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15 January 2013, Volume 32 Issue 1
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Improvement of Successful Rate of ART QIAO Jie;LI Hong-zhen 2013, 32 (1):  1-2.  Abstract ( 1934 )   PDF (325KB) ( 7374 )   About 10%-15% of the couples of childbearing age are suffering from infertility in the world. Since the first test-tube baby was born in 1978，the development of assisted reproductive technology （ART） has been vigorous. This resulted in rapid progress in related fields，such as clinical medicine，molecular biology and molecular genetics. But so far，the success rate of ART is not ideal，and the improvement is not obvious. To explore the influencing factors on ART success rate，give the corresponding improvement and gain good success rate is the direction of our efforts and the goal we pursue. Selecting the appropriate protocols of ovulation stimulation，doing further research about the etiology of infertility and reducing the complications of ART will do good for the development of ART and help us serve patients better. Related Articles | Metrics

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The Clinical Application of SperMagic in the Intrauterine Insemination During Natural Cycle with Husband Sperm WANG Xue-mei;WANG Xing-ling;SUN Li-jun;ZHANG Xia;LOU Hua;GUAN Yi-chun;WANG Jing-yan;LI Zhen;ZHANG Zhan 2013, 32 (1):  3-4.  Abstract ( 1840 )   PDF (362KB) ( 7399 )   Objective：To study the effect of SperMagic on sperm motility and pregnancy rate in intrauterine insemination （IUI） in natural cycles with husband sperm. Methods：70 patients received IUI in natural cycles from March to June 2012 were randomly divided into two groups. After sperm processing，sperms of 30 cases were added SperMagic （Group A）；sperms of 40 cases were not added SperMagic as control（Group B）. The sperm motility and pregnancy rate were then observed. Results：There was no significant difference in age，infertility years，body mass index （BMI） and sperm density and motility, before and after processing, between group A and B（P＞0.05）. There was no significant difference in pregnancy rate in both groups, although group A tended to have higher pregnancy rate（P＞0.05）. After treated with SperMagic，sperms had significantly higher motility （Ｐ＜０．０５）． Conclusions：Applying SperMagic in IUI could obviously improve sperm motility. Related Articles | Metrics

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Comparison of Recombinant Human Luteinizing Hormone and Human Menopausal Gonadotropin in IVF-ET WANG Song;CHEN Lei-ning;QUAN Song 2013, 32 (1):  5-8.  Abstract ( 2013 )   PDF (512KB) ( 7384 )   Objective：To compare IVF outcomes of the controlled ovarian stimulation （COS） protocols with r-FSH plus recombinant LH （Luveris） versus r-FSH plus HMG （Le BaoDe）. Methods：The outcomes of 281 infertile normogonadotropic patients undergoing IVF/ICSI treatment were retrospectively analyzed from Feburary to November in 2011 in our center. Patients were divided into two groups according to the addition of different exogenous luteinizing hormone preparation in COS：the HMG group （n=100） and the r-hLH group （n=181）. Numbers of oocytes retrieved and fertilized，and the high quality embryos rate，as well as thickness of endometrium on the day of hCG administration，incidence of OHSS and clinical pregnancy rate，were compared as the main parameters of outcomes. Results：Duration of ovarian stimulation of the HMG group was shorter than that of the r-hLH group（P=0.049）. The mean level of serum E2 on the day of hCG administration of the HMG group was statistically higher than that of the r-hLH group（P=0.033）. The incidence of OHSS in the HMG group was much higher than that in the r-hLH group（P=0.016）. Higher fertilization rate was found in the HMG group（P=0.000）. There existed no significant differences between two groups in the total FSH consumption，thickness of endometrium on the day of hCG administration，the number of oocytes retrieved，embryo cleaved rate，high quality embryos rate，implantation rate and clinical pregnancy rate（P＞0.05）. Conclusions：Compared with HMG，r-hLH may lead to better IVF outcomes in safety and efficiency，and lower risk of OHSS. Related Articles | Metrics

