometrial neoplasm under hysteroscopy. The hysteroscopy combined with histopathology is the golden standard for the diagnosis of endometrial lesion. Related Articles | Metrics

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Expressions of miRNA-29c，miRNA-30b and Their Target Genes in Endometrium WANG Yu;WANG Li-yan;LI Guang-peng;CHEN Xiu-juan 2015, 34 (2):  116-118.  Abstract ( 1411 )   PDF (665KB) ( 7596 )   Objective：To detect the expressions of miRNA-29c，miRNA-30b and those predictive target genes in human endometrium and decidua tissues，and to explore their effects on decidualization of endometria. Methods：Tissue samples including 14 secretory endometria，16 early pregnancy deciduas and 18 spontaneous miscarriage deciduas were collected. Expressions of miRNA-29c and miRNA-30b were detected by quantitative real-time polymerase chain reaction（ｑＰＣＲ）. Expressions of two predicted target genes of miRNA-29c and ｍｉＲＮＡ－３０ｂ， ｓｅｒｕｍ ａｎｄ ｇｌｕｃｏｃｏｒｔｉｃｏｉｄ－ｉｎｄｕｃｉｂｌｅ ｋｉｎａｓｅ １（ＳＧＫ１） ａｎｄ lｅｐｔｉｎ rｅｃｅｐｔｏｒ （ＬＥＰＲ）， ｗｅｒｅ ａｌｓｏ detected by qPCR. Results：The expression of miRNA-29c in the spontaneous miscarriage decidua tissues was higher than that in the secretory endometrial tissues（P＜0.05）. There were not significant differences in expressions of miRNA-30b among three groups（P＞0.05）. Moreover，expressions of SGK1 and LEPR mRNAs were at highest level in the early pregnancy deciduas，while they were at lowest level in the spontaneous miscarriage deciduas（P＜0.05）. Conclusions：Expression of miRNA-29c in endometrium may be associated with decidualization by targeting SGK1. Expressions of SGK1 and LEPR in deciduas tissue may be associated with maintaining early pregnancy. Related Articles | Metrics

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Effect of Estrogen on Expression of SIRT1 in Ovariectomized Rats ZHANG Hong-yan;CEN Jia-ping;HUANG Jian;DENG Miao;LIU Yuan-wei;ZHANG Zhi-fen 2015, 34 (2):  119-122.  Abstract ( 1397 )   PDF (604KB) ( 7633 )   Objective：To investigate the effects of estrogen replacement on the expression of silent information regulator 1（SIRT1） in those ovariectomized rats, so as to explore the anti-aging effect of estrogen. Methods：Thirty-three female Sprague-Dawley（SD） rats aged three months were used to develop the models by bilateral ovariectomy, which partly imitated the pathophysiological characteristics of menopause. There were three groups as follows: the treatment group（n=11） was treated with estradiol once a day for 12 weeks by intragastric administration in those ovariectomized rates; the sham-operated group（Sham，n=11） and the ovariectomized group（OVX，n=11） were treated with saline as controls. The levels of serum FSH and estradiol E2 was detected after 12 weeks′ treatment. The expressions of SIRT1 mRNA and protein in heart，liver and brain were analyzed by reverse transcriptional polymerase chain reaction（RT-PCR） and enzyme-linked immunosorbent assay（ELISA）. Results：After 12 weeks intragastric administration in rats，the level of FSH in the OVX group was significantly increased compared with the treatment group and the OVX group（P＜0.001），while the level of E2 was significantly decreased（P＜0.001）. In the heart，liver and brain tissues，the expression of SIRT1 protein and mRNA in the treatment group and the sham group were significantly higher than that in the OVX group（P＜0.05），while there was not significantly difference between the treatment group and the sham group（P＞0.05）. In the treatment group and the sham group，the expression of SIRT1 protein in the heart tissue was significantly higher than that in the liver and brain tissues（P＜0.05），while the expression of SIRT1 protein in the liver tissue was significantly higher than that in the brain tissue（P＜0.05）. However，the level of SIRT1 protein in the heart and liver tissues were higher than that in the brain tissues in the OVX group（P＜0.05），while there was not significantly differences in the liver and brain tissues（P＞0.05）. In the three groups，the level of SIRT1 mRNA in the heart and brain tissues were lower than that in the liver tissue（P＜0.05）. Conclusions：Estrogen can significantly increase the expressions of SIRT1 protein and mRNA in the ovariectomized rats, suggesting its potential effect of anti-aging. Related Articles | Metrics

