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15 September 2012, Volume 31 Issue 5
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Reproductive Medicine Research in the Era of Translational Medicine：Challenges and Perspectives WANG Yi-fei 2012, 31 (5):  327-329.  Abstract ( 1968 )   PDF (423KB) ( 7266 )   Translational medicine is an idea and major research strategy，rather thana slogan or a label. People’s needs and demands in public health is the starting point of translational medicine. The priority areasof reproductive medicine in China are：development of new contraceptives，prevention and management of infertility，assisted reproductive technology （ART）development and application，birth defects and birth quality，prevention and management of reproductive tract infections （RTIs）and reproductive tract cancer，alleviation of impacts of environment and life styles on reproductive health. The key to translational medicine is to facilitatethe transitions from public health problems into basic and laboratory studies，as well as from research results of basic and laboratory studies into clinic diagnosis，treatment and optimal clinic pathway. In the field of ART，there are three major research priorities：how to improve the successful rate of ART，how to satisfy the ART safeties of both mother and offspring，and how to develop the bioethical guideline of ART. Chinese scientists should，can and must make our contribution in the era of translational medicine. Related Articles | Metrics

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Menstrual Cycle and A New Concept of Ovarian Cycle in Assisted Reproductive Technology ZHUANG Guang-lun 2012, 31 (5):  330-331.  Abstract ( 1886 )   PDF (396KB) ( 7312 )   Menstrual cycle is a mirror which reflects the follicle development，ovulation and luteinization. This cycle is precisely regulated by the hypothalamic-pituitary-ovary axis. In aged women,this regulation becomes less and less precise with aging, which seems to be more important for those agedwomen undergoing ART. For ART, it is important that we should understanda new concept of ovarian cycle. This isa challenging concept for the observation of follicle development and ovulation. A new technique, ovum pick up whenever lutein phase and menstrual period, can be used to improve the pregnant rate. Related Articles | Metrics

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Status of Assisted Reproductive Technology in China QIAO Jie;MA Cai-hong 2012, 31 (5):  332-333.  Abstract ( 1985 )   PDF (401KB) ( 7310 )   Over the past 30 years，assisted reproductive technology （ART）has been rapidly developed in China. The application range and technical level has met those of the advanced world. Combining our national condition and traditional culture，a series of management regulations have been established. In future，we must have the group thinking，perfect management system，improve training for reproductive specialist，and adjust the goals for technical development. By those effort，the orderly and healthy development of ART will be finally achieved in China. Related Articles | Metrics

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Progress of Reproductive Security HUANG He-feng;LUO Qiong;ZHU Yi-min 2012, 31 (5):  334-340.  Abstract ( 1771 )   PDF (627KB) ( 7321 )   The concept of reproductive security was firstly suggested in 2005 by the inaugural meeting of the China Medical Association Reproductive Medicine Branch. So far，the reproductive security received unprecedented attention. The new concept of embryo origin of adult diseases has been explored in the national kebasic research program’The mechanism of embryo origin of adult disease caused by assisted reproductive technology ‘. Those non -physiological process involved in assisted reproductive technology （ART），includingsuperovulation，in vitro fertilization，in vitro culture，gamete/embryo freezing and thawing，blastomere biopsy，cause the problem of reproductive security. ART may related to the high rates of miscarriage，premature birth，congenital malformations，low birth body mass and other adverse health risks，genetic diseases，chromosomal abnormalities，abnormal epigenetic modifications，nervous system abnormalities，cardiovascular disease and metabolic disorders in adulthood. Besides ART itself，those parental reproductive disorders might influence gametogenesis，fertilization，embryo development，and implantation. The adverse intrauterine environment caused by parental pregnanccomplications might related to the occurrence of the delayed adult disease in offspring interfereing the gene andprotein expression. Parental infectious diseases possibly might vertically transmit to offspring by gametes，which significantly affect the health of offspring. The reproductive security also depends on environmental safety. Theharmful physical and chemical factors in environment might have an adverse impact on the reproductive behavior. Related Articles | Metrics

