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15 March 2014, Volume 33 Issue 2
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Management of Endometriosis-associated Infertility ZHANG Qing-xue;LI Lin 2014, 33 (2):  77-79.  Abstract ( 1713 )   PDF (441KB) ( 7553 )   It is important to treat regularly the endometriosis-associated infertility in clinical practice. The new guidelines of Chinese，American and European suggested that the fertility，stages of endometriosis and other infertile factors of endometriosis patients should be synthetically assessed. Surgery is effective in those patients with mild or middle endometriosis，but the potential risk of ovarian damage should be noticed adequately. It is not recommended to prevent relapse of endometriosis with any medicine after surgery. Patients with severe endometriosis，poor ovarian reserve or failure surgery should be treated timely by assisted reproductive techniques. Related Articles | Metrics

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Epidemiological Study on Contraceptive Knowledge Levels and Related Factors of Migrant Population in Beijing，Shanghai and Chengdu JI Hong-lei;ZHAO Rui;WU Jun-qing;ZHOU Ying;CHENG Jian-ping;LI Yu-yan;HUANG Ping;LI Yi-ran;CHEN Jia-peng 2014, 33 (2):  80-84.  Abstract ( 1641 )   PDF (792KB) ( 7613 )   Objective: The Sixth National Census showed that the amount of migrant population in China reached 260 million in 2010，which had increased by about 120 million compared with "the fifth census". This epidemiological study was designed to explore the contraception knowledge level of migrant population in three cities, Beijing，Shanghai and Chengdu. Methods：This study was a multicenter cross-sectional survey. From Aug. to Dec. 2007，we chose 4 factories, 4 construction sites and 4 entertainment sites which were the gathered lots of migrant population in three cities. All the employees who met the inclusion criteria were included. Face-to-face questionnaire survey was done by those investigators trained uniformly. Database was established with Epidata 3.1，and data were inputted by two different persons and analyzed using SAS 9.1 package. Results：6 304 migrant population were actually investigated，including 2 001 from Shanghai，2 106 from Beijing and 2 197 from Chengdu. The knowledge levels of 9 common contraceptive methods, including their usage methods，principles，advantages and side effects, were scored. The average scores of 3 cities were all very low. The fitted multivariate linear regression model suggested that subjects from Beijing and Chengdu，male subjects，subjects unmarried and had no sexual behavior，subjects from construction sites，subjects who had lower capita income, and subjects who were agricultural residence registration, had lower scores. As for answering whether the six contraception could prevent HIV transmission，75.08% of subjects provided correct answer in the item of male condom，while only 40% subjects provided correct answer in the items of other 5 contraception methods. Conclusions：The knowledge levels of the usage, principles, advantages and side effects，and prevention against HIV transmission of common contraceptive methods, are still poor in migrant population. Subjects who are male，unmarried，haven′t sexual behavior, or are in bad economic status, are the key population of reproductive health services. Related Articles | Metrics

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Effect of Intervention Program on IUD Popularization in Migrants ZHAO Rui;WU Jun-qing;ZHOU Ying;JI Hong-lei;CHEN Jia-peng;ZHAO Hong-xin;LI Yu-yan;HUANG Ping;CHENG Jian-ping;LI Yi-ran 2014, 33 (2):  85-88.  Abstract ( 1654 )   PDF (629KB) ( 7520 )   Objective: To analyze the effects of the intervention program on IUD popularization in migrants，so as to get the basic information for the further contraceptive promotion. Methods：The multi-stage and random cluster sampling was used to select 6 304 migrant population aged between 18 to 49 years. Those subjects were randomly divided into two groups. The control group (2 974 migrants) was given routine service for family plan. The so-called intervention group （3 330 migrants） was given additional activities, including propose, mobilization, management and training. The data of IUI popularization was analyzed by the chi-square test and weighted least squares estimation model. Results：There were 1 688 subjects who were using IUD in both baseline survey and evaluation survey. In the control group，the rate of people who did not know IUD species declined to 43.77% from 58.28%. In the intervention group, this rate declined to 18.59% from 66.56%. There was significant difference between two groups, or between before and after treatment. Conclusions：Intervention can improve the IUD cognition in migrants. The further contraceptive intervention in migrants will be helpful for promoting family plan in practice. Related Articles | Metrics