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Correlation of Menopause Symptoms with Anxiety and Depression CHENG Yun;GUO Xue-tao;CONG Xin-ru;LIU Hui-ping 2015, 34 (2):  123-125.  Abstract ( 1463 )   PDF (598KB) ( 7633 )   Objective：To explore the association between menopause symptoms and depression and anxiety in those women at different aging stages. Methods：The questionnaire was designed for those outpatient women, which included demographic characteristics, modified Kupperman score and self-rating depression/anxiety scale（SDS/SAS）. 372 questionnaires were finished by face to face. According to the Stages of Reproductive Aging Workshop +10 system, they were divided into four groups: premenopause group（n=１０５）, early transition group（n=１１０）, late transition group（n=８４）, and postmenopause group（n=７３）. Results：There were significant differences in the degrees of menopausal symptoms, SDS, SAS, Kupperman scores, and incidences of anxiety and depression among four groups（P＜0.05）. Hot flashes, sweating, heart palpitations were related to depression and anxiety, while vaginal dryness and painful intercourse were related to anxiety. Kupperman scores were correlated with SDS, SAS（r=0.465, 0.421, P＜0.001，r2=0.22，0.18）. SDS scores were positively correlated with SAS scores（r=0.801， P＜0.001，r2=0.64）. Conclusions：Menopausal symptoms, depression and anxiety can occur in women aged over 40 years, with the increasing trend following the reproductive aging. There are significant correlations between menopausal symptoms and depression and anxiety, and interaction between depression and anxiety. Related Articles | Metrics

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Application of Double-J Ureteral Stents in Pregnant Women with Ureteral Calculi XU Zun-li;DOU Wei-long;MA Li-ying;ZHANG Qian-xing;ZHU Jian-ping 2015, 34 (2):  126-128.  Abstract ( 1532 )   PDF (486KB) ( 7665 )   Objective：To evaluate the efficacy and safety of the double-J ureteral stents in those pregnant women with ureteral calculi. Methods：The clinical data of 27 pregnant women with ureteral calculi who underwent operation of placing double-J ureteral stents by cystoscope in the 11th Hospital of PLA from June 2009 to December 2013 were retrospectively analyzed. The curative effect and adverse effects were recorded. Results：Of all the 27 cases, surgery was successful without severe complications; renal colic was relieved by placing double-J ureteral stents under cystoscope. All of them successfully had full-term birth. After delivery, the stones were spontaneously eliminated in 7 cases, and removed by ureteroscopic lithotomy in other 20 cases. There were not severe adverse events within 6 to 60 months′ follow-up visiting in all patients. Conclusions：Placing double-J ureteral stents under cystoscope is safe and efficient for those pregnant women with ureteral calculi, if the conservative treatment to eliminate renal colic was unsuccessful. Related Articles | Metrics

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Effect of Cervical Conization on Pregnancy Outcomes ZHAI Jun-ying;DENG Xiao-hui 2015, 34 (2):  129-131.  Abstract ( 1675 )   PDF (444KB) ( 7640 )   Objective：To evaluate the effect of cervical conization on the clinical outcomes of subsequent pregnancy. Methods：Thirty-nine patients who had pregnancy desire with cervical cone cut were retrospective analysed from January 2009 to May 2013. The pregnancy outcomes with cold knife conization（CKC） and loop electrosurgical excision procedure（LEEP） were analyzed. Results：Among all the patients, there were one case of ectopic pregnancy and two cases of embryo damage. In 36 delivery cases, there were three premature delivery (8.3%), three premature rupture of membrane (8.3%), twenty-five cesarean section (72.2%) and seven vaginal dilivery. In those 33 full-term delivery cases, there were 14 cases (38.8%) who underwent the hospitalized tocolysis treatment in their different gestational period. Conclusions：There is not significant effect of cervical conization on the clinical outcomes of subsequent pregnancy. However, the rates of cesarean section and the hospitalized tocolysis treatment were increased in those patients who underwent the cervical conization. Related Articles | Metrics

