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Table of Content

    15 September 2014, Volume 33 Issue 5
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    热点问题
    论著
    综述
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    热点问题
    Androgens and Female Reproduction
    CUI Yu-gui;SHAO Li;QIAN Ri-cheng;LIU Jia-yin
    2014, 33 (5):  329-333. 
    Abstract ( 1798 )   PDF (419KB) ( 7482 )  
    Androgen is the most abundant and important steroid hormone in male. Androgen is also very important for female reproductive function. In female,androgen originally comes from ovary and adrenal gland. The bioactive androgen includes testosterone and dihydrotestosterone,while adrenal androgen is transformed into testosterone. Besides the testosterone converted to estradiol through aromatase,testosterone and dihydrotestosterone regul ate the expressions of target genes via binding to androgen receptor(AR). AR is located in ovary,brain,muscle,bone,skin,kidney and liver. Androgen plays important roles in follicular development and maturation. Hyperandrogenism is commonly seen in polycystic ovary syndrome. In this review,we discussed the target organs in female and the effects of androgen in ovarian tissue and peripheral non-reproductive organs,as well as those female reproductive events such as breast cancer.
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    论著
    Animal Model of Intrauterine Adhesions Developed by Mechanical Curettage
    CAO Xing-feng;WANG Ai-ming;YIN Shan-de;ZHAO Jun;ZHAO Yong;WANG Ming-kai
    2014, 33 (5):  334-338. 
    Abstract ( 1797 )   PDF (1118KB) ( 7465 )  
    Objective:To develop a stable beagle model of intrauterine adhesions(IUA) by mechanical curettage. Methods:The uterine tissues from six sexual maturity and healthy female beagle dogs were divided into four groups:Group 1,distal endometrial samples of the right uterus from those beagle dogs treated by mechanical curettage method, after two months;Group 2,distal samples of the left uterus without treatment;Group 3,proximal samples of the right uterus without treatment;Group 4,proximal samples of the left uterus without treatment. Samples were analyzed by HE staining, Masson staining and immunohistochemistry. Results:The incidence of abnormal endometrial appearance in the Group 1 was obviously higher than that of the Group 2(P<0.05). The endometrial thickness of the Group 1 was obviously thinner than those of Group 3 and Group 2(P<0.05). The number of endometrial gland of the Group 1 was significantly less than those of other groups(P<0.05),while the area of endometrial fibrosis was also significantly bigger(P<0.001). The expression levels of IGF-Ⅰ and TGF-β1 in the Group 1 were significantly higher than those in other three groups(P<0.05),while the expression level of bFGF was significantly higher than that in the Group 2(P<0.05). Conclusions:A stable beagle model of IUA was successfully developed by the mechanical curettage. The increased expressions of IGF-Ⅰ,bFGF and TGF-β1 may be involved in IUA in this model.
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    Experimental Study of Pen Yan Xiao Enema Improving Microcirculation in Mice
    FU Zheng-ying;BAO Man-xi;CHEN Ning
    2014, 33 (5):  339-341. 
    Abstract ( 1510 )   PDF (547KB) ( 7381 )  
    Objective: To explore the improved effect of the Pen Yan Xiao enema on microcirculation in mice. Methods:Sixty adult mice were used. Ten mice were used as control group. Fifty mice were induced with the high-molecular dextran to develop animal models of microcirculation disturbance, and then randomly divided into 5 groups as follows, model group, three groups treated with Pen Yan Xiao enema liquid(2.5, 5.0, 10.0 g/kg), and a group treated with Chuanxiongzine as positive control. Microcirculation in mice was compared before treatment and 5, 10, 20, 30 min after treatment using the WX-9 microcirculation microscope and the microcirculation detection and analysis system. Those parameters were analyzed, including the diameter size of capillary, the blood flow velocity, the blood flow pattern and the red cell aggregation. Results:Pen Yan Xiao enema can improve microcirculation in the model mice in a dose-dependent manner and a time-dependent manner. In three treatment groups, the diameter size of capillary and the blood flow velocity were increased; the blood flow pattern was improved, while the red cell aggregation was decreased. Those effects of large doses(10.0 g/kg) of Pen Yan Xiao enema were significant(P<0.05). Conclusions:Pen Yan Xiao enema can significantly improve microcirculation in the animal model of microcirculation disturbance induced by high polymer dextran, suggesting the pharmacologic action of Pen Yan Xiao on microcirculation.