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Acceptability of Woman′s Condom among 30 Couples in Shanghai，China WANG Cai-yan;HUANG Zi-rong;QIAN Jin-feng 2014, 33 (2):  89-91.  Abstract ( 1549 )   PDF (654KB) ( 7513 )   Objective: To evaluate the performance，acceptability and safety of Woman′s Condom（WC） in China. Methods：This is a single-arm，open study. 30 couples were enrolled into the study and asked to use 4 WCs in 3 weeks. Data were collected via questionnaires and interviews. Results：WC is easy to use. 79.3% users reported the insertion process was easy，20.7% moderate and none difficult. WC location did not move during intercourse. For the affection on sexual pleasure，86.2% females and 69.0% males answered "no affect"，3.4% females and 3.4% males "enhanced" and 10.3% females and 27.6% males "interfered". 96.6% females and 93.1% males expressed "satisfactory" or "okay" for the general feel of WC，only 3.4% females and 6.9% males expressed "unsatisfactory". The incidence of adverse events was 0.4%（1/234）. Conclusions：The Woman′s Condom is easy to use，stable and acceptable，with high comfort level and satisfaction. Related Articles | Metrics

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Termination of Second Trimester Pregnancy with Mifepristone and Misoprostol in Patients with Scarred Uterus QIAN Jin-feng;HUANG Zi-rong 2014, 33 (2):  92-94.  Abstract ( 1660 )   PDF (461KB) ( 7454 )   Objective: To investigate the efficacy and safety of the termination of second trimester pregnancy with mifepristone and misoprostol in patients with previous cesarean section. Methods：105 women with scarred uterins （ｇｒｏｕｐ １） ｄue to previous cesarean and 105 matched patients （ｇroup ２） without uterine scar were retrospectively analyzed. They underwent termination of second trimester pregnancy with mifepristone and misoprostol. The success rate of abortion，the induction-to-delivery interval，the occurrence rate of retained placenta，uterine rupture and hemorrhage were compared. Results：There were no significant differences in the abortion rate （９６．２％ ｖｓ． ９４．３％），the induction-to-delivery intervａｌ （both 5 ｈ） and the retained placenta rate （１５.2% vs. 7.6％） ｂｅtween the two groupｓ （Ｐ＞０．０５）． There was only one case of uterine rupture in the group 1. Conclusions：Mifepristone combined with misoprostol are safe and effective in the termination of second trimester pregnancy for those patients with scarred uterins. But during the termination of pregnancy，overall evaluation and careful monitoring are necessary. Related Articles | Metrics

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Construction of the Recombinant Lentiviral Vector Containing Mouse Tox3 Gene and Its Expression in Primary Granulosa Cells CUI Yu-qian;ZHAO Han;MA Zeng-xiang;ZHAO Shi-dou;XU Hai-jing;WANG Wen-ting;GUO Hai-peng;CHEN Zi-jiang 2014, 33 (2):  95-98.  Abstract ( 1775 )   PDF (896KB) ( 7448 )   Objective: To construct the recombinant lentiviral vector containing mouse Tox3 gene, and to check its expression in primary granulosa cells. Methods: The full length of Tox3 fragment was amplified by PCR, and subcloned into the lentiviral vector pCDH-MCS-T2A-copGFP-MSCV. The resultant lentivirus were confirmed by PCR, restriction enzyme digestion and DNA sequencing． The recombinant lentivirus （LV-Tox3-Flag） were produced from HEK293FT by a transient co-transfection with psPAX2 and pMD2.G. Primary granulosa cells were infected by LV-Tox3-Flag lentivirus，and the expression of TOX3 was confirmed by RT-PCR and Western blot. Results: The recombinant lentiviral vector carried the Tox3 gene was successfully constructed. RT-PCR and Western blot analysis revealed that the Tox3 gene can be correctly transcript and translated in the granulosa cells infected by LV-Tox3. Conclusions: The recombinant LV-Tox3-Flag was successfully constructed. It will be used to transfect target cells in our future study． Related Articles | Metrics

