Loading...

Table of Content

    For Selected: Toggle Thumbnails
    述评
    Research and Development of Genetics/Genomics in Reproductive Medicine
    LIU Jia-yin;WU Bai-lin
    2014, 33 (3):  149-153. 
    Abstract ( 1794 )   PDF (768KB) ( 7608 )  
    Improving reproductive health and reduce birth defects are important mission in the 21st century in the field of reproductive medicine of China. By a national survey in 2011, the incidence of birth defects in China was 5.6 % (approximately 900 000 new cases each year), which is nearly two times higher than that for developed countries and causes annual economic burden of the state and society as much as hundreds billion dollars. Of them, the majority of birth defects and reproductive related diseases including infertility are complex disorders, which involve the interaction of genetic factors (causative or predisposing) and environment conditions. The first draft of decode of Human Genome in 2003 knocked on the door of post-genome era and promoted genomic medicine -- the foundation of personalized medicine. In the past years, discovery of numerous genetic/genomic variants associated with birth defects and reproductive disorders have been revealed and development of advanced technology based genomic profiling platform (i.e. microarray-biochip and next-generation sequencing) are rapidly applied to the field of reproductive medicine, demonstrating the powerful combination of life science, biomedicine, information technology and computational science.
    This mini-review focuses on recent genetics/genomics research and development in the field of reproductive medicine of China:① Two high-impact research articles, recently published by Cell and Nature, showed precise genomic profiling of oocytes and early embryos: One group revealed genome analyses of single human oocytes by using multiple annealing and looping-based amplification cycle-based technology and sequencing the triads of the first and second polar bodies and the oocyte pronuclei, which demonstrated that the genome of the oocyte pronucleus, including information regarding aneuploidy and SNPs in disease-associated alleles, can be accurately deduced from the genomes of polar bodies. This may be applied to preimplantation genomic screening in IVF clinic to enable accurate and cost-effective selection of normal fertilized eggs for embryo transfer. Another team reported a comprehensive analysis of transcriptome dynamics from oocyte to morula in both human and mouse embryos, using single-cell RNA sequencing. They identified novel stage-specific monoallelic expression patterns for a significant portion of polymorphic gene transcripts(25% to 53%), which indicates a sequential order of transcriptional changes in pathways of cell cycle, gene regulation, translation and metabolism, acting in a step-wise fashion from cleavage to morula. They also identified conserved key members (or hub genes) of the human and mouse networks. These genes represent novel candidates that are likely to be key in driving mammalian pre-implantation development. ② Two GWAS of polycystic ovary syndrome(PCOS), published by Nature Genetics, with a total of 8 226 cases and 7 578 controls: Identified 11 new loci associated with PCOS in Han-Chinese. The association signals show evidence of enrichment for candidate genes related to insulin signaling, sexual hormone function and type 2 diabetes. Other candidate genes were related to calcium signaling and endocytosis. The findings provide new insight into the pathogenesis of PCOS and direction for discovering the biological mechanisms. ③ Whole exome sequencing for premature ovarian failure/primary ovarian insufficiency(POF/POI): In the March of this year, the New England Journal of Medicine published two independent studies that identified pathogenic mutations in the meiosis genes(HFM1 and STAG3) caused POF/POI in Chinese and European pedigrees respectively, which is the first time that detected genetic defects of meiosis genes in patients with POF/POI and supported by evidences from knock-out mice. ④ GWAS of Non-obstructive azoospermia(NOA), published by Nature Genetics, with a total of 2 927 cases and 5 734 controls: Identified 3 common variants contributing to NOA in Han-Chinese men using a three-stage genome-wide association study. The findings implicate genetic variants at 1p13.3, 1p36.32 and 12p12.1 in the etiology of NOA.
    This mini-review also briefly discussed the GWAS of endometriosis and the advancement of preimplantation genetic diagnosis/screening(PGD/PGS) with genomic profiling technology, such as CGH array, SNP array and next-generation sequencing (NGS), resulted in significantly improves the clinical pregnancy rate.
    Related Articles | Metrics
    热点问题
    Clinical Application of the Next-Generation Sequencing Technology
    GAO Chao;SHEN Jian-dong;CUI Yu-gui
    2014, 33 (3):  154-156. 
    Abstract ( 1810 )   PDF (598KB) ( 7658 )  
    In recent years, the sequencing technology has been innovated following the breakthrough of the engineering material bottleneck. The high-throughput gene-sequencing technology matured gradually made the transformation from routine and basic research laboratory to clinical practice, because the next-generation sequencing(NGS) technology met the needs of individual diagnosis and treatment. In this paper, the developing progress of NGS technology, and operational process, were introduced. Those mainstream products in the international market at present were also introduced. The Ion Torrent sequencing platform of Life Tech Company was introduced in detail, including its basic principle, laboratory protocol, coefficient of performance and clinical application. This paper also provided some examples to show the specific significance in clinical application and potential insufficient of NGS technology.