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    Effect of Semen-associated Factors on IVF Outcome
    ZHANG Mei-xiang;BAO Xiao;XIONG Yu-jing;SUN Ying-pu
    2014, 33 (5):  342-344. 
    Abstract ( 1559 )   PDF (629KB) ( 7415 )  
    Objective: To investigate the effect of sperm relative parameters on the outcome of in vitro fertilization (IVF),in order to direct the selection of fertilization method. Methods:Total 2 591 IVF cycles in the controlled ovulation from January 2012 to June 2013 were selected. After matching female factors(age,weight,cause of infertility,base FSH and LH,endometrial thickness on hCG day and the number of acquiring ovum)between pregnant women and non-pregnant women, 457 pairs were analyzed. The sperm relative factors were analyzed in those women with different pregnant outcomes. Results:The rate of normal sperm morphology in pregnant cycles was significantly higher than that in non-pregnancy cycles(P<0.05),but there was no significant difference in sperm density,activity, survival rate and qudlified rate between two groups(P>0.05). Conclusions:There were different rates of normal perm morphology in IVF cycles with different outcomes,suggesting that the rate of normal perm morphology could have good forecasting value for IVF outcomes.
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    Pregnancy Outcomes of Different in Vitro Fertilization Methods in Older Patients IVF-ET Cycles with Poor Ovarian Response
    YU Min;PENG Xian-dong;ZHENG Yu;CHEN Hua;SUN Xiao-xi
    2014, 33 (5):  345-347. 
    Abstract ( 1585 )   PDF (659KB) ( 7366 )  
    Objective: To compare the efficacy of conventional in vitro fertilization(IVF) and intracytoplasmic sperm injection(ICSI) in older patients with poor ovarian response. Methods: The data of 381 in vitro fertilization-embryo transfer (IVF-ET) cycles of older patients (≥40 years old) with poor ovarian response were analyzed retrospectively. Those cycles were divided into two groups:IVF group(conventional IVF,200 cycles) and ICSI group(181 cycles). Fertilization rate and clinical pregnancy rate were compared between two groups. Results: The fertilization rate and clinical pregnancy rate in the IVF group were insignificantly higher than those in the ICSI group,while the rate of effective cycles and high quality embryos in the ICSI group were very limitedly higher than those in the IVF group. However, there were not statistically differences in those rats between two groups(P>0.05). Conclusions: ICSI treatment did not increase fertilization rate and clinical pregnancy rate in IVF-ET cycles in those patients at ≥40 years with poor ovaian response.
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    Analysis of Factors Influencing Blastocyst Formation of the Embryos with Low Score on Day 3
    LI Yun;QUAN Song;SHI Xiao;LUO Chen
    2014, 33 (5):  348-350. 
    Abstract ( 1888 )   PDF (780KB) ( 7320 )  
    Objective: To explore the developmental potentiality of the embryos with low morphological score on Day 3(D3) during in vitro blastocyst culture, and analyze the clinical and embryonic factors affecting the blastocyst formation. Methods:Those embryos with D3 low score were further cultured to form blastula through the sequential methods. The blastocyst formation rate and the high-quality blastocyst formation rate were calculated. Those factors related to blastocyst formation were analyzed, including age,antral follicle count,bFSH, total dose of Gn,E2 level on hCG day,the number of retrieved oocytes,the number of blastomere on D3, and the embryonic fragmentation on D3. Results:A total of 1 745 low score embryos from 422 cycles were collected. 1 046 blastulas were formed(59.9%) after in vitro culture,among which 763(43.7%) were high-quality blastulas. There were no significant differences in the blastocyst formation rate and the high-quality blastocyst formation rate among subgroups grouping with the antral follicle count,bFSH, total dose of Gn,E2 levels on hCG day, or the number of retrieved oocytes(P>0.05). There was no significant difference in the blastocyst formation rates among subgroups grouping with age(P>0.05),while there was significant difference in the high-quality blastocyst formation rate among those subgroups (P<0.05). Particularly, there were significant differences in the blastocyst formation rate and the high-quality blastocyst formation rate among subgroups grouping with the number of blastomere or the degree of embryonic fragmentation on D3(P<0.05). Conclusions:Embryos with low score have developmental potentiality on different degrees. The number of blastomere and the degree of embryonic fragmentation on D3 significantly influence the blastocyst formation of those embryos with low score. The factors of age, the number of blastomere and the degree of embryonic fragmentation significantly influence the high-quality blastocyst formation of embryos with low score.