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Prediction of Pregnancy Outcome by Serum β-hCG and Progesterone on the Fourteenth Day After IVF-ET LI Yan;XIANG Yun-gai;ZHANG Mei;MA Li-ying;TAN Li;ZHAO Dong-mei 2013, 32 (1):  9-12.  Abstract ( 1970 )   PDF (587KB) ( 7554 )   Objective：To investigate the predictive value of serum β-hCG and progesterone （P4） for the early pregnancy outcome on the fourteenth day after in vitro fertilization and embryo transfer （IVF-ET）. Methods：The levels of serum β-HCG and P4 of 554 patients treated with IVF/introcytoplasm sperm injection （ICSI） in our center from April 2010 to November 2011 were analyzed retrospectively. Patients were divided into the normal pregnancy group，the abnormal pregnancy group and the non-pregnant group. The normal pregnancy included single pregnancy and multiple pregnancy. The abnormal pregnancy included early pregnancy miscarriage，ectopic pregnancy and biochemical pregnancy. The differences of β-hCG and P4 among groups were compared. Results：①The level of serum β-hCG in the normal pregnancy group was higher than those in the early abortion/ectopic pregnancy group，the biochemical pregnancy group and non-pregnant group（P＜0.05）. There was no statistical differences of β-hCG between the early abortion group and ectopic pregnancy group（P＞0.05）. ②The level of serum P4 in the normal pregnancy group was higher than those in the abnormal pregnancy group and the non-pregnant group （P＜0.05）, while the level in the multiple pregnancy group was significantly higher than that in the singleton pregnancy group （P＜0.05）. ③When the level of β-hCG of single test was＞197.27 IU/L, the possibility of normal pregnancy was 88.9%. When the level of β-hCG of single test was＞613.94 IU/L，there were a better pregnancy outcome and a higher possibility of multiple pregnancy. Conclusions：Serum β-hCG and progesterone on the fourteenth day after transplantation can be used as the good combined markers of early pregnancy outcome of IVF-ET. Related Articles | Metrics

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Efficacy of Laparoscopy and Hysteroscopy Combined with ART for the Treatment of Oviduct Obstructive Infertility SU Li-xiao;ZHANG Mei;XIANG Yun-gai;TAN Li;ZHANG Dan;LI Yan 2013, 32 (1):  13-15.  Abstract ( 1893 )   PDF (551KB) ( 7449 )   Objective：To evaluate the efficacy of the laparoscopy and hysteroscopy combined with assisted reproductive techniques on the treatment of oviduct obstructive infertility. Methods：146 patients with oviduct obstructive infertility treated with the laparoscopy combined with hysteroscopy from February 2008 to August 2010 were followed up for the pregnancy. There were 112 patients （112/146） without pregnancy after six months of operation. Fifty-four cases （54/112） did IVF-ET. The pregnancy rate was analyzed. Results：In 146 cases，46 cases were pregnant after the laparoscopy combined with hysteroscopy （40 cases palace pregnancy，6 cases ectopic pregnant）. Among them，34 cases were pregnant between 0 and 6 months after surgery （30 cases palace pregnancy， 4 cases ectopic pregnant），11 cases were pregnant between 7 and 12 months （9 cases palace pregnancy，2 cases ectopic pregnant），1 case was pregnant after 12 months. In 54 cases treated with IVF-ET，23 cases were pregnant after 7 months to 1 year （21 cases palace pregnancy，2 cases ectopic pregnant）. Conclusions：The laparoscopy combined with hysteroscopy have both diagnostic and therapeutic value. Within six months after surgery，the pregnancy rate was the highest. Those patients who were not pregnant after 6 months of operation or had severe oviduct obstruction should do IVF-ET as early as possible. Related Articles | Metrics

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Effect of Metabolic Syndrome on Female Reproductive Function SUN Ting;LI Rong;HAO Gui-qin;GENG Lan;GUO Liang-jie 2013, 32 (1):  16-19.  Abstract ( 1902 )   PDF (677KB) ( 7399 )   Objective：To compare the expressions of IRS-2，PPAR-γ mRNAs in the granular cells from patients with metabolic syndrome （MS） and normal women，and explore the relation between MS and infertility. Methods：Twenty-seven patients with MS were regarded as group A，13 patients with MS who reached the standards of blood fat and sugar by combination therapy with food，sport and drugs as group B，and 30 women without MS as the control group. Quantitative RT-qPCR was used to detect the expression of IRS-2，PPAR-γ mRNAs in the granular cells. Results：The dose of Gn of the control group was significantly lower than those of group A and Group B. （Endometrial thickness on the day of hCG injection of group A was significantly higher than those of group B and control group.） E2 level on the day of hCG injection of group A was also significantly lower. Total numbers of retrieved oocyte and mature oocyte of group A were significantly lower than those of group B and control group. However，there were not significant differences in the high-quality embryo rates，implantation rates，clinic pregnancy rates，live birth rates and miscarriage rates among three groups（P＞0.05）. There were significant differences in those parameters among three groups （P＜0.01）. Conclusions：The elevated expressions of IRS-2 and PPAR-γ mRNAs could be related with the local insulin resistance，which could play a role in the pathological mechanism of female reproductive disorders. Related Articles | Metrics

