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15 January 2018, Volume 37 Issue 1
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Expressions of Six MiRNAs in Follicular Fluid of Patients with Polycystic Ovary Syndrome LIU Kai-lu, HU Meng-ting, CAI Ling-bo, LI Han, YANG Wei-jie, LIU Jia-yin, CUI Yu-gui, QIAN Ri-cheng 2018, 37 (1):  5-10.  Abstract ( 1248 )   PDF (2613KB) ( 9016 )    Objective：To analyze the expressions of miRNA-9, miRNA-18b, miRNA-19, miRNA-24, miRNA-199 and miRNA-320 in the follicular fluid and exosome of patients with polycystic ovary syndrome (PCOS), and to explore the potential roles of these miRNAs in the pathophysiological mechanism of PCOS. Methods: A total of 48 patients undergoing in vitro fertilization and embryo transfer (IVF-ET), including 23 PCOS patients and 25 controls, were enrolled. The follicular fluid was collected. The exosome from the follicular fluid was isolated using ultrafiltration. NTA, Western blotting and TEM were used to identify the exosmoe. The expressions of miRNA-9, miRNA-18b, miRNA-19, miRNA-24, miRNA-199 and miRNA-320 in the follicular fluid and exosome were examined by real-time quantitative PCR. Results: The expression level of miRNA-199 in the follicular fluid of PCOS patients was significantly higher than that in the control group (5.42±0.80 vs. 1.02±0.94, P＜0.01), while the expression level of miRNA-320 was significantly lower (0.47±0.06 vs. 1.23±0.09, P＜0.01). The expressions of miRNA-9, miRNA-18b, miRNA-19 and miRNA-24 were showed no significant differences between the two groups (P＞0.05). In exosomes, the expressions of miRNA-9 and miRNA-18b in the PCOS group were significantly higher than those in the control group (8.94±0.54 vs. 1.01±0.97，2.66±0.19 vs. 1.12±0.06, both P＜0.01), while the expressions of miRNA-199 and miRNA-320 were significantly lower (0.43±0.11 vs. 1.22±0.07, 0.53±0.09 vs. 1.18±0.15, both P＜0.01). Conclusions: It is helpful to analyze the expressions of miRNA-9, miRNA-18b and miRNA-199 in the follicular fliud and exosome of PCOS patients for us to explore the roles of miRNAs in the pathophysiological mechanism of PCOS. Related Articles | Metrics

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Relationship between BDNF Val66Met Gene Polymorphism and Endometriosis Infertility and Its Influence on IVF-ET Pregnancy Outcomes WANG Yun, WEN Ji, FANG Zhou, ZHOU Xue-yuan 2018, 37 (1):  10-14.  Abstract ( 1383 )   PDF (951KB) ( 8943 )   Objective：To clarify the relationship between the brain-derived neurotrophic factor (BDNF) with single nucleotide polymorphism (SNP, Val/Met) and the female infertility with endometriosis, as well as its effect on the pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 112 cases with III-IV EMs undergoing IVF-ET from September 2015 to September 2016 were enrolled in the study group, and 109 infertile cases with tubal factors as the control group. The Val66Met polymorphism of BDNF gene was analyzed, and the difference in the pregnancy outcome of IVF-ET was compared between the two groups. Results: ①There were no significant differences in age, infertile years, body mass index (BMI), basal follicle stimulating hormone (FSH) and basal estradiol (E2) between the two groups (P＞0.05). ②The proportions of Met/Met genotypes and Met allele frequencies in the study group were significantly higher than those in the control group (33.0% vs. 23.9%, P=0.043; 58.9% vs. 47.7%, P=0.018). In both groups, the patients with Met/Met genotype had a higher Gn dose than those with the other 2 genotypes, while they had lower number of matured eggs (4.5±3.2 vs. 5.2±2.3) and fertilization rate (59.0% vs. 67.0%) (all P＜0.05). ③In both groups, the patients with Met/Met genotype had the decreased level of BDNF protein in follicular fluid when compared with those patients with the other 2 genotypes (P＜0.05). However, there was no significant difference in the level of plasm BNDF between menstrual period and hCG day (P＞0.05). Conclusions: The Val66Met polymorphism of BDNF gene is associated with the endometriosis-related infertility. Moreover, this SNP is also related with the poor IVF-ET outcomes in both endometriosis-related and tubal obstructed infertile women. Related Articles | Metrics