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Signaling Pathways Involving in Mammalian Oocyte Maturation: A Review LI Yan-dong;ZHU Cong-cong;HOU Xiao-xiao;LIU Yue;DING Zhi-de 2015, 34 (2):  132-135.  Abstract ( 1599 )   PDF (663KB) ( 7640 )   Mammalian oocyte maturation is a complex physiological process regulated by a vast number of factors, which aims to produce a fertilizable oocyte from the oocyte finished already the meiotic division and arrested in the secondary metaphase. The meiotic division arrested in secondary metaphase is mainly dependent on the cytoplasm cAMP at high concentration. Meanwhile, many factors and their signaling pathways, as well as cellular structures, are involved in promoting the meiotic division and oocyte maturation, such as LH, EGF, ERK1/2, p38MAPK, Ca2+ and gap junction. Oocyte maturation and its molecular regulation were reviewed, so as to provide useful references for the research and treatment of female infertility and the in vitro maturation. Related Articles | Metrics

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Genesis and Development of Mammalian Germ-cell and Epigenetic Regulation XU Ya-li;DING Zhi-de 2015, 34 (2):  136-140.  Abstract ( 1552 )   PDF (618KB) ( 7672 )   The epigenetic profile of germ cells is defined by the modifications of DNA and chromatin. Meanwhile，those modifications dynamically change during germ cell development. Epigenetic modifiers and their regulatory proteins，such as DNA methyltransferases，histone modification enzymes，B-lymphocyte maturation-induced protein 1（BLIMP1） and calmodulin-dependent protein kinase 4（Camk4），play the crucial roles in reprogramming of the germ-cell genome，repression and activation of the downstream target genes，and germ-cell specific events，for example，germ cell development，regulation of meiosis，chromosome pairing and genomic integrity，and so on, during the germ-cell genesis and development. Herein, the research progress of the genesis and development of mammalian germ-cell, and their epigenetic regulation，were reviewed. Related Articles | Metrics

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Progress on Optimal Protocols of Ovarian Tissue Cryopreservation ZENG Yu-cui;WU Rui-fang 2015, 34 (2):  141-144.  Abstract ( 1467 )   PDF (559KB) ( 7621 )   As the advances in treatment of neoplasia, the protection of female fertility is attaching more and more attention. The application of embryo cryopreservation in IVF center brings definite benefits to some patients. However, there are limitations in embryo cryopreservation. The ovarian tissue cryopreservation is a new research area, in which the cryopreservation technology is the first problem. Two ways of ovarian tissue cryopreservation are slow freezing and vitrification. Compared with the freezing ways using in the piece of ovarian tissue，the directional freezing is a preponderant method for the whole ovary. The directional freezing can keep the whole ovary at the same cooling rate, which is thought to reduce the injury during the whole cooling process. Different freezing protocols have different effects on functional recovery of the frozen-thawed ovarian tissue. It is important to explore the suitable and standard protocol to optimize the efficiency of cryopreservation. Those optimal protocols of ovarian tissue cryopreservation were discussed in this review, so as to provide some references for clinical practice. Related Articles | Metrics

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Application of Hysteroscopic Fallopian Tube Proximal End Occlusion in Patients with Hydrosalpinx before in vitro Fertilization and Embryo Transfer ZHU Lei-lei;FENG Shu-ying 2015, 34 (2):  145-147.  Abstract ( 1640 )   PDF (467KB) ( 7618 )   Hydrosalpinx with a high incidence in women of child-bearing age not only damages their fertility，but also has an obvious adverse effect on the outcomes of IVF-ET. It is always a problem how to handle properly hydrosalpinx before IVF-ET，even there is not a international guideline for standard treatment. There are several classical methods including transvaginal hydrosalpinx aspiration，salpingectomy，proximal tubal ligation，distal salpingostomy and fallopian tube proximal end occlusion. Based on recent publications on the pretreatment protocols of hydrosalpinx before IVF-ET，the advantages and disadvantages of those protocols were reviewed in this paper，while the hysteroscopic fallopian tube proximal end occlusion was especially evaluated，including its feasibility and safety. This therapy has recently been proved to be efficient. It is inconclusive which of the current pretreatment protocols for hydrosalpinx to be better. Hysteroscopic fallopian tube proximal end occlusion，as a new method with advantages of wider indications，effeciency，mild invasion，simple and economic method，is worthy of being recommended in clinical application. Related Articles | Metrics