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Effectiveness of Treatment with Metformin in Women with Polycystic Ovary Syndrome Undergoing IVF：A Systematic Review and Meta-analysis XIAO Jin-song;CHEN Shuang-yun;ZHANG Chun-lian;CHANG Shuang 2013, 32 (1):  20-25.  Abstract ( 1899 )   PDF (705KB) ( 7375 )   Objective：To evaluate of the effectiveness of treatment with metformin in PCOS patients undergoing IVF. Methods：CBM disc，Wan Fang，CNKI，VIP，PubMed，PML，FMJS，Duxiu scholar search （www.duxiu.com） and 9 related journals were searched for the randomized controlled trails （RCTs） on the metformin treatment in PCOS patients undergoing IVF. The search time was from the first published to the end of December，2011. Meta-analysis was performed after quality assessment. Results：Six published studies with 607 patients were included. Meta-analysis showed that E2 value on the hCG day，OHSS rate，and cancellation rate of the metformin group were significantly lower than those of the control group，whereas pregnancy rate of the metformin group was significantly higher （P＜0.05）. No significant differences were found in the stimulation period （days），total amount of gonadotropin, number of oocytes retrieved，miscarrage rate，and live birth rate between the metformin group and the placebo group. Conclusions：Treatment with metformin can significantly increase pregnancy rate，and reduce risk of OHSS，in PCOS patients undergoing IVF. Related Articles | Metrics

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Correlation Between AR Gene Polymorphism and Disorders of Androgen Metabolism YUAN Chun;LIU Jia-yin;CUI Yu-gui 2013, 32 (1):  26-29.  Abstract ( 1787 )   PDF (599KB) ( 7437 )   Androgen receptor （AR） gene has two trinucleotide repeats （CAG and GGN） length polymorphisms，as well as many point mutations，which are associated with a number of diseases resulted from disorders of androgen metabolism，although there are many contradictory findings at the same time. Further，studies on different populations could have different results. In this review，the structure and function of AR，and its genomics，was summarized. Then the relationship between the polymorphic variations in AR gene and some diseases resulted from disorders of androgen metabolism was discussed，including prostate cancer，male infertility，polycystic ovary syndrome and so on. Related Articles | Metrics

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Roles of Sphingosine-1-phosphate in Reproductive System GENG Xu-jing;GUO Lei;QUAN Song;LI Hong 2013, 32 (1):  30-33.  Abstract ( 1991 )   PDF (694KB) ( 7386 )   Sphingolipids are ubiquitous components of cell membranes. Sphingosine-1-phosphate（S1P），one of the metabolities of sphingolipids，have important physiological functions，including regulation of cell survival，growth，proliferation and apoptosis. S1P acts as a regulator of cell function not only by binding to extracellular receptors but also by working as an intracellular second messenger. S1P could protect the ovary，oocyte and male germ cells from apoptosis induced by radiation and heat shock. Exogenous addition of S1P to the human embryo culture medium can decrease the apoptosis of the early embryo，which would improve the developmental potentiality of embryo. Thus，S1P could be used for improving the clinical outcomes of human assisted reproductive technology in future. Related Articles | Metrics