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A New Interdisciplinary Subject LU Guang -xiu;YANG Xiao -yi 2012, 31 (5):  341-343.  Abstract ( 2089 )   PDF (591KB) ( 7292 )   The tumor reproduction is a new interdiscipline subject of oncology and reproductive medicine，which aimed to achieve the balance between patient life and fertility preservation. With medical technologies advanced，the outcome and prognosis of cancer patients have been greatly improved. The radiationand chemotherapy with reproductive toxicity are main reasons of male infertility in those young cancer patients.On the other hand，it should be collaboratively investigated by the multi -disciplinary including oncology，reproductive medicine，radiation medicine，and basic medicine，how to preserve the fertility of young patients，how to treat cancer pregnant women. All these will promote the development of tumor reproduction. Related Articles | Metrics

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Granulosa and Oocyte Development SHEN Huan 2012, 31 (5):  344-347.  Abstract ( 1824 )   PDF (577KB) ( 7335 )   Granulosa is important in the nutrition and signal transduction for oocyte development andmaturation. Similarly，oocyte also plays regulating roles in the granulosa differentiation and development. Theprofile of gene expression of granulosa may be used to evaluate the micro-environment of oocyte development.The patterns of gene expression of granulosa may be associated with the oocyte quality. Therefore，it is possibleto identify the markers of oocyte and embryo competence by analyzing the granulosa transcriptome, by whichthe IVF fertilization rate, implantation rate and pregnancy rate could be increased, and the miscarriage ratedecreased. Related Articles | Metrics

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Impact of Biopsy on the Embryo Developmental Potential XU Yan-wen 2012, 31 (5):  348-348.  Abstract ( 2032 )   PDF (483KB) ( 7270 )   With the wide application of preimplantation genetic diagnosis （PGD），the safety issue of embryo biopsy was emphasized again. The technique points，such as biopsy stages and methods of zona drilling，may have impact on the embryo development after biopsy. Current study on the safety of embryo biopsy mainlyfocused on two stages，the first stage from biopsy to blastocyst development，and the second stage from birth totwo years old. No data was available for the long term safety of adults born after PGD. Related Articles | Metrics

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In Vitro Embryo Survivability Assessment SUN Hai -xiang 2012, 31 (5):  349-350.  Abstract ( 1836 )   PDF (510KB) ( 7290 )   The preimplantation embryonic developmental capacity determined the pregnancy outcome.Morphological assessment asa non-invasive technology was the most commonly method in ART to evaluate thepreimplantation embryo vitality. It will provide the prediction of embryonic development and clinical pregnancyto establish the grading standard of oocyte and embryo morphology. There are special characteristics for eachdevelopmental stage of embryos. In general, it is difficult to identify which embryo has the developmentalvitality of the implantation stage embryo at a time point. It is necessary to set up a continuous embryo scoringsystem including the pronuclear score, early cleavage and cleavage stage embryo scores in order to select theproper embryo for transfer morphological parameters could not accurately reflect the potential of embryodevelopment because the accuracy of morphological assessment was still not good enough. Embryo researchershave been devoted to exploring the objective evaluation of embryonic development potential in order to guideclinical protocol adjustments. High-quality embryos were selected for transplantation effectively improved theclinical outcome of assisted reproductive technology and reduced multiple pregnancy. Related Articles | Metrics

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Application of Single Nucleotide Polymorphism in Preimplantation Genetic Diagnosis LI Gang;LIU Yan;SUN Ying-pu 2012, 31 (5):  351-353.  Abstract ( 1786 )   PDF (577KB) ( 7278 )   Preimplantation genetic diagnosis （PGD）is a method to analyze embryo hereditarysubstance before implantation，and to identify which embryo is normal and suitable to transfer. PGD is one ofthe essential parts of assisted reproductive technology （ART）. With the development of the detectingtechniques，more technologies were applied in PGD. Single nucleotide polymorphism array（SNP array）isa newtechnology of PGD, with many advantages of fast diagnosis，screening for 24 chromosomes in one time，highresolution，detection of uniparental disomy. The origin of implanted embryo or the origin of extra chromosomefrom abnormal embryos can be found by SNP array. In addition, SNP array is widely used in other fields ofassisted reproduction. Related Articles | Metrics