    Related Articles | Metrics
    Application of Chromosomal Microarray Analysis in Prenatal Diagnosis: Some Essential Issues
    AN Yu;WU Bai-lin
    2014, 33 (3):  157-161. 
    Abstract ( 1594 )   PDF (868KB) ( 7608 )  
    Chromosome microarray analysis(CMA), including array CGH and SNP array, was used in the invasive prenatal diagnosis of chorionic villus or amniocentesis samples to detect microdeletion and microduplication in the whole genome. Compared with the conventional karyotyping and FISH methods, CMA with advantages of high throughput, high resolution and high automation can detect synchronously many abnormalities in genome related to birth defects and congenital diseases. This review summarized the recent large multicenter prospective studies about use of CMA in prenatal diagnosis, and recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine(SMFM). Some essential issues were addressed, such as the microarray type, the appropriate women for testing, sampling and the detection window, the data analysis and interpretation in genetic counseling. In addition, the opportunity and challenge during application of CMA in prenatal diagnosis were carefully discussed, and the significance and necessity of the genetic counseling in pretest and posttest were also emphasized.
    Related Articles | Metrics
    论著
    Genetic Analysis and Its Clinical Effect of Spontaneous Abortion after Assisted Reproductive Techniques
    DUAN Cheng-ying;LI Hong;LIU Min-juan;CHEN Ying;SUN Jian;DING Yang;DING Jie;WANG Wei
    2014, 33 (3):  162-164. 
    Abstract ( 1589 )   PDF (514KB) ( 7518 )  
    Objective:To analyze the chromosome abnormalities of spontaneous abortion tissues after assisted reproductive techniques(ART),and to discuss the relationship between genetic change and clinical feature. Methods:40 cases of spontaneous abortion villuses from ART, and 113 cases from natural pregnancy as control, were studied by the routine G banding karyotyping after the standard cell culture and harvest. Those cases of culture failure or without culture were analyzed by the multiplex ligation-dependent probe amplification(MLPA). Results:①There was no significant difference in the rates of abnormal karyotyping between the ART group (50%, 20 cases) and the control group(53.1%,60 cases,P>0.05). ②There were no significant differences in the rates of abnormal karyotyping when analyzed those parameters, including women age, primary or secondary infertility, infertility cause (male, female, or both), cycle type (fresh or frozen) (P>0.05). Although there was significant difference in this rate when analyzed IVF method (routine IVF and ICSI) in the limited cases(P<0.05), it should be further studied in more cases. Conclusions:Chromosome abnomalities are the main reason of spontaneous abortion after ART. The combined genetic techniques to detect the spontaneous abortion tissues are helpful for the ART treatment of infertility.
    Related Articles | Metrics
    Application of Micro-Array Comparative Genomic Hybridization on Preimplantation Genetic Diagnosis for Chromosome Translocation
    SHEN Jian-dong;WU Wei;CAI Ling-bo;XIE Jia-zi;MA Long;SUN Xue-ping;GAO Chao;CUI Yu-gui;LIU Jia-yin
    2014, 33 (3):  165-167. 
    Abstract ( 1610 )   PDF (536KB) ( 7595 )  
    Objective:To estimate the efficiency of preimplantation genetic diagnosis for reciprocal and Robertsonian translocations using the array comparative genomic hybridization(aCGH) technology. Methods:Cell biopsy was carried out on the cleavage-stage embryos (Day3). Single cell was firstly lysed and DNA amplified by whole genome amplification (WGA). WGA product was then processed by aCGH. Embryos with normal and balanced chromosomes were transferred. Results:Total of 90 cases of clinical PGD oocyte retrieval cycles included 58 cases of reciprocal balanced translocation and 32 cases of Robertsonian translocation. Total of 528 embryos were biopsied, of which 518(98.1%) embryos got the confirmed diagnoses. Single embryo transfer was adopted with the clinical ongoing pregnancy rate of 46.8%. The ongoing pregnancy rate of the reciprocal balanced translocation in fresh cycles was 38.7%, and that in freezed cycles 45.0%. The Robertsonian translocation pregnancy rate in freezed cycles was 61.5%. Conclusions:Application of aCGH in the reciprocal and Robertsonian translocation PGD can obviously improve clinical outcomes.