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IVF Outcome of Long Down-Regulation Protocol in 112 Patients with Luteinizing Hormone ＜2 IU/L NI Dan, LIU Yu-sheng, WU Li, JI Jing-juan, TONG Xian-hong 2018, 37 (1):  15-19.  Abstract ( 1274 )   PDF (936KB) ( 9158 )   Objective：To study the ovarian response and IVF/ICSI-ET outcome of the long GnRH-a protocol in those patients with base LH＜2 IU/L, so as to explore the correlation of LH as a single index and ovarian reserve. Methods：Those patients undergoing IVF/ICSI-ET with the base FSH＜10 IU/L from January 2014 to March 2017 were enrolled. According to the age and the base LH level, those patients were divided into four groups, the group A: age ≤35 years [25～35 years old, the average age (28.86±3.10)] and base LH＜2 IU/L (n=88); the group B: age ≤35 years [25～35 years old, the average age (28.48±3.72)] and base LH 2～5 IU/L (n=226); the group C: age ＞35 years [36～42 years old, the average age (38.54±2.84)] and base LH＜2 IU/L (n=24); the group D: age ＞35 years[36～42 years old, the average age (37.64±2.40)] and base LH 2～5 IU/L (n=58). The superovulation rate, the quantity and quality of embryo, and the pregnancy rate were compared. Results：The base LH level and LH levels on the down-regulated day and Gn starting day in the group A were significantly lower than those in the group B (P＜0.05), while the total dose of Gn in the group A was higher than the group B (However, P＞0.05). The E2 level on the day of hCG injection, the number of ≥14 mm follicles, the retrieved oocyte number, the number of 2PN and the number of high quality embryos in the group A were significantly lower than those in the group B (all P＜0.05). The FSH/LH ratio in the group A was 4.06. The base LH level and LH levels on the down-regulated day and Gn starting day in the group C were significantly lower than those in the group D (P＜0.05), while the total dose of Gn in the group C was higher (However, P＞0.05). There were no significant differences in the E2 level on the day of hCG injection, the number of ≥14 mm follicles, the retrieved oocyte number, the number of 2PN and the number of high quality between the group A and group B (all P＞0.05). The FSH/LH ratio in the group C was 4.23. Interestingly, there were no significantly differences in the LH level on the day of hCG injection, the rate of biochemical pregnancy and the rate of clinical pregnancy between the group A and group B, or between the group C and group D (both P＞0.05). Conclusions：The age ≤35 and base LH＜2 IU/L, as two parameters of ovarian reserve function, can be used as clinical references of ovarian stimulation protocols. 【Keywords】   Related Articles | Metrics

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A Retrospective Study on Serum PRO-BNP for Evaluating the Perinatal Outcome of Pre-Eclampsia NI Qing，ZHANG Shi-chang，CHEN Wen-wei，ZHANG Guo-ying，CHEN Li 2018, 37 (1):  20-23.  Abstract ( 1436 )   PDF (858KB) ( 8890 )   Objective：To explore the application of serum pro- B-type natriuretic peptide (PRO-BNP) in pre-eclampsia patients as a potential predictor of maternal and fetal outcomes. Methods: A total of 111 pre-eclampsia women were enrolled in this retrospective study. The level of serum PRO-BNP was measured by immunofluorescence. According to the levels of PRO-BNP, patients were divided into two groups: the normal group (n=85) and the increased group (n=26). The differences of pregnant outcomes were compared between the two groups. Results: The increased group had the lower rate of the expectant treatment (7.7% vs. 36.5%, χ2＝7.893，P=0.005) and the higher incidences of proteinuria and pleural effusion when compared with the normal group (both P＜0.05). However, there were no significant differences in the fetal distress, the rate of premature infant, the newborn treatment transferred to pediatric department, the body mass of newborn and the Apgar score between the two groups (all P＞0.05). Conclusions: The level of serum PRO-BNP was related to the severity of organ injury in those pre-eclampsia women. However, PRO-BNP could not be a predictor of the newborn prognosis. Related Articles | Metrics

