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15 May 2018, Volume 37 Issue 3
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Number of Children and Mother Career Development under the "Two-Child" Background--Based on Logistic Differential Decomposition Model ZHANG Ping，LI Yue-ming，MAO Zhuo-yan 2018, 37 (3):  181-186.  Abstract ( 1267 )   PDF (879KB) ( 8655 )   Objective：To investigate the effect of the number of children on the career development of mother under the "two-child" policy, and to explore the conflict between the child-rearing and women career development. Methods: The data from "Investigation of the present situation and demand of family parenting 0 to 3 years children in Shanghai " was used in this study. The dependent variable was set as " whether will you give up the individual development opportunity for your family in recent 3 years?" The independent variables were those factors related to personal development, including whether the one-child family, demographic characteristics (gender, age, education level) and family demand. Three models were then developed to evaluate comprehensively the effect of the dependent variable by logistic regression. Results: The empirical analysis showed three obvious trends as follows. ①Women gave up more opportunities of the career development when compared with men under the same conditions. ②There were significant differences in the career development between women with the only one child and women with more than one child, suggesting that those mothers with two children could give up more opportunities of the career development. ③The career development of women was jointly affected by the demographic characteristics, family demand and one-child property. Conclusions: There is a negative effect of the increased number of children on the career development of women. It is necessary to do something at present to solve the conflict between the number of children and the career development of women. Related Articles | Metrics

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Fertility Index as a Predictor of Pregnancy Pattern Selection for Patients with Endometriosis after Laparoscopic Surgery YE Jing-jing，LI Liu-xia，HU Zhen-hua，ZHU Ying 2018, 37 (3):  187-191.  Abstract ( 1445 )   PDF (1001KB) ( 8665 )   Objective：To assess the value of endometriosis fertility index (EFI) in predicting the choice of pregnancy in those infertile patients with endometriosis after laparoscopic surgery. Methods: Clinical data of 148 infertile patients with endometriosis underwent laparoscopic surgery were retrospectively studied from Jan. 2013 to Dec. 2014. The pregnancy outcome was followed up by telephone. The EFI score was calculated. Accordingly, patients were grouped, and the pregnancy rate was compared. The receiver operating characteristic (ROC) curve was used to evaluate the value of EFI in predicting the nature pregnancy. Results: The negative correlation between the rate of natural pregnancy and the EMs stage was found in 36 months after operation（rs=-0.535，P＜0.001）. The rate of natural pregnancy in EMs patients in 6 months after operation was significantly higher than those in 7-12, 13-24 and 25-36 months after operation. There was a positive correlation between the rate of natural pregnancy and the EFI score in EMs patients in 36 months after operation（rs=0.617，P＜0.001）. The rates of pregnancy in those patients with the EFI scores of 9-10, 7-8 and 5-6 were significantly higher in 6 months after operation. The area under curve (AUC) of the ROC curve of EFI was 0.854（95%CI：0.794-0.915，P＜0.001）. The critical value of the EFI score predicted by AUC was 6.5 in one year of operation, with the sensitivity of 73.42% and the specificity of 82.61%. Conclusions: EFI score was positively correlated with the rate of natural pregnancy in those EMs patients after laparoscopic surgery, suggesting that EFI score can be tried to predict the natural pregnancy in one year after operation. One year after surgery is the best duration for the patient to have a pregnancy. Related Articles | Metrics

