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15 July 2017, Volume 36 Issue 4
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Prediction of Pregnancy Outcome of ART by AMH: A Meta-analysis OUYANG Xiao-e，HU Rong 2017, 36 (4):  269-275.  Abstract ( 1133 )   PDF (1338KB) ( 5842 )   Objective：To evaluate systematically the predictive value of anti-Mullerian hormone (AMH) on the ovarian response and pregnancy outcome for the women undergoing the different assisted reproductive technology (ART), such as in vitro fertilization- embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI). Methods：The articles were searched electronically from the databases in both English and Chinese including Pubmed, Medline, Cochrane Library and CNKI. The articles were selected according to the inclusion and exclusion criteria, and data corning AMH predicting the ovarian response and pregnancy outcome for women undergoing IVF-ET and ICSI were selected. Then Stata 12.0 software was used for Meta analysis. By combining the diagnostic effect and fitting the SROC, the predictive value of AMH on ovarian response and pregnancy outcome was evaluated comprehensively. Results：The study included 15 effective papers and 3 475 cumulative cases. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of AMH in the prediction of ovarian response were 0.814, 0.826, 3.900, 0.229 and 21.334, and the pregnancy outcomes were 0.661, 0.768, 2.848, 0.357 and 9.403, respectively. The area under curve, and Q values of ovarian response and pregnancy outcome, were 0.890 8, 0.821 6 and 0.822 1, 0.755 5, respectively. There was no statistical significance between the two. Conclusions：The predictive value of AMH for pregnancy outcome is similar to that for ovarian response. AMH can be used as a predictor of pregnancy outcome. However, its sensitivity is low, there are still some limitations for its clinical application. Related Articles | Metrics

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Methodology Study on Preimplantation Genetic Diagnosis of X-linked Chronic Granulomatous Disease WU Hai-tao，SHEN Xiao-ting，LIU Yu-liang，ZHONG Yi-ping，WANG Jing，ZENG Yan-hong，DING Chen-hui，ZHOU Can-quan 2017, 36 (4):  276-279.  Abstract ( 1286 )   PDF (857KB) ( 5953 )   Objective：To develop a reliable and exact protocol for the multiple displacement amplification (MDA)-based preimplantation genetic diagnosis (PGD) of X-linked chronic granulomatous disease (X-CGD). Methods：The haplotype analysis of X-CGD was performed for 16 short tandem repeats (STR) loci on both sides of the CYBB gene. Whole-genome amplification of single cell was carried out by MDA. The STR loci with polymorphism as demonstrated by the linkage analysis and the specific amplification of CYBB gene were analyzed. The locus Amel was used for sex determination. Results：Seven STR loci were found to be polymorphic in the linkage analysis. MDA was performed in 10 single lymphocytes and 10 single blastomeres. The efficiencies of PCR amplification of the pathogenic CYBB exon 8 was 100%. ADO of the mutant allele of CYBB was detected in one of the lymphocytes, the ADO rate 10% (1/10). For those single blastomeres, the 215 bp band corresponding to the normal allele was detected in all MDA products, while the abnormal 204 bp band was not detected. For the 7 polymorphic STR loci and AMELs, the PCR amplification efficiency and the ADO rate were 96.9% (155/160) and 11.3% (13/115), respectively. Conclusions：In this study, MDA combined with pathogenic gene specific amplification and haplotype analysis was performed to detect chronic granulomatous disease in a single cell level. The combination of the two techniques can improve the efficiency of PGD for CGD by reducing the misdiagnosis caused by contamination and ADO. Related Articles | Metrics