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Recent Advances of Differentiation of Human Embryonic Stem Cells into Endoderm and Hepato-like Cell Progenitor SUN Bo;SUN Ying-pu 2013, 32 (1):  34-37.  Abstract ( 1843 )   PDF (678KB) ( 7419 )   Embryonic stem cells （ESC），derived from the inner cell mass，is a highly undifferentiated cells with unlimited proliferation and developmental totipotency. ESC can spontaneously differentiate into many cell types，such as neurocytes，pancreatic cells，cardiocytes，and so on. Previously，ESC were mainly induced to differentiate into a variety of cells by forming the embryoid body （EB），but the efficiency was low. New studies showed that ESC can directly differentiate into definitive endoderm and further into hepatocytes by simply adding inducible factors，by which the efficiency was greatly improved. The efficiency of induced differentiation can be evaluated by the surface markers of definitive endoderm，such as SOX17 and FOX2. However，it is not very clear what combination of inducing factors has the highest efficiency and is closest to the normal development of human embryo. Related Articles | Metrics

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Research Progress on the Effect of Pituitary Down-regulation on the Synchronization of Follicular Development LI Jie;LIU Yu-sheng 2013, 32 (1):  38-41.  Abstract ( 1749 )   PDF (647KB) ( 7593 )   The human reproductive cycle is characterized by single follicular development. Although the controlled ovarian stimulation may promote multiple follicle development and get more oocytes，the desynchronization of follicular growth and development can not be avoided，which is caused by age，ovarian response，polycystic ovary syndrome. In order to obtain the satisfactory outcome in clinical，we should choose the appropriate protocol for each patient. The synchronization between follicles will be improved by adjusting the dosage of GnRHa，injecting HMG/GH and puncturing big ovarian follicle，etc. Related Articles | Metrics

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Androgens Supplementation in Women with Diminished Ovarian Reserve AN Jin-xia;NI Ya-li 2013, 32 (1):  42-44.  Abstract ( 1881 )   PDF (614KB) ( 7410 )   Poor ovarian response is a problem of the control ovarian stimulation in those women with the diminished ovarian reserve in assisted reproductive technology （ART）. In recent years, the various types of androgen supplementation including testosterone and dehydroepiandrosterone （DHEA） can increase the number of retrieved oocytes，improve embryos quality, and increase the clinical pregnancy rate and the live birth rate，for those women with diminished ovarian reserve in ART. The possible mechanisms of androgen supplementation include its roles as substrate of steroid hormones and ligand of androgen，the increased expression of follicle stimulating hormone （FSH） receptor in granulosa cells. The androgen supplementation provides us a new idea for the treatment of women with diminished ovarian reserve. However，application of androgen is still unable to carry out in large-scale due to the lack of strong evidences. It is necessary to carry out some clinical multi-center，large-scale randomized controlled trials to evaluate its safety and efficacy. Related Articles | Metrics

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Ovarian Tissue Vitrification: A Review ZHAO Shuo;DENG Xiao-hui 2013, 32 (1):  45-49.  Abstract ( 1829 )   PDF (763KB) ( 7404 )   The ovarian tissue vitrification was one of the main methods to preserve female fertility in recent two decades. It is an emerging technology of biological cryopreservation，which has been developed with great success for freezing ovarian tissue of both human beings and animal. Compared with program freezing，vitrification method is fast，low expensive and convenient. However，there is not the standard protocol of vitrification as the program freezing. This review summarized those protocols of ovarian tissue vitrification published newly，to explore how to select the proper freezing protocol. Related Articles | Metrics

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Effects of Di（2-ethylhexyl） phthalate （DEHP） on Mammalian Reproductive System: A Review ZHOU Wan-ge;WANG Tong-fei;ZHOU Ren;DING Zhi-de 2013, 32 (1):  50-54.  Abstract ( 1973 )   PDF (784KB) ( 7376 )   DEHPs，chemicals contained abundantly in many industrial products，had severe adverse effects on mammalian reproductive system involved in both male and female development. The development of mammalian reproductive system is related to a variety of hormones and the regulation of genes. DEHPs could interfer the key steps of hormone metabolism or gene expression. This review focused on the toxic effects of DEHP，and its mechanism，which is important for clinic to prevent，diagnose and treat the diseases of reproductive system. Related Articles | Metrics