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Acceptability and Ethical Debate about Preimplantation Genetic Diagnosis YANG Kun;ZHANG Yun-shan 2012, 31 (5):  354-358.  Abstract ( 1675 )   PDF (704KB) ( 7267 )   Preimplantation genetic diagnosis （PGD）was firstly applied in 1990 in two couplesdiagnosed as adrenoleukodystrophy and X-linked mental retardation. It is widely used now in ART. However，There is continuous controversy about PGD. The medical application of PGD is widely acceptable，but its application for the non-medical purposes is still immersed in ethical controversy. In this paper，we reviewed the different acceptability and ethical issues of PGD which provide references for both patients and doctors. Related Articles | Metrics

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Characteristics of Trigger in the Different COS Protocols MA Wen -hong;LIANG Xiao -yan 2012, 31 (5):  359-361.  Abstract ( 2132 )   PDF (671KB) ( 7301 )   The midcycle surge of LH is absolutely required for the final maturation of oocyte，initiationof follicular rupture, and function of corpus luteum. Human chorionic gonadotrophin（hCG）and GnRH analogueare used for the final maturation of oocyte in assisted conception cycles. Which one is used usually depends onthe controlled ovarian stimulation （COS）protocol and different hypothalamus -pituitary condition. The timepoint, dose and medicine variety for trigger are dependent on the hypothalamus-pituitary condition, follicle andendometrium conditions of different protocols. hCG trigger induces better luteum function and high pregnancyrate, but it has higher OHSS rate. GnRH agonist causes low OHSS rate with the impaired pregnant andmiscarriage rate which could be improved by intensity luteum supply. GnRHa is not recommended to useroutinely asa trigger for final oocyte maturation in the fresh autologous cycles because of the lower ongoingpregnancy and live birth rates. Related Articles | Metrics

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Embryo Transfer Strategies for Special Cases in ART Laboratory WU Ke-liang;LIU Hui;YU Guan-ling;ZHAO Hai -bin;LI Mei;CHEN Zi -jiang 2012, 31 (5):  362-364.  Abstract ( 2045 )   PDF (717KB) ( 7252 )   As the great advances in ART，the rate of clinical pregnancy has been gradually improved，while the rate of multiple pregnancies, especially 逸3 pregnancies, was at very high level. The probability ofadverse pregnancy outcomes significantly increases in multiple pregnancies. Recently，patients undergoing IVFwould like to implant more embryos due to the expectation of high pregnant rate and low expense of their own.However，the risks and benefits always coexist in clinical practice. To optimize the outcome of IVF，the risks must be minimized if the clinical pregnancy rate is not significantly affected. In addition，blindness exists in embryo selection. It is important to set upa personalized strategy of embryo transplantation for those differentIVF patients. For normal responders with over 6 good-quality embryos，the blastocyst transfer can obtain ideal clinical pregnancies with decreased multiple pregnancy rate. For patients without obtained good -quality embryos，good clinical outcome can be acquired using blastocyst transfer. Assisted hatching （AH）can markedly improve the clinical pregnancies of those elderly patients. For high responders，freezing-thawing embryo transfer （FET）may bea better choice. Related Articles | Metrics

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Factors Involved in Repeated IVF Failures NI Hao;CHEN Lei-ning;OU Xiang-hong;QUAN Song 2012, 31 (5):  365-368.  Abstract ( 1976 )   PDF (820KB) ( 7313 )   The definition of repeated IVF failures is unclear. Factors involved in repeated IVF failures mainly include the bad gametes quality，poor embryo quality，reduced endometrial receptivity, and the interaction of multiple unexplained factors. Comprehensive screening of the relevant factors together with thetargeted treatment can contribute to increase the embryo implantation and clinical pregnancy rates，and improve the prognosis of patients undergoing repeated IVF failures. Related Articles | Metrics