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Evaluation of the Stability of Embryo Culture System by IVF Outcomes JI Dong-mei;ZHANG Zhi-guo;ZHOU Ping;WEI Zhao-lian;CHEN Bei-li;HAO Yan;CHEN Da-wei;CAO Yun-xia 2014, 33 (2):  99-102.  Abstract ( 1560 )   PDF (658KB) ( 7484 )   Objective: To further evaluate the stability of different batches of culture medium by analyzing the IVF outcomes. Methods：Clinical data were collected from August 2011 to September 2012 in our IVF centre. Patients′ characteristics were summarized as younger than 35 years，normal ovarian reserve, using long protocol for ovulation, and more than 5 oocytes per cycles. There were 18 batches of the culture medium according to the cleavage stage （１８ ｇｒｏｕｐｓ）． Six batches （６ ｇｒｏｕｐｓ） were randomly selected. General clinical features and IVF outcomes were compared. Results：There were no significant differences in the average age，the number of previous IVF，basal FSH level，body mass index （BMI）, and endometrial thickness of hCG day, among the six groups（P＞0.05）. There were no significant differences in the average number of oocyte，oocyte maturation rate，fertilization rate，cleavage rate（P＞0.05） among the groups. The high-quality embryo rate was different among the groups（P＜0.05）. However，there were no significant differences in the average number of embryos transferred，pregnancy rate，miscarriage rate among the groups（P＞0.05）. Conclusions：IVF outcomes from different batches of the embryonic culture medium are stable, suggesting the stability of the overall quality control system in our IVF laboratory. Related Articles | Metrics

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Three Anesthetic Techniques used in Transvaginal Ultrasound-guided Oocyte Retrieval KOU Zhi-jian;LI Li-fei;LI Na;YANG Da-peng;ZHANG Xiao-lan;ZHANG Xue-hong 2014, 33 (2):  103-106.  Abstract ( 1477 )   PDF (653KB) ( 7545 )   Objective: To compare the clinical efficiencies of three anesthetic techniques used in the transvaginal ultrasound-guided oocyte retrieval. Methods：From December 2011 to March 2012 in our Center，462 patients undergoing IVF-ET were divided into three groups according to anesthetic techniques during oocyte retrieval，group A（227 cases） used Dolantin （ｉ．ｍ．） only, group B（54 cases） used acupuncture anesthesia，and group C（181 cases） used Propofol （ｉ．ｖ．）． The anesthesia effects and adverse effects were evaluated. Results：There were higher oocyte retrieval rate in group C than the other groups（P＜0.05），but there were no significant differences in clinical pregnancy rate and miscarriage rate among three groups（P＞0.05）. The analgesic effects in three groups were similar, but the adverse effects in the group B and C, such as nausea and sweating，were lower（P＜0.05） than those in group A. Conclusions：Acupuncture anesthesia and Propｏｆｏｌ （ｉ．ｖ．） can reduce pain intensity and adverse effects in patients undergoing transvaginal oocyte retrieval, although treatments do not affect the clinical pregnancy rate and the abortion rate in IVF-ET. Related Articles | Metrics