    Related Articles | Metrics
    Retrospective Analysis of Cytogenetics in 1 770 Couples with Spontaneous Abortion
    HU Liang;LI Hao-xian;PENG Ying;LONG Zhi-gao;WEN Juan;WU Ling-qian
    2014, 33 (3):  168-171. 
    Abstract ( 1570 )   PDF (504KB) ( 7622 )  
    Objective:To estimate the frequency of chromosomal abnormalities, and to explore the relationship between chromosomal abnormalities and sex,abortion times,gestational age and abnormal childbearing history. Methods:The chromosome karyotyping and clinical characteristics were retrospectively analyzed in 1 770 couples with spontaneous abortion. Results:Chromosomal abnormalities and polymorphisms were detected in 111 cases (3.14%) and 119 cases (3.36%), respectively. 41 cases (2.32%) of chromosomal abnormalities were found in male while 70 cases (3.95%) in female. The abnormal childbearing rate in those chromosome-abnormal couples was 6.36%, while the normal childbearing rate in those couples was 1.8%, respectively. There was no significant difference in early miscarriage rates between those abnormality couples and controls(P>0.05). The rate of spontaneous abortion in those couples with chromosomal translocation (55.1%) was higher than that in normal couples (25.0%,P<0.001), while this rate in those couples with chromosomal inversion did not significantly change(P>0.05). There was significant difference in the rate of multiple spontaneous abortion in those heterochromatin/satellite heteromorphism carriers (37.3%) when compared with normal couples as well as chromosome-translocation couples(P=0.007,P=0.036). Conclusions:In those couples with spontaneous abortion, the rate of chromosomal abnormalities was more frequent in female than that in male. Chromosomal abnormalities were closely related to abortion times, abnormal childbearing history, suggesting that chromosomal abnormalities are risk factors of spontaneous abortion.
    Related Articles | Metrics
    Clinical Characteristics of Heterozygote and Double Heterozygote of Three Rare Mutations in alpha-Thalassemia
    XU Juan-juan;QIU Xiao-xia;DU Juan;LI Meng;HUANG Ping-li;LI Jiao
    2014, 33 (3):  172-174. 
    Abstract ( 2663 )   PDF (411KB) ( 7505 )  
    Objective:To examine clinical characteristics of heterozygote and double heterozygote of three rare mutations [Hb Constants Spring(Hb CS),Hb Westmead(Hb WS) and Hb Quong Sze(Hb QS)] among alpha-thalassemia patients in Guangxi province, China. Methods:135 alpha-thalassemia patients, and 40 controls, were included in this study. Routine examination of blood and hemoglobin electrophoresis were performed. The alpha-thalassemia mutations were detected using Gap-PCR and reverse dot-blotting. Results:There were no clinical symptoms in three heterozygote groups and the double heterozygote group of αCSα/αWSα. MCV and MCH in the heterozygote group of Hb QS were significantly lower than those in other heterozygote groups(Hb CS and Hb WS)(P<0.05). However,there was mild clinical symptoms in the double heterozygote group of αCSα/αQSα, while MCV and MCH were also significantly lower than those in other heterozygote groups(Hb CS and Hb WS)(P<0.05). Conclusions: The heterozygote Hb CS,heterozygote Hb WS and double heterozygote αCSα/αWSα are the silent carrier in clinical manifestations, the heterozygote Hb QS is the thalassemia trait, and the double heterozygote αCSα/αQSα is similar to the HbH disease. It is important to note this variability of clinical manifestations of those double heterozygotes in genetic consultation.
    Related Articles | Metrics
    Correct Errors in the Prenatal Diagnosis Using Combined Genetic Techniques: A Case Report
    WEN Juan;LI Hao-xian;LONG Zhi-gao;XIA Yan;XIA Jia-hui;LIANG De-sheng;WU Ling-qian
    2014, 33 (3):  175-177. 
    Abstract ( 1492 )   PDF (522KB) ( 7552 )  
    Objective:To verify the maternal balanced reciprocal translocation t(22;22) in a pregnant woman and the partial trisomy 22q in her fetus, which detected by G banding in a local hospital, using the combined genetic techniques. Methods:G-banding, N-banding and FISH were performed in the pregnant woman and her fetus,and high-resolution G-banding and N-banding in parents of the pregnant woman. Results:Inherited from her mother,the pregnant woman had the karyotype of 46,XX,t(11;22)(q25;q13),22ps+. 22ps+ which was obviously a balanced reciprocal translocation with a pair of 22ps+ polymorphisms. A 22ps+ and a normal chromosome 11 in fetus were found to transmit from the pregnant woman,leading to a balanced karyotype in the fetus. Conclusions:The comprehensive analysis by using combined genetic techniques should be performed in fetus and family members to prevent errors in prenatal diagnosis.