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Clinical Importance of Screening Antisperm Antibodies in Semen WEN Ren-qian;TANG Yun-ge 2012, 31 (5):  369-372.  Abstract ( 1815 )   PDF (702KB) ( 7330 )   According to the WHO guideline, tests for antisperm antibody （ASAB）on spermatozoa were recommended as: the mixed antiglobulin reaction（MAR），the immunobead test（IBT）and sperm cervical mucus contact test（SCMC）. These tests can detect ASAB on mobile spermatozoa or in biological fluids such as serum，seminal plasma and cervical mucus and so on. Vasectomized men were the good model for the ASAB research.We used IBT and SCMC to detect ASAB on the surface of spermatozoa from the proximal vas deferens ofvasectomized men and the semen after vasovasostomy. The relationship between ASAB and infectious diseases ofthe male reproductive tract，varicocele and cryptorchidism were reviewed, so as to show the importance ofscreening semen ASAB in diagnosis of male infertility. Related Articles | Metrics

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How to Achieve the Best ART Pregnancy Rate via Sperm Selection WANG Xue -mei;FENG Huai-liang 2012, 31 (5):  373-377.  Abstract ( 2190 )   PDF (771KB) ( 7291 )   It is important to get the mature sperm with cellular structure and DNA intact and non-apoptosis for high ART pregnancy rate. The electrophoresis microflew sperm sorter based on sperm size andsurface charge can be used to get quickly the membrane mature sperm. The non -apoptotic sperm can beselected by the outer surface of sperm membrane phosphatidylserine externalization binding with Annexin-V-conjugated paramagnetic microbeads. The formation of hyaluronic-acid (HA)-binding sites on sperm membraneis one of signs of sperm maturation, by which the sperm of membrane mature can be selected. The ultra-microscope provides convenience to distinguish subcellular organelles of sperm. SperMagic hasa unique role inpromoting sperm motility and improving sperm fertilizing capacity ,and consequently increases pregnancy rate.Compared with the routine density gradient centrifugation method, above methods to deal with sperm will resultin different fertilization rate ,embryo quality and pregnancy rate. More efforts to improve ART pregnancyoutcome will still be how to get the ideal sperm. Related Articles | Metrics

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Treatment with Assistant Reproductive Technology for Male Infertility TENG Xiao-ming;HAN Yi-bing;HUANG Wen-qiang;CHEN Zhen -wen 2012, 31 (5):  378-380.  Abstract ( 1971 )   PDF (607KB) ( 7236 )   Treatment of male infertility started from the intrauterine insemination with husband's semen （IUH）. In the early stage, assisted reproductive technology（ART）was mainly for female patients with infertility，specifically for the tubal factor infertility. The outcome of ART treatment of male factor infertility was not goodas that of female factor infertility, because of the low in vitro fertilization rate due to the low spermatozoamotility. To get clinical pregnancies, Gordon and Talansly in 1988 successfully developed 忆zona drilling （ZD）忆，and Cohen developed 'partial zonal dissection（PZD）'. Although these techniques partially overcome the diffic-ulties of fertilization, they were not widely applied due to the low monospermic fertilization rate （15%-25%），the high polyspermic fertilization rate，the relative high requirement for sperm number and motility，and the low clinical pregnancy rate （10%）. In 1992, Palermo successfully developed the intracytoplasmic sperm injection （ICSI）technique for the creative treatment of male infertility. ART should never be the first choice for thetreatment of male infertility，it isa important backup choice after routine treatment. The good treatment for maleinfertility should be evaluated overall factors，including male fertility function, fertility ability of female partner，selectable ART methods，safety and low-invasiveness and low cost. Related Articles | Metrics