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Relationship between Serum Progesterone Level on 6th Day and Clinical Outcome of FET with Hormone Replacement WAN Li-jing;TAN Li;CHU Xi-ying;SONG Yu-xia 2014, 33 (2):  107-109.  Abstract ( 1624 )   PDF (554KB) ( 7514 )   Objective: To explore the relationship between frozen embryo transfer （FET） clinical outcomes and serum level of progesterone on the sixth day in those ＦＥＴ ｃycles combined with hormone replacement. Methods: Those 261 FET cycles combined with hormone replacement were retrospectively analyzed. Those cycles were divided into three groups by serum level of progesterone （P） on the sixth day after FET. Serum level of progesterone was ＜20 μg/L in the group A, 20 μg/L≤P＜30 μg/L in the group B, and ≥30 μg/L in the group C. Clinical features, the pregnancy rate and abortion rate were analyzed. After that, those 261 cycles were divided into three groups by clinical outcomes of FET. The group D had intrauterine fetus, the group E had bad pregnancy outcomes, and the group F had not pregnancy. Then the serum levels of progesterone and estrogen on the sixth day after FET were compared. Results: The pregnancy rate of the group C （５０％） ｗas significantly higher than that of the group B （２８．５％）, and the pregnancy rate of the group B was significantly higher than that of the group Ａ （１1.1%） （Ｐ＜０．０５）. The abortion rate of the group A （６０％） ｗａs significantly higher than that of the group Ｃ （１８％） （Ｐ＜０．０５）． The serum levels of progesterone on the sixth day after FET in the group D and the group E were significantly higher than that of the group F （Ｐ＜０．０５）． Ｃonclusions: The serum level of progesterone on the sixth day after FET combined with hormone replacement can be reasonably used as a marker to predict the clinical outcomes of FET. The higher level of progesterone could mean the better pregnancy outcomes, and the lower abortion rate. Related Articles | Metrics

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Effects of Male Factors on Outcomes of Intrauterine Insemination SU Ning;XIA Wei;WANG Wei;HE Yan;ZENG Yan-hua;HUANG Ting-ting;PENG Ya-ya 2014, 33 (2):  110-112.  Abstract ( 1354 )   PDF (588KB) ( 7533 )   Objective: To assess the effects of male factors on the clinical pregnancy rate of intrauterine insemination（IUI）. Methods： The data of 472 IUI cycles from January 2012 to April 2013 in our center were retrospectively analyzed. These cycles were divided into three groups according to male age（＜30，30～35，≥35 years），four groups according to the percentage of normal morphological spermatozoa（normal：≥15%；mild，moderate and severe abnormal：10%-15%，5%-10%，≤4%）, or five groups according to the processed total motile sperm count（PTMS）（＜2×106，（2-5）×106，（5-10）×106，（10-20）×106，≥20×106）. Then the clinical pregnancy rates were compared. Results：A total of 80 clinical pregnancies were obtained，for a pregnancy rate per cycle of 16.95% and accumulative rate 33.47%. The clinical pregnancy rate in the ≥35 years old group was 10.4%，in severe abnormal group was 8.4%. These rates were significantly lower than those of other groups（P＜0.05）. Conclusions：Male factors such as age, the percentage of normal morphological spermatozoa, and PTMS should be considered during IUI therapy. Those couples with male age ≥35 years, severe abnormal spermatozoa, or PTMS ＜2×106, should be advised to treat with IVF-ET or ICSI-ET. Related Articles | Metrics

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Physical and Psychomotor Development of 266 Children at 1-3 Years Conceived by ART CHEN Xiao-qin;ZHANG Qing-xue;LI Yu;LIN Hai-yan;JIAO Xue-dan;YANG Dong-zi;LI Hong;ZHAO Qian 2014, 33 (2):  113-116.  Abstract ( 1728 )   PDF (593KB) ( 7562 )   Objective: To investigate the physical and mental development of children of assisted reproductive techniques（ART） at 1-3 years, in the limited samples and the limited age range. Methods：A total of 266 ART children，including 106 twins, at 1-3 years were follow-up visited from February 2008 to February 2011. The control group comprised 129 children, including 84 twins, who were naturally bred. The neonatal outcomes，physical and mental development were evaluated. Results：Parent age in the ART children group was elder than that in control group. There were no significant differences in BMI，MDI and PDI between two groups of ART children and control, and between two twins′ groups. A multivariate regression analysis indicated that the conception mode did not affect MDI and PDI. Conclusions：There are no significantly differences in the physical and psychomotor development between ART children and normal conception children in this study. Related Articles | Metrics