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Hysteroscopic Resection of Type 3 Myoma: Feasibility and Postoperative Reproductive Outcome HUANG Rui, HUANG Xiao-wu, XIA En-lan, PENG Xue-bing, XIAO Yu, ZHOU Qiao-yun 2018, 37 (1):  24-28.  Abstract ( 1812 )   PDF (1570KB) ( 8989 )   Objective：To evaluate the feasibility of the hysteroscopic resection of symptomatic type 3 myoma and the reproductive outcome after operation. Methods: Fifty-nine patients with type 3 myoma (＞25 mm, single) who underwent an hysteroscopic resection from January 2013 to October 2017 in Fuxing hospital were enrolled. The following medical data were recorded: symptoms, size of the type 3 myoma, preoperative treatment with GnRH analogue and length of surgery. The distance between the edge of myoma and the serosal layer before surgery and the thickness of the uterine wall of myoma side after hysteroscopic myomectomy were measured immediately. In the one month and three months after operation, the hysteroscopic reexamination was performed for the patients who had childbirth plan, and the symptomatic reexamination was for the patients without birth demand. The postoperative menstrual condition and pregnancy outcome were followed up for 12 months by the telephone follow-up. Results: The patient age was 37.1±4.8 (26-46) years. The surgical time was 49.4±16.4（20-105）min, and there was no surgical complication. The one-step hysteroscopic myomectomy was performed for 53 cases (89.8%), and the volume of  blood loss was 10(10，20) (5-200) mL. The distance between the edge of myoma and the serosal layer before surgery was 3.3±1.1 (1-5.7) mm, and the thickness of the uterine wall of myoma side immediately after hysteroscopic myomectomy was 8.9±1.3 (4.9-11.3) mm. The improvement rate of postoperative menstruation was 100%, and the postoperative pregnancy rate was 73.3%(11/15). Conclusions: Hysteroscopic resection for type 3 myoma under ultrasound guidance is safe as a potential alternative to traditional surgery. The postoperative reproductive outcome is good if it is performed by an experienced surgeon. 【Keywords】   Related Articles | Metrics

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The IVF Outcome of Reducing the Down-Regulation and Controlling the Gn Start Dose in Those Poor Ovarian Responders CHEN Yan, ZHOU Ai-lian 2018, 37 (1):  28-31.  Abstract ( 1646 )   PDF (908KB) ( 9304 )   Objective：To investigate the outcome of reducing the dose of gonadotropin releasing hormone agonist (GnRHa) and controlling the dose of gonadotropins (Gn) starting in the long-down-regulation protocol for those poor ovarian response (POR) patients. Methods: The POR patients undergoing the long-down-regulation protocol with 1.0 mg GnRHa in our center from December 2015 to July 2017 were randomly divided into the group A and B. The Gn starting dose of the group A was 150-225 IU, and the Gn starting dose of the group B was 300-450 IU. Total dose of Gn, the days of Gn using, the estradiol (E2) level on the day of hCG injection, the number of retrieved oocytes, the fertilization rate, the number of excellent embryos, the number of transplantable embryos, and the clinical pregnancy rate were compared between the two groups. Results: There were 285 cycles of obtained-oocytes in the group A, while 292 cycles in the group B. The total dose of Gn and the E2 level on the day of hCG injection in the group A were significantly lower than those in the group B (P＜0.05), the total days of Gn using was significantly more than the group B (P＜0.05). There were no statistical differences in the number of obtained oocytes, the fertilization rate, the number of transplantable embryos and the number of excellent embryos between the two groups (all P＞0.05). Interestingly, the clinical pregnancy rate in the group A was statistically higher than that in the group B (P＜0.05). Conclusions: For those POR patients undergoing IVF-ET, reducing the dose of GnRHa and controlling the dose of gonadotropins startings in the long-down-regulation protocol can improve the IVF outcome and reduce their cost of ovulation drug treatment. Related Articles | Metrics