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The Cellular Junctions and Junctional Proteins Related to Mammalian Blood-Testis Barrier XUE Ke;DING Zhi-de 2013, 32 (1):  55-58.  Abstract ( 2012 )   PDF (702KB) ( 7448 )   In the mammalian testis，tight junction is the primary structure of the blood-testis barrier （BTB） between adjacent Sertoli cells. This structure coexists with the basal ectoplasmic specializations and desmosome-gap junctions. Physically，the BTB divides the seminiferous epithelium into two distinct compartments：a basal compartment where spermatogonia and early spermatocytes are found，and an adluminal compartment where more developing germ cells existed in. In order to enter the adluminal compartment，preleptotene spermatocytes must pass through the BTB，in which several molecules and signalling pathways participate. In this review，we summarized some research results concerning the effect of relevant cellular junctions and junctional proteins of BTB on the penetration of preleptotene spermatocytes. Related Articles | Metrics

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The Models of in Vitro Placental Transfer HAN Fang;SONG Dian-rong 2013, 32 (1):  59-62.  Abstract ( 1890 )   PDF (790KB) ( 7415 )   It is important to study the placental transfer of drugs for the drug safety of pregnancy. Many in vitro techniques were applied in this field. There are three models of in vitro placental transfer of drugs，the perfused placental model with whole placenta，the BeWo cell model used for studying the transfer crossing trophoblastic cells，and the placental tissue model which is a useful and simple model developed by the placental tissues at different pregnancy stages. These models were appropriately used to investigate the drug distribution in placenta，which is important for the clinical treatment with fetal safety and drug discovery for pregnant women. Related Articles | Metrics

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The Progress on the Animal Model of Ovarian Hyperstimulation Syndrome LYU Rui-sha;ZHANG Jian-wei 2013, 32 (1):  63-66.  Abstract ( 1782 )   PDF (864KB) ( 7414 )   Ovarian hyperstimulation syndrome （OHSS），a serious complication of the controlled ovarian hyperstimulation（COH），is related with the exogenous gonadotropins （Gn）. The pathogenesis of OHSS is unclear，and there is not effective treatment. Scientists tried to develop animal models in different animals with different protocol of exogenous gonadotropins. With the successfully developed animal models，the pathological changes of ovarian tissues，levels of hormones，vessel active factors， and capillary permeability，have been explored. It is important to explore further the mechanism and precaution of OHSS. Related Articles | Metrics

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Scar Pregnancy After Cesarean Section YANG Hua;WEI Zhen-he 2013, 32 (1):  67-70.  Abstract ( 1894 )   PDF (807KB) ( 7418 )   Cesarean scar pregnancy （CSP） is one of the rare forms of ectopic pregnancy. With the increasing cesarean sections （CS） around the world，more and more CSP cases were diagnosed and reported. Early diagnosis and treatment can retain the fertility，and avoid uterine rupture or bleeding. Transvaginal sonography and color Doppler can be used to confirm CSP diagnosis. Once the diagnoses of CSP was made，pregnancy should be terminated immediately. Because of the high risk of uterine rupture，the expectant treatment should not be recommended. Methotrexate has therapeutic effect. At present，it is necessary to study further the CSP recurring，the time between CSP and the previous CS，and the effect of suture technique of CS on CSP，which is helpful to find the main causes，clinical manifestations，the best diagnosis and reasonable treatment of CSP. Related Articles | Metrics

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Misplaced Intrauterine Devices and Diagnosis WANG Kun;ZOU Yan;CHU Guang-hua 2013, 32 (1):  71-74.  Abstract ( 2039 )   PDF (796KB) ( 7418 )   Misplacement of intrauterine devices （IUDs） is one of the adverse complications of IUDs. Especially，locating outside of uterus is serious，even life-threatening. The risk factors of IUDs misplacement are the specific physiological status of uterus，abnormal shape，several diseases of uterus，as well as the absent experience of health workers. Clinical symptoms of IUDs misplacement are often unconspicuous and atypical. So，assistant examination is the main diagnosis method of misplaced IUDs. Sonography and ■ are convenient，low cost and nonintrusive，which can be used as the routine examination. The combination of sonography and x-ray can get better result. CT is an alternative method for its expensive cost. Both hysteroscope and laparoscope can make a definite diagnosis under direct vision， for removing the misplaced IUDs at the same time，but not for simple diagnosis. We discussed the diagnostic method，assistant examination，risk factors，clinical manifestation of misplaced IUDs，which are helpful for the service providers of primary family planning to diagnose accurately misplaced IUDs and to improve service level of reproductive health. Related Articles | Metrics