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Clinical Outcome Analysis of Different Luteal Support Protocols in the Frozen-thawed Embryo Transfer of Natural Cycle after hCG Administration WANG Li，ZHOU Xue-yuan，WEN Ji，CUI Wei 2017, 36 (4):  280-282.  Abstract ( 1117 )   PDF (772KB) ( 5907 )   Objective：To analyze the clinical outcomes of different luteal support protocols in natural cycle frozen-thawed embryo transfer after hCG administration. Methods：A total of 286 patients aged ＜35 years undergoing the natural cycles and hCG induced ovulation, from January 2015 to January 2016, were randomly divided into three groups: the patients with no luteal support as the groupⅠ (n=81), the patients who received oral dydrogesterone as the groupⅡ (n=104), and the patients who received a combination of intramuscular progesterone and oral dydrogesterone as the group Ⅲ (n=101). The general data and clinical outcomes were compared among three groups. Results：There were no significant differences in the age, duration of infertility, types of infertility, causes of infertility, basic FSH level and BMI among the three groups (P＞0.05). There were no significant differences in the control ovarian hyperstimulation protocol, fertilization procedure, treatment outcomes of fresh cycle, hormone levels on the hCG day and endometrial thickness on the transfer day among the three groups (P＞0.05). Interestingly, there were no significant differences in the embryo recovery rate, implantation rate, clinical pregnancy rate, early abortion rate, ectopic pregnancy rate and continued pregnancy rate among the three groups (P＞0.05). Conclusions：It is feasible that there is no luteal support for those young patients undergoing hCG administration natural cycles, with a good communication. As for those patients who still have concerns, the protocol of oral dydrogesterone, with its convenience and curative effect, is advisable. Related Articles | Metrics

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The Pregnant Outcome of Poor-quality Single-blastocyst Transfer in Vitrified-warmed Cycles CHEN Qing-fen，LIN Dian-liang，DU Sheng-rong 2017, 36 (4):  283-286.  Abstract ( 1126 )   PDF (741KB) ( 5892 )   Objective：To compare the clinical outcomes of single poor-quality blastocysts between D5 and D6 vitrified-warmed blastocyst transfer cycles, and to optimize the single transfer strategy of poor-quality blastocyst. Methods：A retrospective analysis of the clinical data from patients underwent vitrified-warmed poor-quality single-blastocyst transfer cycles in our center from January 2013 to December 2016. According to the quality of blastocyst and the day of blastocyst development, those patients underwent ET were divided into 4 groups as follows, the D5 including AC/BC group (Inner cell mass and trophoblast score were AC or BC, 53 cycles in total), the D5 including CA/CB group (51 cycles) and the D6 including AC/BC group (65 cycles), the D6 including CA/CB group (61 cycles). The clinical pregnancy rate and early abortion rate were compared. Results：The clinical pregnancy rate of D5 group was higher than that of D6 group (P＜0.05), and the clinical pregnancy rate of CA/CB (D5) group was statistically significantly higher than that of AC/BC (D6) group (P＜0.05). The early abortion rate of AC/BC group was statistically significantly higher than CA/CB group (P＜0.05). Conclusions：The D5 blastocysts with high trophoblastic ectoderm grade can be selected for transfer so as to improve the pregnancy rate and reduce the early abortion rate. Related Articles | Metrics

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Post-operation Spontaneous Pregnancy Rate and Its Influence Factors in Patients with Endometrial Polyps Associated Infertility LUAN Xue-feng，CHEN Da-li，HOU Wen-jie 2017, 36 (4):  287-290.  Abstract ( 1141 )   PDF (715KB) ( 6047 )   Objective：To analyze the spontaneous pregnancy rate of infertility patients with endometrial polyps after transcervical resection of endometrium (TCRE), and the influence factors of postoperative spontaneous pregnancy rate. Methods：A retrospectively study was carried out on clinical data of 153 infertility EPs patients who were admitted to Suzhou Municipal Hospital from January 2012 to January 2015 and undertook TCRE. General clinical data, operation methods, postoperative natural pregnancy rate and related factors were analyzed. Results：105 cases got their spontaneous pregnancies, the overall pregnancy rate 68.63%. Univariate-analysis indicated that influence factors of postoperative spontaneous pregnancy rate were age, duration of infertility, BMI, infertility type, times of previous uterine cavity operation, polyp location, polyp number and progesterone treatment (P＜0.05). Multivariate Logistic regression analyses showed that the postoperative spontaneous pregnancy rate would decrease with higher age, higher BMI or more than one polyp, while progesterone treatment after TCRE would increase the spontaneous pregnancy rate (OR=3.719, 95%CI: 1.376～4.945). Conclusions：TCRE can improve the postoperative spontaneous pregnancy rate of infertile women with EPS. Age, BMI and polyp number were the main influencing factors of postoperative spontaneous pregnancy rate, while postoperative progesterone cycle therapy could significantly improve this rate. References | Related Articles | Metrics