    Related Articles | Metrics
    综述
    Non-invasive Prenatal Diagnosis of α and β-Thalassemia: a Minireview
    ZHOU Wan-jun;XU Xiang-min
    2014, 33 (3):  178-181. 
    Abstract ( 1672 )   PDF (544KB) ( 7518 )  
    Thalassemiases are a group of the most common monogenic diseases in southern provinces of China. It is first choice method to prevent the birth of the affected children by prenatal genetic diagnosis in those high-risk couples through invasive sampling, which is widely accepted in the world. The risk of fetal injury, miscarriage or intrauterine infection may be caused by the invasive operation to collect villus, amniotic fluid, or cord blood for prenatal diagnosis. Since the cell-free fetal DNA(cff-DNA) was discovered in maternal plasma, the cff-DNA-based non-invasive prenatal diagnosis(NIPD) technology has been rapidly developed. The cff-DNA-based NIPD is safer and easily acceptable. In this review, noninvasive approaches in prenatal diagnosis of thalassemias were briefly discussed.
    Related Articles | Metrics
    Genetic Research on Male Spermatogenic Failure
    CAO Yun-xia;GAO Ming
    2014, 33 (3):  182-185. 
    Abstract ( 1532 )   PDF (561KB) ( 7530 )  
    Approximately 10%-15% of couples are infertile, while male infertility is almost half of all infertility. Spermatogenic failure is a major cause of male infertility, which shows azoospermia or oligozoospermia. Studies showed that Y chromosome plays an important role in spermatogenesis, and that Yq microdeletions are related to male infertility. X chromosome, as a single copy and unique expression in male, also plays an important role in spermatogenesis. Studies on teratozoospermia and asthenozoospermia showed that four genes located on autosomal chromosomes(SPATA16, PICK1,CATSPER and AURKC) probably involved in spermatogenic failure. In future, more and more new genetic tests will be developed and used in the clinical practice of spermatogenic failure, with the worldwide efforts.
    Related Articles | Metrics
    Advances in Genetic Study of Kallmann Syndrome
    LIU Meng-ying;WU Ling-qian
    2014, 33 (3):  186-190. 
    Abstract ( 1626 )   PDF (569KB) ( 7463 )  
    Kallmann syndrome(KS) is a complicated human genetic disorder with congenital hypogonadotropic hypogonadism(HH) and anosmia or hyposmia. It is also a genetically and clinically heterogeneous disease. Eighteen genes were found to be related to KS,including KAL1,FGFR1,PROKR2,PROK2,CHD7,FGF8,WDR11,NELF,HS6ST1,SEMA3A,HESX1,SOX10,IL17RD,FGF17,SPRY4,DUSP6,FLRT3 and AXL. However,only six genes(KAL1,FGFR1,PROKR2,PROK2,CHD7 and FGF8) were identified, which covered approximately 30% of the KS cases. Actually, genic mutations in about 70% of KS cases were unknown. The clinical assessment and genetic aspects of KS, as well as its partial reversibility and early diagnosis, were hereby reviewed.
    Related Articles | Metrics
    Diagnosis and Treatment of Hereditary Spastic Paraplegia and Genomic Typing
    YU Wen-qian;DUAN Wen-yuan;JU Ji-feng;WANG Tong-jian;ZHU Meng;HUANG Jing
    2014, 33 (3):  191-196. 
    Abstract ( 1832 )   PDF (841KB) ( 7549 )  
    Hereditary spastic paraplegia (HSP) is a group of neurodegenerative disorders with clinical and genetic heterogeneity. The main clinical feature is the progressive spasticity of lower limbs and myasthenia. HSPs are clinically divided into types: simple type and complicated form, the later with additional manifestations of more extensively neurological or non-neurological disorders. In genetics, HSPs are divided into four groups as follows: autosomal dominant, autosomal recessive, X-linked and mitochondrial traits, according to the inheritance modes. About 60 genetic subtypes have been described. With in-depth research on HSP, many new causative genes have been identified. We systematically reviewed the progress of HSPs, mainly including genotype and the corresponding clinical manifestations, for physicians to precisely identify the subtypes of HSP and to diagnose in genetics.
    Related Articles | Metrics
    Clinical Application of Preimplantation Genetic Screening
    ZHANG Qian;ZHENG Ye;YAN Jun-hao.
    2014, 33 (3):  197-200. 