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    Levels of Inhibin A and Activin A in Gravida with Fetal Growth Restriction
    SONG Qi-ying;SHEN Zong-ji
    2014, 33 (5):  351-354. 
    Abstract ( 1808 )   PDF (794KB) ( 7362 )  
    Objective: To analyze the levels of inhibin A and activin A in maternal blood and cord blood of pregnant women with fetal growth restriction(FGR), so as to evaluate the effects of two factors on fetal development. Methods:Maternal antepartum blood,umbilical vein blood and placenta were collected from forty-six pregnant women in obstetrical department of our hospital, including 23 FGR cases and 23 normal pregnancy cases. Serous levels of inhibin A and activin A were measured using ELISA. HE stain was performed on the placental tissue sections. Expressions of inhibin and activin subunit-α,-βA were analyzed by immunohistochemistry. Results:Serous levels of inhibin A and activin A in maternal blood and umbilical blood of the FGR group were significantly higher than those in the control group(P<0.05). The levels of inhibin A and activin A were negatively correlated with the birth weight and subcutaneous fat thickness(P<0.05). Inhibin/activin subunit-α,-βA were mainly expressed in syncytiotrophoblast, while expressions of two subunits in the FGR group were significantly higher than those in the control group(P<0.05). There were not relationships in levels of inhibin A and activin A between fetal blood and maternal blood. Expressions of inhibin/activin-α,-βA subunits were positively correlated with maternal levels(P<0.05). Area under ROC curve of inhibin A was 0.862,and area under ROC curve of activin A was 0.782. Conclusions:Inhibin A and activin A play important roles in adjusting fetus growth and placenta development. The maternal serum levels of inhibin A and activin A can be used as clinical references to evaluate fetal growth and placental function.
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    Analysis on Unwanted Pregnancy in Lactation Women after Cesarean Section
    LU Jun;HE Ping;HUANG Ying
    2014, 33 (5):  355-357. 
    Abstract ( 1671 )   PDF (603KB) ( 7361 )  
    Objective: To investigate the unwanted pregnancy,and its causes,in those postpartum lactation women in one year after cesarean section,so as to develop personalized intervention in practice. Methods: The questionnaire survey was firstly done in those lying-in women during hospitalization after cesarean section by well-trained investigators. The questionnaire survey was done again after 1 year(or when they used effective contraceptives). Results: 68.3% of women got the contraceptive knowledge from internet in general;61.5% of women restarted sexual activities in 2-3 months after delivery. The optimal chances for those women after childbirth to get contraceptive knowledge were medical guidance during hospitalization,query from internet by themselves, and postpartum follow-up visit by community doctors. There were 3% subjects who had their unwanted pregnancies in one year after delivery. In those women with unwanted pregnancies,51.7% women did not know the available methods of emergency contraception,72.4% women didn′t know the right time of emergency contraception,and 41.4% women did not understand the dangerousness of re-pregnancy during lactation and abortion in one years after delivery. Conclusions: The important way to guide the maternal contraception is to set some columns in the governmental websites of maternal and child health care,or/and to develop professional mechanism of online consulting.
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    Evaluation on Efficiency of the Contraceptive Service after Artificial Abortion
    QIAN Fang-bo
    2014, 33 (5):  358-360. 