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Analysis of Postoperative Pregnancy Related Factors in Patients with Endometriosis Complicated with Infertility LI Shi-zhen，DENG Xiao-hui 2017, 36 (4):  291-294.  Abstract ( 1184 )   PDF (728KB) ( 5978 )    Objective：To analyze retrospectively the multiple factors related to pregnancy before and after the laparoscopic surgery combined with hysteroscopy in those patients with pelvic endometriosis complicated with infertility. It is helpful for clinical treatment of this kind of diseases to explore those main factors related to the postoperative pregnancy. Methods：Clinical data of 247 patients with pelvic endometriosis complicated with infertility, and treated with hysteroscopy combined with laparoscopy, were collected. χ2 test, t test, rank sum test and multi factor Logistic regression were used for analysis. Results：After the operation, 157 cases tried to conduct natural pregnancy, and 90 cases were directly enrolled in the IVF treatment cycle. Finally, 105 cases were not pregnant, and 142 cases had successful pregnancy. There were significant differences in the infertility years, the endometriosis stages (the r-AFS stage), and the fertility index (the EFI score) between women with successful pregnancies and those women without pregnancy after the operation (P＜0.05). However, there were no significant differences in the type of infertility, the incidence of endometrial polyp and the bilateral lesions of ovaries (P＞0.05). The rate of spontaneous pregnancy and IVF-assisted pregnancy was decreased gradually with the postoperative time (P＜0.05). The r-AFS stage and the EFI score were closely related to postoperative pregnancy (P＜0.05), the high EFI score was the protective factor while the high r-AFS stage was the risk factor of postoperative pregnancy. Conclusions：The r-AFS stage, the EFI score and the infertility years are important factors affecting postoperative pregnancy in those patients with endometriosis after laparoscopic treatment. The rate of postoperative pregnancy can be significantly improved by the active direction of natural pregnancy and active IVF treatment according to the evaluation index of disease, as earlier as possible. Related Articles | Metrics

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Clinical Analysis of 9 Cases of Atypical Polypoid Adenomyoma and Literature Review DONG Zhen-zhu, LIN Ting-ting, XU Shu-xia, XU Mu, LIU Da-bin, SUN Peng-ming 2017, 36 (4):  295-299.  Abstract ( 1138 )   PDF (754KB) ( 5829 )   Objective: To discuss the treatment and follow-up strategy of atypical polypoid adenomyoma (APA) based on 9 cases and a mini review. Methods: The clinical data of 9 cases with APA admitted in our hospital (2008 to 2016) were retrospectively analyzed. Results: The average age of 9 cases is 37.4 (20-50), years old. Among 9 cases, 3 cases were simple APA, 1 case was APA complicated with endometrioid adenocarcinoma, 1 case was APA complicated with endometrial complex atypical hyperplasia; 1 case was APA ended up with endometrial complex atypical hyperplasia; 1 case was endometrial complex atypical hyperplasia，ended up with APA complicated with endometrial complex atypical hyperplasia; 1 case was APA ended up with endometrial complex hyperplasia; 1 case was APA complicated with endometrial complex hyperplasia. 3 cases were treated with fractional curettage, and 6 cases with hysteroscopic resection as the initial treatment. All cases underwent the follow-up visit 45.5(3-103) months, and no relapse and canceration were observed until January 2017. 3 cases of APA with primary infertility didn′t achieve their pregnances. Conclusions: Although APA is a benign disease, it should be treated actively because of its potential malignancy. The treatment strategy is related to many factors, such as age, the architectural index of the gland, endometrium situation and fetility demand. Related Articles | Metrics

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Analysis of Factors Affecting AMH Test WANG Hui，HU Rong 2017, 36 (4):  300-304.  Abstract ( 1191 )   PDF (736KB) ( 6014 )   It is important to assay anti-Müllerian hormone (AMH) in the field of assisted reproduction. AMH level can be used to assess the ovarian reserve function, and to predict ovarian response, which provides clinicians the basis to develop an individual treatment so as to reduce the ovarian hyperstimulation syndrome (OHSS) rate and to raise the oocyte-obtained rate. With 20 years′ development, AMH test has been developed from the manual ELISA, the automated ELISA, to the electrochemical luminescence method, and the test reagents have also undergone several generations of development. There are differences in the efficiency of AMH test in different methods and reagents, or the same method and different reagents. If the same method and reagent were used, the main factor of the AMH test differences should be the sample itself. In addition, some non-experimental factors could affect the objectivity of AMH test, such as ovarian function, menstrual cycle, pituitary tone, ovulation and so on. This article summarized those experimental factors and non-experimental factors related to AMH test. Related Articles | Metrics