    Abstract ( 1425 )   PDF (527KB) ( 7543 )  
    With the development of assisted reproductive technology and genetic analysis technology, the preimplantation genetic screening (PGS) is used to detect the numerical chromosomal abnormalities (aneuploid) in embryos, so as to improve pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET). New methods and technologies have been used in PGS, such as blastocyst stage biopsy, comparative genomic hybridization, microarrays and next generation sequencing, which increase the diagnose accuracy and decrease the risk of misdiagnosis. At the same time, PGS is also facing many challenges. The clinical application of PGS was reviewed in this article.
    Related Articles | Metrics
    Application of Sequencing Technologies in Noninvasive Prenatal Screening
    DING Chen-yue;WU Wei;LIU Jia-yin
    2014, 33 (3):  201-204. 
    Abstract ( 1730 )   PDF (612KB) ( 7572 )  
    Many sequencing technologies have been used in molecular biology research and clinical practice. In 1977, Sanger Sequencing (the first generation DNA sequencing technology) was firstly introduced. With the development of sequencing technology in the past 30 years, the next generation sequencing (NGS) was also used, and the third generation sequencing technology based on the single DNA molecule was developed. These sequencing technologies are benefit for the development of noninvasive prenatal screening(NIPS). Compared with those traditional technologies combined with amniocentesis and chorionic villus sampling,NGS obtains the fetal chromosomal information from sequencing cell-free fetal DNA (cffDNA) in maternal plasma, which avoids the fetal risk during the sampling procedure. Researchers found that the massively parallel sequencing (MPS)-based test was of high sensitivity and specificity in detecting fetal trisomies 21 and 18. The clinical application statement and the committee opinion were published by many health organizations. In 2013, the single cell sequencing(SNS) has also been used in the clinical trials of prenatal assisted reproductive technology. The live birth rate of in vitro fertilization and embryo transfer(IVF-ET) could be significantly improved in future using the single oocyte sequencing. So, the NGS will be widely used in the prenatal diagnosis.
    Related Articles | Metrics
    Perinatal Outcomes of Offsprings from Assisted Reproductive Technology:a Review
    QIAN Chun-feng;GAO Liang;LI Hong
    2014, 33 (3):  205-208. 
    Abstract ( 1641 )   PDF (520KB) ( 7523 )  
    The assisted reproductive technology(ART) as an effective method of infertility treatment is widely used in the world. With increasing ART offsprings,the long-term security of ART gets more attention. Multiple pregnancy is associated with adverse perinatal outcomes. Besides, growing evidence showed that ART singletons had the increased risks of preterm birth (PTB) and low birthweight, and an increased rate of congenital malformations. The mechanism is not yet clear, however the infertility background,ART procedures and ovarian stimulation may be potential cause of adverse perinatal outcomes of ART offsprings. Counseling for genetics, good birth and good care, and the preimplantation genetic screening(PGS) or prenatal diagnosis if necessary should be used to improve perinatal outcomes of ART offsprings. In this review, we discussed the ART security and perinatal outcomes of ART offsprings.
    Related Articles | Metrics
    标准与指南
    American College of Medical Genetics Standards and Guidelines for Interpretation and Reporting of Postnatal Constitutional Copy Number Variants
    WU Wei;LIU Jia-yin
    2014, 33 (3):  217-222. 
    Abstract ( 1799 )   PDF (1046KB) ( 7550 )  
    Genomic microarrays used to assess DNA copy number are now recommended as first-tier tests for the postnatal evaluation of individuals with intellectual disability,autism spectrum disorders,and/or multiple congenital anomalies. Application of this technology has resulted in the discovery of widespread copy number variation in the human genome,both polymorphic variation in healthy individuals and novel pathogenic copy number imbalances. To assist clinical laboratories in the evaluation of copy number variants and to promote consistency in interpretation and reporting of genomic microarray results,the American College of Medical Genetics has developed the following professional guidelines for the interpretation and reporting of copy number variation. These guidelines apply primarily to evaluation of constitutional copy number variants detected in the postnatal setting.
    Related Articles | Metrics
    论著
    Survey on the Acceptability of Woman′s Condom in Young Volunteers
    MAO Qun-xia;DONG Shao-ren;XIAO Yuan-hong
    2014, 33 (3):  223-227. 