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Genetic Counseling and Assisted Reproductive Technology Therapeutic Strategies for Male Infertility CAI Jing;YIN Biao;ZENG Yong 2012, 31 (5):  381-387.  Abstract ( 2118 )   PDF (954KB) ( 7344 )   Genetic abnormalities are important reasons of male infertility. Karyotypic abnormalities，Y chromosome microdeletion，abnormality of sperm DNA integrity, and so on, are common genetic abnormalities ofmale infertility. It is different to perform genetic counseling and to choose therapeutic strategy for those differenttypes of karyotype. As for chromosomal polymorphism，they are usually considered to be chromosomal non-pathological changes. The heredity risk is inconsistent among individuals who carry the balanced translocation of chromosome. The ratio between sperm with normal and sperm with balanced chromosome is much higher thanthe theoretical value in most patients. Furthermore，the ratio of babies with anomaly chromosome is lower thanthe expected value in those patients with balanced translocation. The fertility rate has been improved in thosepatients with balanced translocation by conventional IVF/ICSI-ET technique or PGD therapy. For those patientswith chromosome inversion, the percentage of recombinant sperm of paracentric inversion is low, which is similarto that of control with normal chromosome. Effect of pericentric inversion on the pregnant outcome can beevaluated by the size of inverted fragment, or by the ratio of anomaly recombinant sperm detected by FISHanalysis. These data provide basis of ART treatment options. Klinefelter syndrome （47，XXY）is the most common syndrome with abnormal sex chromosome. Patients with Klinefelter syndrome could get healthy offspringthrough the combination treatment with hormone replacement，TESE and ICSI. Patients with Y chromosome microdeletion can procreate a healthy daughter through ICSI treatment and PGD. The clinical significance ofsperm DNA integrity for evaluating male infertility is still controversy. It is known that anti-oxidate therapy canalleviate oxidative damage and improve sperm DNA integrity. Other hereditary diseases associated with maleinfertility，such as congenital bilateral absence of vas deferens，idiopathic hypogonadotropic hypogonadism，androgen insensitivity syndrome，immotile cilia syndrome and globozoospermia syndrome，etc.，may due to gene mutation. Therefore，it is essential to perform genetic diagnosis on the parents to survey related gene mutations，meanwhile PGD or prenatal diagnosis should be performed to avoid the birth of genetic defective infants. Related Articles | Metrics

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Effects of the Supplemental Recombinant Human Luteinizing Hormone on the Ovarian Stimulation andImplantation Rate in Those Down-regulated Women of Advanced Reproductive Age YE Hong;HUANGGuo -ning;PEI Li;ZENG Pin -hong;ZHANG Xiao -dong;LUO Xiu 2012, 31 (5):  388-392.  Abstract ( 1821 )   PDF (843KB) ( 7263 )   Objective：To evaluate the effects of recombinant human luteinizing hormone （rLH）supplementation on the ovarian stimulation and implantation rate in those down -regulated Chinese women ofadvanced reproductive age. Methods :This isa prospective randomized controlled trial. 320 cycles of ART wereanalyzed. All infertile patients with consecutive normogonadotropic function, aged 35-40 years, underwent theirfirst IVF or intracytoplasmic sperm injection （ICSI）treatment cycle. After pituitary suppression with Triptorelinacetate 0.05 mg/d s.c started in the midluteal phase of the previous cycle，the patients were randomized dividedinto five groups：淤control group（n=61）：only received rFSH for ovarian stimulation until day of hCG injection.于T1 （n=63）：rLH 75 IU/d supplementation on day6 of rFSH stimulation until day of hCG injection. 盂T2 （n=65）：rLH 150 IU/d supplementation on day 6 of rFSH stimulation until day of hCG injection. 榆T3 （n=68）：rLH75 IU/d supplementation on day 1 of rFSH stimulation until day of hCG injection. 虞T4 （n=63）：rLH 150 IU/dsupplementation on day1 of rFSH stimulation until day of hCG injection. Ovarian stimulation was initiated withrFSH 225 IU/d, 5 days in all of groups. Results 院No significant differences were observed in terms of numberand maturity of oocytes，fertilized oocytes，implantation rate and pregnancy rate among groups （P ＞0.05）.Conclusions 院The rLH supplementation with daily doses 75 or 150 IU during early follicular phase or secondhalf follicular phase dose not improve ovarian response and implantation rates in those normogonadotropicwomen of advanced reproductive age who were stimulated with rFSH under pituitary suppression with Iriptorelinacetate 0.05 mg/d s.c for IVF，therefore the rLH supplementation is not needed in all down regulated women ofadvanced reproductive age. Related Articles | Metrics