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Fertility Preservation in 51 Patients with Borderline Ovarian Tumor ZHAI Qing-zhi;LI Xiu-li;YANG Yi-zhuo;YAO Yuan-qing 2014, 33 (2):  117-119.  Abstract ( 1653 )   PDF (442KB) ( 7492 )   Objective: To evaluate the effects of fertility-preserving surgery on the efficacy and fertility in patients with borderline ovarian tumor （BOT）. Methods：The clinical data of 51 patients with BOT receiving fertility-preserving treatments were retrospectively analyzed，including surgery，relapse，postoperative menstruation and pregnancy. The correlation was also analyzed between chemotherapy，comprehensive surgical staging and relapse. Results：Among the 51 patients，30 cases were S-BOT，7 cases accepted comprehensive surgical staging，10 cases accepted chemotherapy after surgery, and 13 patients relapsed. Of 8 patients who want pregnancy，3 patients succeeded. Conclusions：Fertility-preserving treatments are effective and feasible ways for patients with BOT. Adnexectomy may be the best way for fertility-preserving treatments. Chemotherapy and comprehensive surgical staging cannot reduce the relapse rate. Recurrence cases can choose fertility-preserving surgery again. Related Articles | Metrics

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Correlation between Galectin-1 and Pregnancy LYU Yuan;LIU Ai-xia;ZHU Yi-min 2014, 33 (2):  120-123.  Abstract ( 1615 )   PDF (550KB) ( 7498 )   Expressions of galectin-1 （Gal-1） in deciduas, placenta and trophoblast cells show a temporal and spatial pattern during pregnancy, which differ between normal and abnormal pregnancy. The expression level of Gal-1 gene is regulated by DNA methylation in its promoter region, and regulated by steroid hormones. Gal-1 takes parts in cell-adhesion, trophoblast differentiation, invasion, formation of syncytium and spiral artery remodeling. Gal-1 is also involved in the immune tolerance by promoting the immune inhibition transformed from the tolerogenic dendritic cells （ＤＣｓ）, cytokines and immunoprotrins. Meanwhile, the oxidative stress of placenta and maternal may change Gal-1 structure, and its biological activity and function. Gal-1 is a potential diagnosis marker or treatment target for the pathological pregnancy and pregnancy-related diseases, since it plays an important role in the initiation, development and maintenance of pregnancy. Related Articles | Metrics

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Clinical Application and Development of NovaSure Impedance Controlled Endometrial Ablation WANG Zi-jing;YANG Yong-xiu 2014, 33 (2):  124-127.  Abstract ( 1559 )   PDF (582KB) ( 7536 )   Abnormal uterine bleeding （AUB） is a common problem. Hysterectomy is the standard treatment for those women with heavy menstrual bleeding who have no response to medical treatment. The endometrial ablatiｏｎ （ＥＡ） ｂｙ the minimal invasive procedure to destroy the endometrium has been used to replace hysterectomy. The NovaSure impedance controlled endometrial ablation, one of those minimal invasive procedures, is a second-generation method of EA for clinical practice in foreign countries over decade. Its principle is based on the power delivery and procedure termination concept, and the well-analyzed physical characteristics of tissue （impedance/resistance） allowing for a controlled depth of tissue destruction in an short time. It is not necessary to pre-treat endometrium. Patient can even be treated when actively bleeding. Other benefits for patients are high safety, effective treatment, short operating time, and automatic operation. Related Articles | Metrics

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Vitamin D and Polycystic Ovary Syndrome DU Xu-yuan;GU Lin 2014, 33 (2):  128-130.  Abstract ( 1850 )   PDF (485KB) ( 7546 )   Polycystic ovary syndrome（PCOS） is the gynecologic endocrine diseases characterized by chronic anovulation and hyperandrogenism. The women with PCOS may be complicated with vitamin D deficiency. Many clinical trials in recent years indicated the association between 25-hydroxy vitamin D [25（OH）D] level and PCOS, including insulin resistance，ovulatory dysfunction，menstrual irregularities，low pregnancy success，hirsutism，hyperandrogenism，obesity and the elevated risk factors of cardiovascular diseases. Vitamin D deficiency may play an important role in aggravating symptoms of PCOS. The preliminary clinical data suggested the possible benefits of vitamin D supplementation in women with PCOS. This review summarized the current clinical researches on the correlation between vitamin D and PCOS． Related Articles | Metrics