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Pregnant Outcome of Single-Blastocyst Transfer in High Ovarian Responders with the Different Level of Estradiol ZHANG Yu-ting，CHEN Ting，SU Ying-chun 2018, 37 (1):  32-35.  Abstract ( 2456 )   PDF (913KB) ( 11282 )   Objective：To compare the pregnant outcomes of single-blastocyst transfer in those high ovarian responders with the different levels of serum estradiol on the day of human chorionic gonadotrophin (hCG) injection in their ovarian stimulation cycles. Methods：A total of 1 167 cycles in those high ovarian responders who performed embyo transfer in their fresh stimulation cycles were retrospectively analyzed. According to the concentration of serum estradiol (E2) on the day of hCG administration, 1 167 cycles were divided into four groups as follows. The group A (n=59) was the D5 single-blastocyst transfer group while E2＜5 000 pg/mL. The group B (n=219) was the D3 embyo transfer while E2＜5 000 pg/mL. The group C (n=387) was D5 single-blastocyst transfer while E2≥5 000 pg/mL. The group D (n=502) was the D3 embyo transfer while E2≥5 000 pg/mL. The basical characteristics and pregnancy outcomes were compared between the group A and B, and between the group C and D. Results：The number of retrieved oocytes，mature oocytes/MⅡ oocytes, 2PN fertility rate, number of embyo transfered in the group A were higher than those in the group B, while the twins pregnancy rate and twins delivery rate were lower than those in the group B (all P＜0.05). However, there were no significant differences in the implantation rate, clinical pregnancy rate, abortion rate, live birth rate and moderate-severe ovarian hyperstimulation syndrome (OHSS) between the group A and the group B (P＞0.05). The bFSH and the dose of gonadotroph in the group C were lower than the group D, while the AFC, the number of retrieved oocytes, mature oocytes/MⅡ oocytes, the concentrations of serum E2, progestron (P) on the day of hCG, 2PN fertility rate, 2PN cleavage rate, number of embyo transfered, number of high quality in the group C were higher than those in the group D (all P＜0.01). Interestingly, the implantation rate in the group C was higher than group D, while the twins pregnancy rate, twins delivery rate and the rate of moderate-severe OHSS were significantly lower than those in the group D (all P＜0.05). There were no significant differences in the clinical pregnancy rate, abortion rate, live birth rate between the group C and the group D (P＞0.05). Conclusions：Compared with the two cleavage embryos transfer，the single-blastocyst transfer under the different concentrations of E2 on the day of hCG stimulation can ensure the similar pregnancy rate and live bith rate, while significantly reduce the twins pregnancy rate and twins delivery rate. Meanwhile, the incidence of OHSS is not increased in those cycles with the higher level of estradiol.   Related Articles | Metrics