    Abstract ( 1603 )   PDF (738KB) ( 7356 )  
    Objective:To evaluate the effects of the contraceptive guide and service after artificial abortion on reducing the repeated abortion and gynecological diseases. Methods:900 women with gynecological diseases received induced abortion were divided into two groups, Observation group with the contraceptive guide and service and control group without. Telephone follow-up was performed for one year after operation. The differences of contraceptive choice, repeated abortion rate and the effect on gynecological diseases were compared between two groups. Results:IUD and male condoms were the top two choices in observation group, while IUD and contraceptive drugs were the top in control group. Observation group had higher rates of IUD and male condoms, and its rate of male condoms was significantly higher than that of control group(χ2=28.145, P<0.01). The rates of oral contraceptives and coitus interruptus in control group were higher than those in observation group(P<0.05). The rate of repeated abortion in control group was significantly lower than that in observation group(19.29% vs. 30.63%, χ2=15.22, P<0.01). The factors related to repeated abortion included failing IUD, failing condom, failing oral contraceptives, the rhythm method, coitus interruptus and not use any contraception. By multivariate Logistic regression analysis, safety period contraception, not contraception, and in vitro ejaculation were the independent risk factors of contraceptive failure of repeated abortion. Conclusions:The contraceptive guide and service after abortion allows women to choose the efficient contraceptive methods, which reduce the risk of gynecological diseases and the rates of unwanted pregnancy and repeated abortion.
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    Internal Quality Control of Vaginal Secretions Routine Test
    SU Li;ZHOU Xiang-hong;AN Bang-quan;HUANG Sheng-wen;LING Xiao-wu;XU Zhu;XU Jian;YANG Xiu-hua
    2014, 33 (5):  361-363. 
    Abstract ( 1842 )   PDF (814KB) ( 7374 )  
    Objective: To evaluate the internal quality control (IQC) of vaginal secretions (leucorrhea) routine testing. Methods:Total 1 235 samples were included in this study. Five samples were randomly selected every day from leucorrhea testing by suspension. The smears stained with Wright’s were conducted by microscopic examination. Those suspicious samples with positive neisseria gonorrhoeae were rechecked by Gram stain,to assess the quality of suspecsion assay. The quality of normal saline was monthly checked by microscopic examination in direct smear or centrifugal sediment. Results:Among 12 months in 2011, besides the compliance rates of clue cells only in July and September were not qualified, 74.3% and 78.1% respectively, those rates in other months matched the standard of 82.5%-100%,the monthly average 90.2%-94.7%,suggesting that the testing quality was excellent. The compliance rate of trichomonas was highest(99.3%) in pathogens,while the compliance rate of clue cells was lowest(83.1%). The quality normal saline was eligible. Conclusions:The IQC of routine leucorrhea suspension testing, which established by Wright’s method,can effectively ensure the testing quality in clinical practice.
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    综述
    Physiological and Pathological Effects of miR-23a and miR-27a in Ovary
    NIE Ming-yue;YANG Xiao-kui
    2014, 33 (5):  367-369. 
    Abstract ( 1593 )   PDF (583KB) ( 7437 )  
    MicroRNAs(miRNAs) play important roles in many cellular events,such as proliferation, differentiation,apoptosis,survive and tumorigenesis by regulating expression of target genes at posttranscriptional level. Many miRNAs have been found in ovary, including miR-23a and miR-27a. miR-23a and miR-27a are members of the miR-23a~27a~24-2 super-family,induce apoptosis via caspase-dependent or caspase-independent pathways and endoplasmic reticulum stress. It was found that miR-23a and miR-27a were involved in many ovarian function and pathophysiology,including follicular development,hormone synthesis and secretion,premature ovarian failure and ovarian cancer. Many effects of miRNAs in ovarian function have been elucidated,which is helpful for new treatment options for sterility and other ovarian diseases. The functions of miR-23a and miR-27a in ovary were reviewed in this paper.
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    Effect of MicroRNAs on Follicular Development
    BA Lin-lin;LIU Dong-e
    2014, 33 (5):  370-374. 