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The Relationship between Fertility Stress and Life Quality in Non-Pregnant Patients after IVF-ET SHI Li，LUO Li-yan，SONG Dong-hong，CHEN Li-xue 2018, 37 (3):  191-195.  Abstract ( 1272 )   PDF (850KB) ( 8643 )   Objective：To investigate the relationship between fertility stress and life quality in non-pregnant patients undergoing IVF-ET. Methods：The cross-sectional survey was carried out by studying the basic situation, the Fertility Question Inventory (FPI) scale and the Fertility Quality of Life (FertiQoL) scale among 351 non-pregnant patients with IVF-ET failures in our center from May 2017 to October 2017, including 104 non-pregnant patients underwent more than 3 times of transplantation and 247 non-pregnant patients underwent less than 3 times of transplantation. The fertility stress and life quality was described by FPI and FertiQoL, respectively. The correlation between fertility stress and life quality was explored using Pearson method. Results：The total score of FPI in non-pregnant patients underwent IVF-ET was 162.22±20.63, and the total score of FertiQoL was 58.79±12.79. There were no significant differences in the FPI total scores and sub-item score, and FertiQoL total score and sub-item score, between patients being transplanted more than 3 times and patients being transplanted less than 3 times (all P＞0.05). Pearson analysis showed that there was positive correlation between the childless stress score in FPI and the total score in FertiQoL (P＜0.05), and that there was negative correlation between other item score in FPI and the total score in FertiQoL (P＜0.05). Multiple linear regression analysis showed that fertility stress, age and literacy were the main factors of the life quality in patients with IVF-ET failures (F=9.140, R2=0.391, P＜0.01). Conclusions：The fertility stress of non-pregnant patients underwent IVF-ET is an important factor influencing the life quality. The greater the fertility stress, the lower the life quality. Should pay attention to the psychological pressure in those non-pregnant patients underwent IVF-ET failures, and improve their life quality by proactively releasing the fertility stress. Related Articles | Metrics

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Association of ERα PvuⅡ and XbaⅠ Polymorphism with Male Infertility in Chinese Zhuang Population LI Jie，YUAN Hui-xiong，PANG Yan-fang，WEI Yu-xia，CHEN Wen-cheng，WANG Jun-li 2018, 37 (3):  196-200.  Abstract ( 1318 )   PDF (2055KB) ( 8689 )   Objective：To explore the association of single nucleotide polymorphism (SNP) of estrogen receptor α (ERα) gene with male infertility in Chinese Zhuang population. SNPs of PvuⅡ and XbaⅠ in ERα gene were checked as targets. Methods：A total of 96 infertile men were recruited as the observation group, and 76 fertile men as the control group. After routine semen analysis, the restricted enzyme digestion and DNA direct sequencing of PvuⅡ and XbaⅠ in ERα gene were performed. Results：The XbaⅠallele frequency and genotype distributions were significantly different between the control group and the observation group (all P＜0.05). Genetic model analysis showed that the ERα gene XbaⅠ were significantly different between the two groups under codominant (CC vs. TT) and recessive genetic model (both P＜0.05). Subjects carrying the T allele frequency of XbaⅠ had the decreased risk of infertility compared to the subjects carrying the G allele frequency. However, the SNPs of ERα gene Pvu Ⅱ did not show the correlation with male infertility. Conclusions：We concluded that in this study ERα XbaⅠ polymorphism was associated with male infertility. Related Articles | Metrics

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Comparison of Two Protocols in Infertile Patients with PCOS Underwent in Vitro Fertilization-Embryo Transfer Cycles WANG Hai-yan，LI Bei-qing，LI Yue-hong 2018, 37 (3):  201-204.  Abstract ( 1332 )   PDF (828KB) ( 8732 )   Objective：To compare the clinical outcomes of two protocols, the classical gonadotropin releasing hormone antagonist (GnRHA) protocol and the new GnRH agonist (GnRHa) long protocol, in those infertile patients with PCOS underwent in vitro fertilization-embryo transfer (IVF-ET) cycles, in order to explore the feasibility protocol with fewer complications. Methods： The infertile women with PCOS underwent IVF-ET in our center from January 2015 to September 2017 were respectively analyzed. A total of 240 cycles were divided into the GnRHA protocol group (GnRHA group, 90 cycles) and the GnRHa long protocol group (GnRHa group, 150 cycles). The clinical outcomes were compared between the two groups, including the gonadotropin duration, the number of retrieved oocyte, the number of 2PN fertilized egg, the fertilization rate, the number of usable embryos, the number of good quality embryos, the pregnancy rate of once ET and the rate of ovarian hyperstimulation syndrome (OHSS). Results：The day of drug-use of the GnRHA group was lower than that of the GnRHa group (Z=－11.230, P=0.000). There were no statistical differences in the number of 2PN fertilized egg, the fertilization rate, the number of usable embryos and the number of good quality embryos (both P＞0.05). The difference in the pregnancy rate of once ET (including fresh and thawed transplants) between the two groups was not significant (P＞0.05). There were 11 cases of severe OHSS in the GnRHa group and 1 case in the GnRHA group ( χ2=4.340, P=0.037). Conclusions：The pregnancy rates of once ET (including fresh and thawed transplants) in two protocols were not significantly different, however the rate of middle and severe OHSS in the GnRHA group was lower. The GnRHA protocol, without adjustment and with the reduced economic pressures and complications, and with the same pregnancy rate of GnRHa long protocol, may be tried in those infertile patients with PCOS underwent the IVF-ET treatment using freeze-thawed embryos. Related Articles | Metrics