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Progress in Controlled Ovarian Stimulation Protocols of Polycystic Ovary Syndrome CHEN Yuan-hui;XU Xiao-hang;ZHANG Cui-lian 2015, 34 (2):  148-152.  Abstract ( 1530 )   PDF (682KB) ( 7657 )   Polycystic ovary syndrome（PCOS），a common clinical endocrine disorder，is the main cause of anovulatory infertility in women of childbearing age. Due to the particular endocrine disorders in PCOS patients，it is hard to predict ovarian responses to drugs during controlled ovarian stimulation（COS）. So，poor ovarian responses and ovarian hyperstimulation syndrome（OHSS） are incredibly common. The common protocols used in IVF for PCOS patients include long protocol，antagonist protocol，mild stimulation protocol, revised super-long protocol，super-long protocol and in vitro maturation（IVM）. Presently，long protocol is most frequently used in most of reproductive centers. At the same time，antagonist protocol and mild stimulation protocol，as new protocols，are gradually favored by many clinicians. Super-long protocol and the revised super-long protocol，as the improved traditional protocols，have also obtained good clinic results. IVM，as a technical innovation, can simplify treatment and reduce the risk of OHSS. During IVF for patients with PCOS，it is the key point for clinicians to choose the optimal and economical treatment，to get high-quality eggs and embryos, and to avoid complications such as OHSS. Related Articles | Metrics

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Effect of Psychological Factors on IVF-ET Outcomes SHI Xiao;QUAN Song 2015, 34 (2):  153-155.  Abstract ( 1327 )   PDF (417KB) ( 7617 )   The infertility is a serious negative life event for couples. Although in vitro fertilization-embryo transfer（IVF-ET） and its derivative technology bring hope to those couples，the pain during treatment，the worry for outcome and the financial burden also increase their psychological stress. The psychological stress impacts the treating procedure and outcome of IVF-ET/ICSI，suggesting that doctors of reproductive medicine and psychological medicine should pay more attention to this issue. In this article, we reviewed the effect of psychological factors on the clinical outcomes of IVF-ET/ICSI treatment，as well as the potential neurobiological mechanism. We also imparted some new consideration and advice on psychological intervention. Related Articles | Metrics

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Research Progress on Multifetal Reduction for Monochorionic Diamniotic Twin MO Li-jing;ZHAO Jun-zhao 2015, 34 (2):  156-159.  Abstract ( 1707 )   PDF (630KB) ( 7731 )   The incidence of monozygotic twining （MZT） is increased in those women treated with assisted reproductive technology（ART）. Determining monochorionic or diachorionic twin can be used as a factor for the risk stratification. The perinatal morbidity and mortality of monochorionic diamniotic（MCDA） twin are high. There are several methods of multifetal reduction for MCDA twin with respective merits and demerits. The traditional transvaginal ultrasoundguided puncture and aspiration of embryonic tissue has its demerits. The vessel-occluded techniques have been generally used in the selective reduction for MCDA twin，including the bipolar cord coagulation（BCO） and the radiofrequency ablation（RFA），etc. Premature rupture of membrane（PPROM） and premature delivery are the main complications of selective reduction. However，there is not the standard guideline on the time，method，prognosis and indication of the selective reduction for MCDA twin. It is necessary to do long-term follow-up for those living infants after the multifetal reduction. Related Articles | Metrics