    Abstract ( 1562 )   PDF (703KB) ( 7325 )  
    MicroRNAs,a class of non-coding small RNAs with 22-25 nucleotides,regulate gene expression at the post-transcription level or translational level. MicroRNAs play important roles in multiple biological processes,including cell differentiation,proliferation and apoptosis,tissue self-renewal,metabolism and cell lifespan. It was reported that microRNAs expressed in oocytes at different development stages, and that microRNAs play important roles in ovarian follicular development and oocyte maturation through regulating gonad development,steroid hormone synthesis,ovulation and luteal formation. It is true that the expression of microRNAs is important for the normal follicular growth and development. The effects of microRNAs on follicular development were reviewed.
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    Effect of MicroRNAs on Follicular Development
    BA Lin-lin;LIU Dong-e
    2014, 33 (5):  370-374. 
    Abstract ( 623 )   PDF (703KB) ( 7101 )  
    MicroRNAs,a class of non-coding small RNAs with 22-25 nucleotides,regulate gene expression at the post-transcription level or translational level. MicroRNAs play important roles in multiple biological processes,including cell differentiation,proliferation and apoptosis,tissue self-renewal,metabolism and cell lifespan. It was reported that microRNAs expressed in oocytes at different development stages, and that microRNAs play important roles in ovarian follicular development and oocyte maturation through regulating gonad development,steroid hormone synthesis,ovulation and luteal formation. It is true that the expression of microRNAs is important for the normal follicular growth and development. The effects of microRNAs on follicular development were reviewed.
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    Effect of Melatonin on In Vitro Oocyte Maturation
    LIU Ting-ting;ZHANG Zhi-guo;CAO Yun-xia
    2014, 33 (5):  375-378. 
    Abstract ( 1759 )   PDF (653KB) ( 7406 )  
    Melatonin,a broad-spectrum antioxidant, can get through the biological membranes directly and reduce the intracellular oxidative stress induced by reactive oxygen species,which plays an important role in regulating cell biological activities via its special receptors. It was suggested that melatonin improved oocyte maturation and embryo development by its effect of antioxidant. The antioxidant effect of melatonin has recently been focused on. However,it is still not clear whether melatonin improves oocyte maturation and developmental potentiality of oocyte when of added into IVM culture medium. Effects of melatonin in oocyte development and in vitro maturation,as well as its potential application,was discussed in this review.
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    Non-invasive Biomarkers of Oocyte and Embryo Developmental Competence
    SHAO Li;CUI Yu-gui;QIAN Ri-cheng
    2014, 33 (5):  379-383. 
    Abstract ( 1603 )   PDF (785KB) ( 7455 )  
    The developmental competence of oocyte is gradually accumulated through folliculogenesis,during which the tight communication between cumulus cells (CCs) and oocyte is established while follicle fulid(FF) maintains an optimal micro-environment for oocyte maturation. So,it is generally accepted that oocyte competence can be evaluated through biological functions of CCs and molecular components of FF within the ovarian follicle. CCs play an important role by providing metabolic nutrients for the oocyte such as pyruvic,alanine,cholesterol and so on,meanwhile CCs are involved in oocyte maturation,ovulation as well as fertilization process. Metabolic factors,hormones,reactive oxygen species and some cytokines in FF are closely linked to oocyte growth. Herein we reviewed the biomarkers of oocyte quality and embryo developmental competence in CCs and FF.
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    Loss of Asymmetry during Meiotic Division in Aged Oocytes
    XIONG Yu-jing;SUN Ying-pu
    2014, 33 (5):  384-387. 
    Abstract ( 1593 )   PDF (739KB) ( 7380 )  
    Mammalian oocyte meiosis encompasses two consecutive rounds of asymmetric divisions to generate one big egg and,as by-products,two small polar bodies. This asymmetric division is crucial for the oocyte and embryonic development. The interaction between various factors associated with spindle positioning, the formation of myosin ring and extrusion of the first polar body,such as actin-related protein 2/3(Arp2/3)complex,JMY,small GTPase(actin nucleation activation factor),forms the signal pathways regulating the asymmetrical division of oocyte. However,it is found that the aged oocyte shows loss of oocyte cortical polarity,reduction of the nucleation-promoting factors and related regulatory factors and their activities,resulting in the decreased rate of fertilization and then rate of cleavage in aged oocyte. We reviewed the progression of research on loss of asymmetry during meiotic division in aged oocytes.