    Abstract ( 1649 )   PDF (797KB) ( 7484 )  
    Objective:To investigate the acceptability of the Chinese domestic woman′s condom in Chinese young volunteers of childbearing age, and to survey those factors affecting application. Methods:A total of 332 volunteers (about 89% of them are women) from Nanjing, Qingdao and Xi′an were selected. The self-designed questionnaire was used to collect the data. SPSS software 13.0 was used to analyze the data. Results:About 90.5% of those untapped persons were willing to try the woman′s condom. After multi-variable adjustment, there was a statistically significant difference on the acceptability between areas, ORXi′an vs. Nanjing=0.197 (P<0.05). The main reason why to be willing to try the woman′s condom among those untapped persons and purchasers was "curious" (47.7%), while the main reasons of the unacceptability were "insufficient knowledge" or "inconvenient or conservative". There was the various of acceptability in color, fragrance, price, outside and inside packing and the convenient place to get. About 55% of the participants could accept colorful, dulcet woman′s condom. Nearly 59% of them could accept the price as ≥12 Yuan(RMB). More participants preferred the packing with two condoms in a paper box. In general, drugstore and the family planning service center were the favorite places to get such condom. Conclusions:In order to improve the acceptability of the domestic woman′s condom, those factors, including color, fragrance, price, outside and inside packing and the favorite place to get, should be considered, besides the product quality, easy-to-use and the differences in culture, education and economic status. Moreover, the related health education in those target population will be helpful to improve the acceptability of the woman′s condom.
    Related Articles | Metrics
    Factors Related to Triploid Zygotes in Routine in vitro Fertilization
    ZHANG Ying;SUN Ying-pu;SUN Jing;BU Zhi-qin;WANG Fang
    2014, 33 (3):  228-231. 
    Abstract ( 1912 )   PDF (557KB) ( 7516 )  
    Objective:To explore those factors related to triploid zygotes in routine in vitro fertilization-embryo transfer (IVF-ET). Methods:To analyze retrospectively the clinical data of 1 987 IVF cycles. According to the 3PN rate, 1 987 IVF cycles were divided into three groups:normal group(3PN%=0, n=754), the low frequency group(0<3PN%<20%, n=660) and the high frequency group(3PN%≥20 %, n=573). Results:There were significant differences in the age of patients, the basal level of follicle stimulate hormone (FSH), days of Gn, the total ampoules of Gn, the progesterone level on the day of hCG administration, and sperm concentration after optimization (P>0.05). The numbers of the retrieved oocytes and the maturated oocytes in both low and high frequency of 3PN groups were significantly higher than that in the normal group (P<0.01). E2 levels on the day of hCG administration in those groups were also higher than that in the normal group (P<0.05), while the ≥14 mm follicles rates on the day of hCG administration were significantly lower than that in the normal group(P<0.01). It was sure that there was significant difference in the normal fertilization rate among the three groups(P<0.01). The clinical pregnancy rates in the low frequency of 3PN group and the normal group had no statistical differences (P>0.05), but were higher than the high frequency of 3PN group(P<0.01). Interestingly, the sperm mobility rates after optimization in both low and high frequency of 3PN groups were significantly higher than that in the normal group, the rates of class a and b movement sperms were higher while the rates of class c and d movement sperms were lower in two groups than those in the normal group (P<0.01), There were not significant differences in the rate of good quality embryo, the implantation rate and the abortion rate among three groups (P>0.05). Conclusions:The higher level of estrogen on the day of hCG administration are positively associated with the occurrence of 3PN. The higher rate of ≥14 mm follicle by B ultrasound on the day of hCG administration, and the lower rate of living sperm after optimization, is negatively associated with the occurrence of 3PN. The higher rates of 3PN may affect the implantation rate and the clinical pregnancy rate.
    Related Articles | Metrics
    Effects of Different Criteria of hCG Administration on IVF/ICSI-ET Outcomes
    LI Yan-hui;GAO Ying;GENG Yu-hong;CHEN Li-juan;LIU Lin;CHEN Chun-yan
    2014, 33 (3):  232-235. 
    Abstract ( 1527 )   PDF (898KB) ( 7536 )  
    Objective:To explore the effects of two criteria of hCG administration on the clinical outcomes of IVF/ICSI-ET. These criteria were individually based on the follicle diameter and the follicle symmetry. Methods:It′s a prospective randomized study in our hospital reproductive center. IVF/ICSI-ET patients were randomly divided into two groups from Jan 2013 to Mar 2013. The criterion of hCG administration in Group A was based on the follicle diameter,while Group B on the follicle symmetry. Clinical and laboratory outcomes were then compared. Results:The average days of Gn, serum levels of progesterone and estradiol on the hCG day,the average number of matured eggs, and the rate of matured oocytes of group B were significantly higher than those of group A(P<0.05). There was not significant difference in the numbers of frozen embryos and good quality embryos between the two groups. However,the clinical pregnancy rate of group B was significantly lower than that of group A(42.19% vs. 54.22%, χ2=4.18,P=0.04), and the incidence of OHSS in group B significantly higher than that of group A(10.77% vs. 5.86%, χ2=4.07,P=0.04). Conclusions:The criterion based on the uniform size of follicular is not superior to the traditional criterion focused on the dominant follicle size in the efficacy and safety of IVF/ICSI-ET treatment.