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Effect of GnRH Antagonist on the Endometrial Receptivity in Fresh Embryo Transfer Cycle: A Retrospective Study WEI Han，LI Dan，WANG Lei，SHAO Xiao-guang 2018, 37 (1):  36-40.  Abstract ( 1731 )   PDF (963KB) ( 9186 )   Objective：To evaluate the endometrial thickness on the day of hCG injection (the hCG day), clinical pregnancy rate and embryo implantation rate in those patients undergoing the in vitro fertilization-embryo transfer (IVF-ET) with the GnRHa long protocol or GnRH antagonist (GnRHA) protocol, in order to find whether GnRHA has a negative effect on endometrial receptivity. Methods：Those cases with the GnRHa long protocol (the long-protocol group, 1 459 cases) or the GnRHA protocol (the GnRHA group, 395 cases) in our Center from January 2015 to June 2017 were enrolled. The basic characteristics of the two groups were compared. According to the age, patients were divided into four subgroups: the ＜30 years old group (352 cases), the 30-35 years old group (781 cases), the 35-40 years old group (601 cases) and the ≥40 years old group (120 cases). According to the number of eggs, patients were divided into three subgroups: the low response group (oocytes ≤3 218 cases), the normal response group (oocytes 4-14, 1 535 cases) and the high response group (oocytes ≥15 101 cases). The endometrial thickness on the hCG day, clinical pregnancy rate, embryo implantation rate and early abortion rate were compared. Results：There was no significant difference in BMI between the two groups (P＞0.05). There were significant differences between the two groups in years, infertility years, the basic level of FSH, AFC and average implanted embryos number (P＜0.05). In those cases of the ＜30 years old subgroup and the ≥40 years old subgroup, the differences in the endometrial thickness on the hCG day and embryo implantation rate between the two groups were no significant (P＞0.05), while the difference in the clinical pregnancy rate was significant in the ＜30 years old group (P＜0.05). In those cases of the 30-35 and 35-40 years old subgroups, the endometrial thickness, embryo implantation rate and clinical pregnancy rate in the GnRHa long protocol group were significantly higher than those in GnRHA protocol group (P＜0.05). In those cases of the low response subgroups, there were less transplanted embryos and higher embryo implantation rate in the GnRHa long protocol group (P＜0.05). In those cases of the normal response subgroups, the endometrial thickness on the hCG day, embryo implantation rate and the clinical pregnancy rate were higher in the GnRHa long prolocol group (P＜0.05). In those cases of the high response subgroups, there were no significant differences between the two groups. Conclusions：In those cases of the 30-40 year old and normal ovarian response population, the GnRHA protocol may reduce the endometrial receptivity, and to reduce the embryo implantation rate and clinical pregnancy rate. Related Articles | Metrics

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Study on Pain-Related Factors in Outpatients Undergoing Hysteroscopy without Anesthesia LIU Jin-lian，ZHAO Jia，DU Xiao-guo，LIU Dan，ZHANG Meng，SONG Dong-hong 2018, 37 (1):  41-44.  Abstract ( 1568 )   PDF (854KB) ( 9039 )   Objective：To explore the pain-related factors in those outpatients undergoing hysteroscopy without anesthesia, in order to provide theoretical guidance for clinical study of nursing intervention to alleviate pain. Methods：The questionnaire survey was conducted in those patients undergoing hysteroscopy without anesthesia at the Reproductive Center of a tertiary hospital in Beijing from June to September in 2016. The questionnaire included general information, self rating anxiety scale, self rating depression scale, general self-efficacy scale, hysteroscopy related knowledge questionnaire and visual analogue scale (VAS). A total of 125 patients were examined by OLYMPUS′s flexible mirror. A small endometrial tissue from each patient was pathologically tested.  Twenty-eight of them underwent polypectomy. Results：The median VAS score of 125 patients was 4.42 (3, 6), which is normal distribution data after logarithmic conversion. Multivariate analysis showed that some factors could be included in the equation（regression equation F=7.189, P=0.000）, including whether removal of polyps, the total family monthly income, depression score, education degree, the score of knowledge on hysteroscopy. Those risk factors of pain were polypectomy, the family monthly total income, educational degree and the depression score. Interestingly，the high score of hysteroscopy-related knowledge was a protective factor. Conclusions: The adequate education before hysteroscopy is necessary for those patients to undergo hysteroscopy without anesthesia, especially for patients with polyps, high family monthly income, high education degree and severe depression. Related Articles | Metrics