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    Ovarian Aging
    LIU Meng-yuan;ZHANG Hui-juan
    2014, 33 (5):  388-391. 
    Abstract ( 2225 )   PDF (922KB) ( 7441 )  
    The functional ovarian aging is in many years before other organs aging of female body. More and more women postpone their childbearing age in modern society. These facts made the ovarian aging be widely concerned in recent years. We hereby introduced the main manifestation of ovarian aging: loss of folliles, reduction in oocytes quality, and decreased level of ovarian hormones. We reviewed the mechanism of ovarian aging including: accumulation of reactive metabolic byproducts (ROS, RCS), mutation of genome DNA and mtDNA, shortened telomere length and diminished telomerase activity. In recent years, many findings suggested that antioxidant and caloric restriction could exert significant effects in delaying ovarian aging, or even elongate the animal lifespan.
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    Clinical Outcomes of Assisted Reproductive Technology
    CHEN Xu;LI Zhi-ling
    2014, 33 (5):  392-395. 
    Abstract ( 1536 )   PDF (748KB) ( 7388 )  
    With the improving equipment and laboratory technology,as well as the optimized protocols of controlled ovarian stimulation,the pregnancy rate of assisted reproductive techniques(ART) has significantly increased. Meanwhile,the security of ART is of a focus. Infertility itself may be the risk factor of adverse pregnancy outcomes of ART. The increased rates of gestational hypertension,gestational diabetes,placenta previa,cesarean section,premature birth,multiple pregnancy,low birth weight,congenital malformations,and some latent risks of neonatal long-term disease(abnormal growth and development,malignant tumors in children,gene imprinting abnormalities),in those ART pregnancies could be related to excess ovarian stimulation,manipulation and frozen-thawing of gamete and embryo,in vitro embryonic culture and micromanipulation. The pregnancy outcomes of ART and risk factors were reviewed.
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    Molecular Mechanisms of Mammalian Embryonic Implantation
    ZHANG Xing;YE Bin;DING Zhi-de
    2014, 33 (5):  396-400. 
    Abstract ( 1621 )   PDF (845KB) ( 7379 )  
    Embryonic implantation in mammalian is the process of fusion between embryo trophoblast and endometrium. A successful implantation requires:endometrium receptivity;a normal and functional embryo at the blastocyst developmental stage;synchronized development and functional coordination of maternal and embryonic tissues. The implantation process is composed of apposition,adhesion and invasion. Recently,new studies revealed that a lot of crucial genes,protein molecules and their related signaling pathways participated in the mammalian embryo implantation,such as CSPG4,EGF,VEGF,and etc. It is beneficial to the diagnosis,treatment and prevention of infertility in future to elucidate those critical genes,molecules and related mechanisms in the process of embryonic implantation.
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    Umbilical Artery Blood Flow and Perinatal Outcomes
    CHEN Yan-min;CHEN Dan-qing
    2014, 33 (5):  401-404. 
    Abstract ( 1577 )   PDF (748KB) ( 7472 )  
    The monitoring of umbilical artery blood flow,a noninvasive,simple and convenient method,is widely used in clinic in order to evaluate fetal health and predict the perinatal outcomes. It is a sensitive method to monitor fetal distress in those high-risk pregnancies. The common causes of abnormal umbilical artery blood flow include placental dysfunction,abnormal umbilical cord,fetal abnormalities,gestational hypertension disease,fetal growth retardation(FGR) and so on. Abnormal umbilical artery flow,such as absent flow and the reversed end-diastolic velocity during pregnancy,is associated with intraventricular hemolysis,periventricular leukomalacia, neurodevelopmental impairment,bronchopulmonary dysplasia, respiratory distress syndrome,necrotic enteritis,thrombocytopenia,and even perinatal mortality. Pregnant women with complications,such as preeclampsia and FGR,should be advised to evaluate the umbilical artery doppler velocimetry. It was suggested that delivery should be considered in those pregnant women whose FGR and absent end-diastolic umbilical artery flow were found at >34 weeks,and that fetal lung maturity should be antenatally induced by corticosteroids for premature delivery if absent or reversed end-diastolic flow was found at <34 weeks.
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