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Evaluation for the Intermittent Withdrawal Protocol in COH GAO Ming-xia;CHEN Si-tong;MA Xiao-ling;ZHANG Xue -hong;LIU Kun 2012, 31 (5):  393-396.  Abstract ( 1852 )   PDF (890KB) ( 7273 )   Objective：To evaluate the protocol of intermittent withdrawal in controlled ovarian hyperstimulation （COH）in high -responders and slow-responders. Methods 院Total 223 high-responders and slow -responders in IVF-ET circles, reviewed from Sep.2009 to Feb.2011, were divided into two groups: 110patients with the intermittent withdrawal protocol and 113 patients without intermittent withdrawal. Embryonicquality，OHSS's incidence，pregnancy rate，and miscarried rate of two groups were compared. Results 院There were significant difference in basalE2，serumE2 on the third and seventh day，serum LH on the seventh day between with and without the intermittent withdrawal protocol group（P＜0.01）. No significant difference（P＞0.05）was found in fertilization，M域ova，2PN，good quality embryos，pregnancy and miscarried rate between two groups，nor the incidence of moderate severe OHSS in high risk patients. Conclusions 院Although the intermittent withdrawalprotocolinhigh-resorponders and slow-responders does not affect the ovular quality and embryonicquality, it reduces the cycle cancellation caused by obtaining no egg or high risk of OHSS，slows down the speed of endometrial development，and gets a better synchronization between endometrim and embryo. Related Articles | Metrics

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Application of Gradient Centrifugation In Vitro Treatment of Sperm -binding Antibody LIU Li;YUE Zong-xiang;LAI Yu;HE Wei;WANG Shi-heng;ZHANG Chang-hui 2012, 31 (5):  397-398.  Abstract ( 1897 )   PDF (785KB) ( 7280 )   Objective：To compare the PureSperm technique alone and the PureSperm combined withswim-up method in processing the sperm-binding antibody positive sperm. Methods 院The PureSperm techniquealone and the PureSperm combined with swim -up method were used to process in vitro the sperm -bindingantibody positive sperm from patients with male sterility. Results 院The titer of sperm -binding antibodies wassignificantly declined after treatment by both the PureSperm technique （P＜0.01）and the PureSperm combined with swim -up method （P＜0.01）. The titer of sperm -binding antibodies of the PureSperm alone group wassignificantly lower than that of the PureSperm combination group（P＜0.05）. Conclusions 院The sperm quality can be improved by the PureSperm technique alone or combined with swim -up method in those patients with the positive sperm -binding antibodies. The treatment outcome of IUI for patients with immune infertility can beimproved when used the sperm samples treated with the PureSperm technique. Related Articles | Metrics

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Strategy and Its Outcomes in Reducing the Multiple Pregnancy Rates of IVF/ICSI ZHANG Bo;FENGGui-xue;ZHOU Hong;WU Fang-rong;GAN Xian-you;SHU Jin -hui 2012, 31 (5):  399-403.  Abstract ( 2058 )   PDF (861KB) ( 7233 )   Objective：To investigate the effects of elective blastocyst culture and single blastocysttransfer （eBC -SBT）on the reduction of multiple pregnancy rate. 酝藻贼澡燥凿泽院Patients undergoing in vitrofertilization（IVF）or intracytoplasmic sperm injection（ICSI）in our center from January 2009 to December 2010were analyzed. Patients with good prognosis and high risk of multiple pregnancy were advised to receive eBC-SBT with the consent. Patients who refused to perform eBC-SBT and did not meet the criteria were transferredday -3 cleavage embryos. The implantation rate, clinical pregnancy rate and multiple pregnancy rate werecompared between the two groups. 砸藻泽怎造贼泽院淤The age of patients and embryo vitrifaction rate were similarbetween two groups（P＞0.05）. The implantation rate and live birth rate in the eBC-SBT group were significantlyincreased when compared to the D3 cleavage group（缘2.4% vs. 43.4%，P＜0.05）. Though the clinical pregnancy rate （52.4% vs. 60.1%，P＜0.05）slightly decreased in the eBC-SBT group, the multiple pregnancy rate （3.3% vs. 44.2% ，P ＜0.05）, preterm delivery and low weight birth significantly decreased when compared to the D3 cleavage group （P ＜0.05）. 于No significant differences in maternal age, number of oocytes and embryovitrification rate were observed between two periods（P＞0.05）. The implantation rate （26.2% vs. 34.6%，P＜0.05）,clinical pregnancy rate（42.4% vs. 47.1%，P＜0.05）and live birth rate（30.6% vs. 38.0%，P＜0.05）of the eBC-SBT group were higher, while the multiple pregnancy rate （30.9% vs. 17.3%，P＜0.05）and low weight birth rate （30.7% vs. 24.0%，P＜0.05）were lower，than those of anterior period. 悦燥灶糟造怎泽蚤燥灶泽院The strategy of eBC -SBT can effectively reduce the multiple pregnancy rate, and improve the outcome of pregnancy, but do not decreasethe clinical pregnancy rate. Related Articles | Metrics