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Effects of Predeposit Autologous Blood Donation on the Pregnancy Outcome of Pregnant Women LE Jiang-hua, TANG Gui-yan, HE Yan-fang, PENG Ling-xiang 2018, 37 (1):  45-48.  Abstract ( 1444 )   PDF (890KB) ( 8968 )   Objective：To evaluate the effects of predeposit autologous blood donation (PABD) on the pregnancy outcome of pregnant women. Methods: A total of 404 pregnant women in our department of obstetrics from January to December 2015, who were in accordance with the PABD indications, were included in this study. There were 203 pregnant women undergoing PABD (the research group, n=203), and 201 pregnant women not enrolling in PABD (the control group, n=201). The postpartum haemorrhage volume in 24 hours, neonatal birth weight, Apgar score, 24 hours postpartum hemoglobin (Hb), hematocrit (HCT), blood platelet count (PLT), prothrombin time (PT), activated partial thrombopastin time (APTT) and fibrinogen (FIB) were recorded and analyzed. The Hb、HCT、PLT、PT、APTT、FIB before PABD and 7 days after PABD in the research group were analyzed too. Results: There were no significant differences between the two groups in the maternal age, gestational age, the prenatal Hb, PLT, HCT, PT, APTT and FIB (all P＞0.05). There were no significant differences between the two groups in the 24 hours postpartum haemorrhage volume, birth weight, 1 minute Apgar score, 5 minutes Apgar score, Hb, PLT, HCT, PT, APTT and FIB (all P＞0.05). In the research group, the Hb, HCT, PLT, PT, APTT and FIB were not significantly changed after 7 days of PABD (all P＞0.05). Conclusions: There was no adverse outcome after PABD in this study. PABD is a safe, economic and effective way for those pregnant women to get timely autologous blood when they are in need. Related Articles | Metrics

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Molecular Epidemiological Characteristics of HPV Infection and the Relationship with Cervical Lesion in Chengdu China LUO Zhong-qiu, LENG Ping, LIU Xiang-qin, LUO Ping 2018, 37 (1):  49-53.  Abstract ( 1526 )   PDF (928KB) ( 9083 )   Objective：To study the molecular epidemiological characteristics of cervical human papillomavirus (HPV) infection and the relationship with cervical precancerous lesion among women in Chengdu China. Methods：A total of 8 204 patients who tested HPV infection during January 2015 to January 2017 were enrolled. All patients had the HPV genotyping detection, among them 4 390 patients were requested the cervical cytology test and 229 patients had pathological diagnosis. Results：In 8 204 cases, the HPV infection rate was 23.28%, including 58.53% of high-risk HPV infection. Most of HPV infections were single infection (72.88%), mainly caused by HPV52, HPV58 and HPV16, while in those multiple HPV infections the double infections took priority of 62.13%, mainly caused by HPV52 combined with HPV58, HPV16 and HPV53. There was significant difference in the HPV infection rate of different age groups (P＜0.001), and this rate in the ≤20 age group was highest (61.76%). The increasing rate of high-risk HPV infection was along with the diagnosis grade of cytology, and this rate in people with cytological abnormality was significantly higher than that in normal people（P=0.025）. The high-risk HPV infection was related to the different grade of CIN and cervical cancer, however the low-risk HPV infection was only correlated with CINⅠ. Conclusions：The distribution of HPV genotypes has significant difference in the different age group and region, while the HPV infection rate is positively related with cervical lesions. This study can provide more reasonable reference for the development of specific HPV vaccine that suit for the women in Chengdu, and for the screening of cervical lesions and the prevention of cervical cancer. Related Articles | Metrics