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The Function of GSK-3 in Spermatozoon Maturation, Capacitation and Acrosomal Reaction QU Xia，WANG Hao，ZHOU Jia-hao，ZHAO Zi-wei，LIU Qiang 2017, 36 (4):  305-308.  Abstract ( 1221 )   PDF (1075KB) ( 5971 )   Glycogen synthase kinase-3 (GSK-3), a kind of kinase expressed widely in different tissues and cells, is involved in the regulation of many biological processes. Two isoforms of GSK-3, GSK-3α and GSK-3β, are located in spermatozoon, suggesting that GSK-3 participate in the regulation of epididymal spermatozoon maturation, capacitation and acrosomal reaction in female reproductive tract. Through phosphorylating target proteins or enzymes such as septins4 and PP1γ2, GSK-3 could influence the sperm capacitation and acrosome reaction. As a vital kinase in many signaling pathways including Wnt signal pathway, Toll like receptor signaling pathway, cAMP/PKA mediated protein phosphorylation pathway and so on, GSK-3 is strictly regulated. Thus, the investigation about the role of GSK-3 in spermatozoon is important for elucidating the cause of male infertility as well as the physiological process of spermatozoon in the male and female reproductive tract. 【Keywords】   Related Articles | Metrics

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Research Progress in Differentiation of Stem Cells to Female Germ Cells LI Yu, JIANG Hong 2017, 36 (4):  309-313.  Abstract ( 1276 )   PDF (692KB) ( 5897 )   Stem cells are a class of cells with self-renewal and multi-lineage differentiation potential. According to their derivation, stem cells can be classified as embryonic stem cells (ESCs), adult stem cells (ASCs) and induced pluripotent stem cells (iPSCs). The germ cell lineage is responsible for transmitting genetic and epigenetic information across generations, and for ensuring new individuals. Human assisted reproductive technology (ART) could solve some intractable infertility problems, but it cannot help such infertile women as premature ovarian failure (POF) due to germ cell deficiency. If germ cells could be in vitro induced and differentiated from stem cells, it would be possible to help those POF patients to achieve their healthy offsprings through ART. Gametogenesis are involved in several complicated and rigorous steps, including primordial germ cell (PGC) specification, proliferation, migration to the gonadal ridges and final differentiation into mature gametes such as oocytes. However，the detail of gametogenesis has not been clearly elucidated up to now. Recently, many  in vitro models were developed to differentiate female germ cells from stem cells，with some encouraging achievements. Related Articles | Metrics

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The Effects of Cumulus Cells on Vitrification Cryopreservation of Human Immature Oocyte LYU Ai-xiang，JIN Hai-xia 2017, 36 (4):  313-317.  Abstract ( 1207 )   PDF (726KB) ( 6019 )   The vitrification cryopreservation of oocytes is a hot topic of the assisted reproductive technology. The cryopreservation of immature oocytes is an effective method to save fertility with great application prospect. Cumulus cells are in direct contact with the oocyte through gap junctions. There are intense bidirectional communication and substance exchange between two kinds of cells. Currently, the important effects of cumulus cells in in vitro maturation of oocytes has been elaborated. However, there is no consensus about the action of cumulus cells in cryopreservation of human immature oocytes. With the development of vitrification technology, there was more and more researches on the salutary effects of cumulus cells on oocyte cryopreservation. Cumulus cells can slow down the penetration rate of cryoprotectant agents, so as to avoid the cell damage in oocytes of osmotic pressure，which improve the cell survival rate after freezing and fertilization rate. This review mainly summarizes the effects of cumulus cells on vitrification cryopreservation of human immature oocyte in order to provide reliable theoretical and experimental evidences for those patients undergoing cancer chemotherapy or delayed childbearing who quest fertility preservation with their immature oocytes. Related Articles | Metrics