    Related Articles | Metrics
    Days of the Elevated Level of Serum Progesterone before Follicular Maturation are Related with Outcomes of IVF/ICSI-ET Treatment
    SONG Rui-fang;SU Ying-chun;YANG Xin-hong;SUN Jing
    2014, 33 (3):  236-238. 
    Abstract ( 1696 )   PDF (440KB) ( 7511 )  
    Objective:To explore the effect of days of the elevated serum progesterone before hCG administration on the outcomes of IVF/ICSI-ET treatment. Methods:2 905 cases of IVF/ICSI -ET treatment, from June 2012 to June 2013, were divided into two groups according to whether finding the follicle(s) of diameter≥20 mm (Group A 2 725 cases, and Group B 180 cases) on the hCG day. Two groups were respectively divided into 3 subgroups according to days of the elevated level of progesterone (>1 ng/mL). Group A1 (1 788 cases) and B1 (83 cases) had 0 day of the elevated level of progesterone. Group A2 (717 cases) and B2 (67 cases) had 1-2 days of the elevated level of progesterone. Groups A3 (220 cases) and B3 (30 cases) had ≥3 days of the elevated level of progesterone. The clinical pregnancy rates of groups were meticulously compared. Results:There was significant difference in the clinical pregnancy rates among the Group A1 (55.42%), A2 (44.21%) and A3 (41.81%, P<0.01). Interestingly, there was no significant difference in those rates among the Group B1 (48.19%), B2 (47.76%) and B3 (46.66%, P>0.05). Conclusions:The clinical pregnancy rate could decrease following days of the elevated level of serum progesterone (>1 ng/mL) in those IVF/ICSI-ET patients with the follicle(s) of diameter ≥20 mm on the hCG day.
    Related Articles | Metrics
    Effect of Female Age on Outcomes of IVF-ET during Long Protocols Controlled Ovarian Hyperstimulation
    ZHANG Jing;SUN Bo;BU Zhi-qin;SUN Ying-pu
    2014, 33 (3):  239-242. 
    Abstract ( 1645 )   PDF (601KB) ( 7494 )  
    Objective:To investigate the effect of female age on the pregnancy outcomes, as well as ovarian responses, of in vitro fertilization-embryo transfer(IVF -ET), and to find the optimal age range for women undergoing the associated reproduction treatments. Methods: This is a retrospective analysis of all patients firstly undergoing IVF -ET using the standard long protocol for the controlled ovarian hyperstimulation(COH) in our center from May 2011 to May 2012. Patients were divided into four groups according to female age: age of the group A was 20-24 years old(n=170), the group B 25-29 years old(n=741), the group C 30-34 years old(n=866), and the group D over 35 years old(n=691). The laboratory indexes and main clinical outcomes [pregnancy rate, miscarriage rate and live birth rate(LBR)] were compared. Results:The duration of infertility was significantly longer following female age. The basal FSH level of the group D was significantly higher than those of other groups, while AFC and the basal LH level were significantly lower following age. The mean total dose of Gn was increased following age, while the number of mean retrieved oocyte was decreased. The 2PN zygote rate in group A was significantly lowest. The high quality embryo rate was significantly higher in the group B than this in other groups. The biochemical pregnancy rate and LBR were significantly lowered following age, while the spontaneous abortion rate was increased following age. The clinical pregnancy rate of group B is significantly higher than group D. LBR in the group D was significantly lower, and the spontaneous abortion rate was higher when compared with other groups. Conclusions: The oocyte quality and embryo quality in those women aged <25 years undergoing ART are not better than those in women aged 25-29 years, while the pregnancy rates in two groups are similar. The ovarian reserve, and pregnancy outcome of IVF-ET, will reduce following age, especially in those women aged over 35 years.
    Related Articles | Metrics
    Application of Mifepristone Combined with Misoprostol or Ethacridine in Induced Labor in Mid-Pregnancy of Cicatricial Uterus:A Systematic Review
    LIAO Jing;HE Ming-feng;YANG Ya-chuan;HU Li-na
    2014, 33 (3):  243-247. 