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Advance in Diagnosis and Treatment of Polycystic Ovary Syndrome XU Xiao-hang;CHEN Yuan-hui;WANG Qian;ZHANG Cui-lian 2015, 34 (2):  160-164.  Abstract ( 1515 )   PDF (782KB) ( 7758 )   Polycystic ovary syndrome（PCOS），a common endocrinal disorder in women of reproductive age, causes the non-ovulation infertility. It is difficult to reach the consensus on the diagnostic criteria due to the high heterogeneity of clinical presentation and biochemical criterion in PCOS patients. At present，the common international criteria include NIH criteria，Rotterdam criteria and AES criteria. The expert consensus of China and the clinical practice guideline of AACE were also published. It is urgent to develop a diagnostic criterion of PCOS based on Chinese features. The accurate pathogenesis of PCOS is still unclear，which is related to genetic，environment，psychology，and/or combined factors. Based on characteristics of patients, therapy for those women with fertility requirement should be individual，including mainly the adjustment of life style，oral contraceptives，insulin sensitizing agents，ovulation treatment，assisted reproductive technology and operation. Meanwhile，the long-term management should be emphasized to avoid the long-term complications. In this article，the advance in diagnosis，pathogenesis and treatment of PCOS was discussed. Related Articles | Metrics

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Polymorphisms of Metabolic Syndrome Related Genes WU Xian;WANG Xiao-feng 2015, 34 (2):  165-168.  Abstract ( 1450 )   PDF (566KB) ( 7577 )   Metabolic syndrome（MS），a collection of complex metabolic disorders，is becoming a public health problem in recent years. The pathogenesis basis of MS is the combined effect of genetic factors and environmental factors，which results in big genetic heterogeneity and big phenotypic heterogeneity. Many genes and/or their polymorphisms were found to be associated with the pathogenesis of MS or some of clinical features. Those studies on the gene polymorphisms of MS focused on adiponectin gene（ADIPOQ），peroxisome proliferator-activated receptor γ gene（PPAR γ），transcription factor 7-like 2 gene（TCF7L2），fat mass and obesity associated gene（FTO），apolipoprotein gene and so on. There were few studies on the genetics of female MS patients，it is necessary to find further more specific genes related to MS pathogenesis so as to improve women′s health. The polymorphisms of those genes related to MS and research progress were reviewed in this paper. Related Articles | Metrics

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Evaluation and Treatment for Postpartum Depression CUI Li-li;WANG Dong-na;MAO Pei-xian;REN Yan-ping;TANG Yi-lang 2015, 34 (2):  169-172.  Abstract ( 1485 )   PDF (609KB) ( 7631 )   Postpartum depression（PPD），one of the most common complications after childbirth，is a common，potentially disabling and even life-threatening disease. About one seventh peripartum and postpartum women were subjected to PPD. The apparent effects of untreated PPD on those postpartum women individuals include distress and functional impairment. PPD is actually associated with negative effects on the growth and development in their children. Fortunately，PPD is detectable in routine practice，and there are effective treatments. Studies indicated that both biological and psychosocial factors contributed to PPD pathogenesis. So，clinical treatment of PPD should combine pharmacotherapy with psychotherapy，in which pharmacotherapy includes antidepressants and hormonal therapy. Since there is wide and far effect of breast-feeding on infant development and psychological health，it is the point at issue whether to stop breast-feeding in those PPD women who are taking medicines. Related Articles | Metrics

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Treatment of Pregnancy with Cervical Cancer PAN Lu;ZHANG Ke;ZHU Jue;MA Sheng-lin 2015, 34 (2):  173-176.  Abstract ( 2011 )   PDF (599KB) ( 7638 )   The mortality of cervical cancer is the second highest in women tumors, while cervical cancer is also one of the most common malignancies in pregnant women which is a serious threat to health, fertility and mental state. For those pregnant women with cervical cancer, the individualized treatment was recommended which was dependent on the stage of cancer, the gestational stage at the time of diagnosis, patients′ wish to pregnancy, metastasis of lymph nodes and histological subtype. Unfortunately, there is not a guideline accepted universally for the diagnosis and treatment of those patients. It is necessary to discuss deeply how pregnancy to affect the management of cancer, how cancer to affect the process of pregnancy, and how to treat according to the different stages of cancer and pregnancy. Related Articles | Metrics