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Sirt3 and Its Effect in ROS-mediated Reproductive Diseases HUANG Qiao-yao, MA Tian-zhong 2017, 36 (4):  318-322.  Abstract ( 1148 )   PDF (796KB) ( 5890 )   Sirt3, a member of the sirtuin family of type Ⅲ histone deacetylases (HDACs) dependented on nicotinamide adenine dinucleotide (NAD+), was located in the mitochondrial matrix of mammalian cells. By deacetylating the most of mitochondrial proteins, sirt3 plays an important role in mitochondria. The deacetylation by sirt3 affects the quantity of reactive oxygen species (ROS), from transcription factors to metabolic enzymes, such as hypoxia-inducible factor (HIF-1), p53, peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) and other factors; antioxidant enzymes catalase (CAT), amino acid dehydrogenase (GDH), catalase and superoxide dismutase 1 (SOD1) and other metabolic enzymes. Just based on above mechanism, sirt3 participates in the pathogenesis or pathophysiology of the decreased potential of embryonic development, premature ovarian failure, ovarian tumor and other reproductive diseases. This review summarizes the biological characteristics of sirt3, the molecular mechanism of sirt3 in regulating ROS, and the effect of sirt3 in the ROS-mediated reproductive diseases. Related Articles | Metrics

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Research Progress of Cell-free DNA in Embryo Culture Medium in Human Preimplantation Genetic Screening ZHAO Xue, ZHANG Ling 2017, 36 (4):  323-326.  Abstract ( 1224 )   PDF (698KB) ( 5938 )   Preimplantation genetic screening (PGS) is a method used in the process of IVF-ET to help those patients with the high risks of genetic diseases to select a normal embryo to transfer by cell biopsy and genetic analysis, so as to get healthy babies. However, PGS is an invasive method at present which depends on the cell biopsy, with the potential risks for the embryonic development and offspring, and obstetrics and neonate. In recent years, the cell-free DNA with embryonic genetic material in the embryo culture medium has been found, which is positively associated with the embryonic fragment rate. This cell-free DNA has been tried to use in the detection of aneuploidy and single gene disease, which provided a new method of a non-invasive PGS with some advantages of non-invasive test, easy to get samples and the ability of embryo genetic detection at the molecular level. This technology needs to be furtherly optimized before its application in clinical practice because the cell-free DNA is easy to pollute, and the specificity is not good at present. 【Keywords】   Related Articles | Metrics

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Trigger Strategy of GnRH Antagonist in IVF/ICSI Cycles YANG Yuan，HU Jun-ping，ZHANG Xue-hong 2017, 36 (4):  327-330.  Abstract ( 1233 )   PDF (686KB) ( 5916 )   In IVF/ICSI cycle, GnRH antagonist (GnRHA) is widely used with the advantages of the short time of Gn stimulation, the low cost, the flexible solutions, which is easily accepted by patients. Human chorionic gonadotropin (hCG) is usually used to lead follicle final maturity and discharge (also called hCG trigger). Compared with the luteinizing hormone (LH), hCG has similar effect in follicle final maturity and discharge, and long half-time. However, the risk of ovarian hyperstimulation syndrome (OHSS) of hCG trigger is increased due to its long luteinization effect. However, gonadotropin-releasing hormone agonist (GnRHa) can not only promote follicle maturation and ovulation (also called GnRHa trigger) at the same time, but also reduce the incidence of OHSS. The present studies showed that GnRHa trigger could eventually lead to the defects of luteal function and influence the clinical pregnancy rate, and increase fresh embryo abortion. There is an inconclusion on what kind of the luteal support protocols after GnRHa trigger, to eliminate the concerns in the fresh embryo transfer. The advantages and disadvantages of GnRHa trigger in IVF/ICSI cycles were discussed in this article. Related Articles | Metrics

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Mycoplasma Infection and Assisted Reproductive Technology Failure ZHONG Jiao-jiao，HE Yu-nan，SHAN Nian-chun 2017, 36 (4):  331-334.  Abstract ( 1096 )   PDF (938KB) ( 5932 )   The infection rate of mycoplasma is high in the female reproductive tract. The clinical symptoms of mycoplasma infection could be inapparent, or mild in those infected women. Mycoplasma can cause the morphological and functional changes in fallopian tube and endometrium by immune inflammation, which could lead to infertility. In those women with assisted reproductive technology (ART) failure, the change of endometrial receptivity induced by mycoplasma infection should be considered as a potential cause of the embryo implantation failure. The hysteroscopy, endometrial biopsy and cervical secretions smear to detect the chronic endometritis caused by mycoplasma infection can be suggested before the next embryo implantation. If the detection shows the positive mycoplasma infection, antibiotics and others should be used. To evaluate the efficacy of treatment, transvaginal ultrasonography is used to detect the thickness, blood flow and peristaltic wave of endometrium, so as to avoid the failure of assisted reproduction. In addition, the effect of mycoplasma infection on reproductive failure may have individual difference. Related Articles | Metrics