    Abstract ( 1589 )   PDF (665KB) ( 7518 )  
    Objective:To systematically review the application effect of two main methods in induced labor in midtrimester pregnancy of cicatricial uterus. Two methods were the Mifepristone combined with misoprostol and the mifepristone combined with ethacridine. Methods:We searched MEDLINE,EMBASE,VIP Database,Wanfang Database and CNKI(from inception to Nov. 2013). Randomized controlled trials(RCTs) of induced labor in mid-pregnancy of cicatricial uterus, with methods of the Mifepristone combined with Misoprostol(group A) or the Mifepristone combined with Ethacridine(group B), were reviewed and evaluated. RevMan5.2 software was used for Meta-analysis. Results:Eight literatures were included, and quality of the literatures was based on the Jadad scale scoring criteria. Meta-analysis showed that the group B was significantly superior to the group A in the time of launching uterine contraction(P<0.000 01,WMD=-12.60,95%CI:-17.17, -8.03) and induction(P=0.000 5,WMD=-10.50,95%CI:-16.46,-4.55),placental and fetal membrane residues(Z=3.07,P=0.002,95%CI:0.37,0.80) and induced labor success rate(Z=2.31,P=0.02,95%CI:0.19,0.88),and that there were no significant differences between two groups in the total stage of labor(P=0.10,WMD=-2.16, 95%CI:-4.73,0.42) and the amount of vaginal bleeding within 24 hours after delivery(P=0.11,WMD=-29.01, 95%CI:-64.12,6.09). Conclusions:When the induced labor in midtrimester pregnancy of cicatricial uterus was used, the Mifepristone combined with Ethacridine was significantly superior to the Mifepristone combined with Misoprostol in the time of launching uterine contraction, total time of induced labor,placental and fetal membrane residue, and the success rate of induced labor, except the total stage of labor and amount of vaginal bleeding within 24 hours after delivery.
    Related Articles | Metrics
    Treatment of Female SUI with Pelvic Floor Muscle Training Combined with Biofeedback and Electrical Stimulation
    WEI Wei;ZENG Ding-yuan;MO Ke-liang;ZHONG Hui-min;LU Yu-hua;QU Xiu-fang;LUO Jian-bing
    2014, 33 (3):  248-249. 
    Abstract ( 1726 )   PDF (378KB) ( 7458 )  
    Objective:To assess the clinical effectiveness of the conservative treatment of female stress urinary incontinence (SUI) with the pelvic floor muscle training(PFMT) combined with biofeedback and electrical stimulation(ES), and the application of the surface electromyography on the pelvic floor muscles in clinical practice. Methods:79 patients with SUI were treated with the PFMT combined with biofeedback and ES. The surface electromyography and clinical symptoms were observed after treatment. Results:There were significant improvement in the surface electromyography after treatment(P<0.01),while the changed levels after treatment in the mild incontinence group and in the moderate incontinence group were coincident(P>0.05). Total effective rate was 81.0% after 3 months follow-up, while the effective rates the mild incontinence group and the moderate incontinence group were similar(P>0.05). Conclusions:PFMT combined with biofeedback and EI is noninvasive and effective in treatment of female SUI, and the surface electromyography was a useful test to assess the curative effect.
    Related Articles | Metrics
    综述
    Role of Integrin in Gynecologic Diseases and Reproduction
    GONG Ting;XIE Yun-peng;KONG Ying
    2014, 33 (3):  250-252. 
    Abstract ( 1635 )   PDF (456KB) ( 7517 )  
    Integrin, a member of the adhesion molecule family, plays an important role in the common gynecological diseases and reproductive health. Integrin was found to be related to ovarian cancer,endometrial cancer,endometriosis,cervical cancer,trophoblast cells diseases,and reproductive diseases. The research on integrin is benefit for prevention,diagnosis,treatment,and prognosis of gynecological diseases,as well as reproductive health and aristogenesis. In this paper,the function of integrin in the field of gynecologic diseases was reviewed.
    Related Articles | Metrics
    Mechanism and Risk Factors for Recurrence of Endometriosis after Surgery
    CAI Liu-yun;HU Li-na
    2014, 33 (3):  253-256. 
    Abstract ( 1724 )   PDF (569KB) ( 7457 )  
    Endometriosis is a common disease in women of reproductive age. The laparoscopic treatment is reliable and effective. However, the frustrating problem is the high rate of recurrence after surgery. The mechanism of recurrence, as well as those risk factors, is still unclear. It may be related to the retrograde menstruation, the estrogen-dependent mechanism and the ectopic endometial stem cells. There are many risk factors of recurrence after surgery, the key factor being whether to operate thoroughly. Thus,for reducing the postoperative recurrence, we should not rely too much on postoperative auxiliary drug therapy. We should eliminate the residual lesions as far as possible with respect to the surgery safety.
    Related Articles | Metrics