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Analysis of the Outcomes of Transabdominal Multifetal Reduction in Those DCDA Twin Pregnancies by IVF-ET LI Man-chao, AI Xi-xiong, LIANG Xiao-yan 2018, 37 (1):  54-56.  Abstract ( 1695 )   PDF (843KB) ( 9092 )   Objective：To investigate the necessity and clinical outcomes of transabdominal multifetal reduction in those patients with dichorionic dianionic (DCDA) twin pregnancies after in vitro fertilization and embryo transfer (IVF-ET). Methods: A total of 248 DCDA twin pregnancies after IVF-ET were retrospectively analyzed, from Jan 2014 to Dec 2016. 59 patients received the transabdominal multifetal reduction (the reduced group), and 189 did not (the nonreduced group). The rate of midterm abortion, preterm birth, birth weight and birth week were compared between two groups. Results: Compared with the nonreduced group, the reduced group had higher birth weight [(2.92±0.58) kg vs. (2.40±0.42) kg], longer birth weeks (38.29±2.55 vs. 36.60±1.85), lower preterm birth rate (13.56% vs. 36.51 %) [34～36+6 weeks (10.17% vs. 29.10%), 28～33+6 weeks (3.39% vs. 7.41%)], and lower rate of low birth weight(14.55% vs. 53.63%). Conclusions: The transabdominal multifetal reduction is helpful to improve the clinical outcomes in those DCDA patients after IVF-ET. Related Articles | Metrics

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Research Progress in the Etiology, Pathogenesis and Treatment of Polycystic Ovary Syndrome LENG Qin, WEI Zhao-lian 2018, 37 (1):  57-61.  Abstract ( 2458 )   PDF (929KB) ( 10817 )   Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women of reproductive age. In addition to their inherent polycystic ovary, hyperandrogenism and ovarian dysfunction, there are obesity, type 2 diabetes, dyslipidemia and other metabolic abnormalities. With the change of living environment, the incidence of PCOS gradually increases. If the condition is not improved for a long time, it will not only affect reproductive health, but also affect general health. Although we have made a little progress in understanding PCOS, the complicated etiology and heterogeneous clinical manifestations suggested that the comprehensive treatment was very important for those PCOS women. For those PCOS women with fertility demand, the ovulation induced with drugs will help them to get pregnancy. However, the objective of the ovulation induction should be to get a single developed follicle, and to avoid the multiple developing follicles. In IVF/ICSI cycles, an excess of developing follicles should be avoided so as to prevent ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy. The research progress of the etiology, pathogenesis and treatment of PCOS were briefly discussed in this review. Related Articles | Metrics

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Clinical Research Progress of Ovarian Response Predictors KE Jia-min, XIA Wei, SU Ning, LUO Xiao-huan 2018, 37 (1):  62-65.  Abstract ( 1776 )   PDF (825KB) ( 9201 )   Ovarian response refers to the response of the follicle to the exogenous gonadotropin during the controlled ovarian stimulation (COS). In assisted reproductive technology, COS is the key and difficult step. In clinic, some parameters were used as the predictors of ovarian response during COS, and as the reference of the optimized schedule and individual treatment so as to obtain an ideal outcome of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Some of common ovarian response predictors were evaluated in this review, such as age, basal follicle stimulating hormone (FSH), basal FSH/basal LH ratio, basal estradiol, inhibin B, anti-Mullerian hormone (AMH), follicular output rate and the antral follicle count, in which the evaluation mainly included the ovarian responsiveness and the outcome of IVF/ICSI-ET, as well as their advantages and limitations in clinical application. Meanwhile, the future development of those ovarian response predictors was also proposed. Related Articles | Metrics