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Application of Long-term GnRHa in Endometriosis Associated with Infertility ZHAO Ying，YAN Lei 2017, 36 (4):  335-339.  Abstract ( 1303 )   PDF (767KB) ( 5904 )   Endometriosis (EMs) is a common gynecological disease. The incidence of EMs in reproductive women is about 10% to 15%, and up to 50% of EMs patients are infertile. Gonadotropin releasing hormone agonists (GnRHa), commonly used in the treatment of EMs, act on the hypothalamus pituitary system and endometrium through different mechanisms. Most reports confirmed the efficacy of GnRHa treatment after conservative surgery in increasing the pregnancy rate and decreasing relapse rate in EMs patients with infertility. GnRHa can also play a certain role in preventing the recurrence of ovarian endometriosis and alleviating the pain of deep invasive endometriosis. GnRHa and hormonal reverse therapy are often applied to improve the life quality of patients with adolescent endometriosis. The prolonged GnRHa protocol don't affect the number of oocytes obtained in fresh embryo transplantation, and pretreatment with GnRHa could also increase the success rate of in vitro fertilization (IVF) before the frozen embryo transfer. Related Articles | Metrics

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The Treatment Strategy and Prognosis of the Patients with Ectopic Pregnancy Who Desire Fertility PENG Chao，ZHOU Ying-fang 2017, 36 (4):  340-344.  Abstract ( 1173 )   PDF (732KB) ( 5948 )   Ectopic pregnancy remains one of gynecological emergency. Treatment of this disease includes expectant management, medical treatment and surgical treatment, which  tends to be conservative. The medical treatment as methotrexate (MTX) and laparoscopic surgery are the current mainstream treatment. For those patients with a healthy contralateral tube and a tubal pregnancy, the subsequent fertility rates after salpingectomy and salpingotomy are similar in the long term. The two years intrauterine pregnancy rates are similar regardless of the treatment methods. Cesarean scar pregnancies are becoming more and more common in recent years. The experts consensus announced in 2016 can be referred in the treatment of cesarean scar pregnancy. Related Articles | Metrics

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Air Pollutants and Hypertensive Disorder Complicating Pregnancy MA Shi-yue，HOU Hai-yan，CHEN Ya-qiong 2017, 36 (4):  345-348.  Abstract ( 1225 )   PDF (693KB) ( 6070 )   Haze, a serious form of air pollution, is mainly consists of gaseous pollutants and particulate matter. With high physicochemical properties and great harmfulness, particulate matter is the key point of haze. Hypertensive disorders of pregnancy (HDP) is a common clinical disease specially correlated to pregnancy, which had serious harm on maternal and child health. The etiology and pathogenesis mechanism of HDP is not yet entirely clear. The physiological characteristics of pregnant women make them and fetus to be susceptible to pollutants and to increase their exposure to air pollutants. Previous studies confirmed the close relations between HDP and maternal exposure to air pollutants during pregnancy. The pathogenesis might be related with oxidative stress and systemic inflammation. However, those hypothese need more study to validate. In this paper, we discuss the close relations between haze and gestational hypertension and preeclampsia. Related Articles | Metrics

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Research Progress in Endometrial Thickening of Postmenopausal Women WANG Tian-hua，ZHANG Hui-ying 2017, 36 (4):  349-352.  Abstract ( 1259 )   PDF (687KB) ( 6016 )   With the improvement of ultrasound technology and application, more endometrial thickening of postmenopausal women were found. According to whether there is vaginal bleeding, the endometrial thickening in postmenopausal women is divided into two groups，postmenopausal endometrial thickening with vaginal bleeding and asymptomatic postmenopausal endometrial thickening. The etiologies and pathologies of postmenopausal endometrial thickening are complicated. There is no clinical symptom, or only accompanied by vaginal bleeding, at the early stage of disease. Diagnostic curettage, or combined with hysteroscopy, is the primary way to diagnose endometrial diseases. Currently, the relationship between endometrial thickness and endometrial diseases is unclear. The evaluation standards of endometrial thickness are different between the two groups. However, the evaluation endometrial thickness is important for gynecologists to consider further examination to diagnose early and treat endometrial diseases. This article summarizes the causes, diagnosis and treatment of postmenopausal endometrial thickening. Related Articles | Metrics