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Progress of Early Diagnosis and Treatment of Tubal Pregnancy LI Chang-dong;ZHANG Wei-yuan 2014, 33 (2):  131-135.  Abstract ( 1575 )   PDF (682KB) ( 7512 )   Tubal pregnancy，the most common ectopic pregnancy, has a increased incidence in recent years. However, the mortality trends to decrease mainly due to early diagnosis and treatment before rupture. Vaginal ultrasound examination combined with serum levels of hCG and progesterone can help early diagnosis of tubal pregnancy. The treatment outcomes can be improved by timely prediction of ectopic pregnancy for those patients with indistinct position of embryonic implantation. Serum levels of β-hCG，progesterone and CA125 are useful to predict the outcomes of tubal pregnancy and helpful to select a suitable therapy. Laparoscopic surgery and medical treatment are main methods for treatment of ectopic pregnancy. According to indications，these two kinds of conservative methods could obtain good effect and fertility preservation. In this article，the early diagnosis and treatment of tubal pregnancy were reviewed. Related Articles | Metrics

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Progress of Preimplantation Genetic Diagnosis LI Na;FAN Jun-mei;LIU Zhong-yu;YU Chun-hua;YAO Yuan-qing 2014, 33 (2):  136-139.  Abstract ( 1722 )   PDF (599KB) ( 7607 )   he genetic tests of the preimplantation human embryo mainly include： preimplantation genetic diagnosis（PGD） and preimplantation genetic screening （PGS）. PGD based on PCR and FISH has been used to detect the single gene disorders and inherited chromosome abnormalities for the last 20 years. PGS with the same technology in PGD was used to detect aneuploidy chromosomes in embryos, to select those embryos with normal chromosomes for IVF transfer. It has been applied in those patients of advanced age，repeated implantation failure，repeated miscarriages and severe male factor infertility. There are dramatic changes in the PGD methodology. Both array-comparative genomic hybridization and single nucleotide polymorphism arrays have been introduced into clinical practice for PGD and PGS. In this review，we introduced some new methods and controversies in the field of PGD/PGS. Related Articles | Metrics

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Nodal Signal Pathway in Human Embryonic Stem Cell CHENG Ting-ting;SUN Ying-pu 2014, 33 (2):  140-143.  Abstract ( 2223 )   PDF (503KB) ( 7575 )   Nodal, a member of TGF-beta family, plays an important role in maintaining pluripotency of human stem cells, and inducing development of embryonic tissues. In recent years, the Nodal signal pathway was also a key in the in vitro differentiation of human embryonic stem cells. Nodal could be involved in the mechanism of prostate cancer, testicular cancer, melanoma, ovarian cancer, liver cancer, pancreatic cancer and other tumors. It provided us reliable theoretical basis on the development of human embryo and tumorigenesis to explore the role of Nodal pathway in human embryonic stem cell. Related Articles | Metrics

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Effects of Diabetes on Reproductive System: a Review SHI Ying-yun;SUN Yi;WAN Sheng;DING Zhi-de 2014, 33 (2):  144-148.  Abstract ( 1747 )   PDF (754KB) ( 7583 )   The incidence of diabetes increased year by year in the world. The complications of diabetes extremely affect human health. Effects of diabetes on the reproductive system are drawing more and more attention, including structure of reproductive organ，synthesis and secretion of reproductive hormones，development and function of reproductive cells，sexual function and offspring′s health. The pathological mechanism was related to the disorders in hormonal level, and cellular and molecular regulation. It is important for diabetes patients to prevent, diagnose and treat those diseases related to diabetics by studying the effects of diabetes on the reproductive system. Related Articles | Metrics