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Study Progress of Postovulatory Oocyte Aging YANG Ji-hong, WANG Hui, QIAN Yun 2018, 37 (1):  66-70.  Abstract ( 1890 )   PDF (895KB) ( 9052 )   The oocyte aging is related to many adverse factors, in which oxidative stress and mitochondrial dysfunction lower the quality of oocyte and affect further development. Postovulatory aging (POA), one type of oocyte aging, is more common in the in vitro culture of oocyte, which causes not only dysembryoplasia and poor oocyte quality but also the reduced pregnancy rate and the increased birth defects. Oxidative stress is the essential trigger factor of POA, which may influence the oocyte quality and embryonic developmental potential via the activated apoptosis-related pathways. This paper summarizes the factors of POA, oxidative stre Related Articles | Metrics

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Study Progress of Anti-Mullerian Hormone in Assisted Reproduction LAI Hai-yan, GUI Wen-wu 2018, 37 (1):  71-75.  Abstract ( 1482 )   PDF (892KB) ( 9012 )   Anti-Mullerian hormone (AMH), also named mullerian inhibiting substance (MIS), is a dimeric glycoprotein produced by the granulosa cells of early developing follicles in female and the Sertoli cells in male. Initially, AMH was known as a hormone involved in the sexual differentiation. Recent studies shows that AMH can also be used as a marker for diagnosis and treatment in assisted reproduction, including assessing ovarian reserve, forecasting ovarian response, predicting the fertilization rate and the clinical pregnancy rate in in-vitro fertilization (IVF). Besides, AMH can be used as an assistant marker to evaluate semen quality and the activity of frozen-thawing semen. Otherwise, AMH has been tried in the assistant diagnosis of premature ovarian failure (POF) and polycystic ovary syndrome (PCOS), the differential diagnosis of severe oligoasthenozoospermia and azoospermatism, and the treatment choices of tumor patients of reproductive age. Related Articles | Metrics

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Diagnosis and Treatment of Hydrosalpinx LU Zhen-zhen，LI Ai-jun 2018, 37 (1):  76-80.  Abstract ( 1434 )   PDF (894KB) ( 8998 )   Hydrosalpinx is a morphological change that the chronic inflammatory exudate is accumulated in the fallopian tubes, in which the pathological basis is the chronic inflammation of fallopian tubes. The diagnosis mainly depends on the ultrasonic, hysterosalpingography and the exploration combined hysteroscopy and laparoscopy. The exploration combined hysteroscopy and laparoscope as the gold standard of diagnosis has also been used to treat hydrosalpinx at the same time exploring the pelvic cavity. According to the degree of hydrosalpinx, requirement of fertility and clinical symptoms, the treatment methods were optimized, including the conservative treatment and surgical treatment. As for surgical treatment, it is required to be minimally invasive and highly safe and efficient. In recent years, hydrosalpinx is one of the main causes of tubal secondary infertility. The diagnosis and treatment of hydrosalpinx play an important role in the natural conception and the pretreatment of in vitro fertilization and embryo transfer (IVF-ET). Related Articles | Metrics

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Chronic Endometritis and Recurrent Spontaneous Abortion SHI Xiao-yun，ZHENG Mei-ling 2018, 37 (1):  81-86.  Abstract ( 1341 )   PDF (908KB) ( 8921 )   Recurrent spontaneous abortion (RSA) is one of the most important factors of secondary infertility. The incidence of RSA in child-bearing women is 1%~5%. Chronic endometritis (CE) is a persistent inflammation of the endometrium. Patients usually have no clinical symptom, or have only mildly-increased vaginal discharge and menstrual flow, pelvic pain or dysmenorrhea. Therefore, CE is easily overlooked. Histological examination is the gold standard for the diagnosis of CE, which is characterized by the plasma cells in the endometrial stroma. On the basis of traditional HE staining, the CD138 immunohistochemistry can improve the detection rate of CE. CE is a cause of RSA, treatment by antibiotics in those CE patients can improve their pregnancy outcomes. CE has a certain influence on gestation, therefore, it is important to diagnose and treat the potential CE in those RSA patients. Related Articles | Metrics