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Therapy for the Poor Ovarian Responses in IVF -ET ZHANG Hui-juan;SONG Xue -ru 2012, 31 (5):  405-407.  Abstract ( 1920 )   PDF (791KB) ( 7298 )   The poor ovarian response, a problem of controlled ovarian hyperstimulation in IVF-ET, ischaracteristic of the poor outcome of ovarian hyperstimulation failure, the limited number of recruit follicles, andlowerE2 level, which often leads to the cycle cancel of IVF-ET. The incidence of poor response in IVF-ET is9% to 24% . The mechanism of poor ovarian response is not well clarified; even the diagnosis standard isskimble-scamble. Various treatment protocols were proposed to improve the ovarian reactivity of patients withthe poor ovarian response. These protocols were listed as follows：淤Increasing the stimulation dose of rFSH. 于Pituitary down regulation. 盂The use of androgens or androgen-modulating agents. 榆Administration of growth hormone. 虞Modified natural cycle IVF. 愚Adjuvant therapy such as the use of oral contraceptive pill（COCP），E2. There is little understanding which one is the best protocol to treat effectively the poor ovarian response. Itcould be a feasible choice for different individual to havea suitable and personalized protocol. Related Articles | Metrics

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The Fertility Preservation for Female with Hematologic Malignant Tumor WANG Lei;SHAO Xiao-guang 2012, 31 (5):  408-412.  Abstract ( 2014 )   PDF (869KB) ( 7319 )   Blood system malignant tumor isa group of malignant diseases with the highest incidence inyouth. For the early treatment，chemotherapy is of first choice. Chemotherapy will produce serious andirreversible damage for ovarian structure and function. So far the female with blood system malignant tumor, theprimary chemotherapy should be carried with consideration of the fertility preservation of ovary. At present，thepossible methods of effective fertility preservation are embryo cryopreservation，mature and immature oocytecryopreservation，ovarian and ovarian tissue cryopreservation，ovarian transplantation，GnRH -analogues usage，oral contraceptive，hormone replacement therapy and so on. Related Articles | Metrics

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Relationship Between Th17 Cells and Unexplained Recurrent Spontaneous Abortion HUANG Ying;XUWang-ming 2012, 31 (5):  413-416.  Abstract ( 1817 )   PDF (798KB) ( 7216 )   T helper 17 （Th17）cells were recently found to bea subgroup of independent T cells, whichare distinct from Th1 and Th2 cells. Th17 may play an important role in the inflammation development related topathogenetic mechanism of autoimmune diseases and acute transplant rejection. Now，the new Th1/Th2/Th17 and Treg balance model has replaced the Th1/Th2 paradigm，which is considered to play an essential role in maintaining the immune tolerance during pregnancy. As a common disease in clinical，the immunological pathogenesis of unexplained recurrent spontaneous abortions （URSA）is still unknown. Th17 cells could provide us a new research target on the pathogenesis and treatment of URSA. Related Articles | Metrics

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Research Progress of Mechanism of BisphenolA SHENG Lei;ZHU Yan;CAO Lin 2012, 31 (5):  417-421.  Abstract ( 1993 )   PDF (862KB) ( 7296 )   Related Articles | Metrics

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The Integrated Control Strategies of Neonatal Respiratory Distress Syndrome YANG Jing;ZHANG Jie-sheng 2012, 31 (5):  422-425.  Abstract ( 1755 )   PDF (859KB) ( 7266 )   Neonatal respiratory distress syndrome is a disease of neonatal alveolar hypoplasia due topulmonary surfactant deficiency，which threatens to the life and health of newborn. Now a comprehensive prevention strategy has been used to treat the disease，including prenatal care，postpartum perservation of the stability of the neonatal conditions，pulmonary surfactant applications，support for treatment，and the rational allocation of medical resources. Related Articles | Metrics