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Effects of Lowered Oxygen Concentration in Embryo Culture on the Outcomes of In Vitro Fertilization-Embryo Transfer for Elderly Women YU Qiu-feng，WANG Hui-jie，CHEN Yan，JIA Xiao-li，ZHOU Xian-qiong，CHEN Ya-jun，HUANG Zhi-yong，GAO Song-cheng，FU Xue-wen，WANG Ai-ping 2018, 37 (3):  205-207.  Abstract ( 1261 )   PDF (790KB) ( 8602 )   Objective：To evaluate the effects of the lowered oxygen concentration (5% oxygen) in incubator during embryo culture on the outcomes of in vitro fertilization-embryo transfer (IVF-ET) for elderly women. Methods: The women aged ≥38 years who underwent IVF and fresh embryo transfer in our center from September 1, 2015 to June 1, 2017 were retrospectively analyzed. A total of 283 cycles were assigned into two groups according to the oxygen concentration in the incubator: the 5% oxygen concentration group (n=120) and the 20% oxygen concentration group (n=163). The normal fertilization rate, cleavage rate, available embryo rate, good quality embryo rate, clinical pregnancy rate, implantation rate and early abortion rate were compared between the two groups. Results: There were no significant differences in the normal fertilization rate, cleavage rate, available embryo rate, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, early abortion rate and live birth rate between the two groups (all P＞0.05)，while the good quality embryo rate in the 5% oxygen concentration group was significantly higher than that in the 20% oxygen concentration group (P＜0.05). Conclusions: The lowered incubator oxygen concentration for the embryos of elderly women could obtain the higher rate of good quality embryo，but the effects on clinical pregnancy rate and implantation rate were not obvious. Related Articles | Metrics

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Clinical Outcomes of Frozen-Thawed Single Blastocyst Transfer on Different Developmental Days LYU Xing-yu，MENG Xiang-qian，WANG Qi，HUANG Jun，GENG Li-hong，ZHONG Ying 2018, 37 (3):  208-211.  Abstract ( 1303 )   PDF (832KB) ( 8611 )   Objective：To compare the clinical outcomes of frozen-thawed single blastocyst transfer, on the different frozen day and with the different blastocyst score. Methods: This retrospective analysis included 1 675 cycles of frozen-thawed single blastocyst transfer in our IVF center from January 2008 to December 2015. Those cycles were divided into six groups, according to the frozen day and the blastocyst score. They are group D5BB and above, group D5BC/CB, group D5CC, group D6BB and above, group D6BC/CB, group D6CC. The clinical outcomes were compared among groups. Results: There were no significant differences in those rates of monocyesis, gemellary pregnancy, ectopic pregnancy, first trimester abortion, preterm birth, full-term birth, and low birth weight infant among six groups（all P＞0.05）. The rates of clinical pregnancy, late trimester abortion and live birth were significantly different （both P＜0.05）. When compared between any two groups, there were no significant differences in the rates of clinical pregnancy and live birth between group D5 blastocysts and group D6BB, or between group D5CC and group D6 blastocysts (all P＞0.05). Interestingly, the rates of clinical pregnancy and live birth were significantly increased in the group D5BC/CB when compared with the group D6BC/CB and group D6CC（all P＜0.05）. Conclusions: In those frozen-thawed cycles of single blastocyst transfer, there are good clinical outcomes when do the transfers on D5 with high and mediate-grade blastocysts, and on D6 with high-grade blastocysts. Related Articles | Metrics

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Pregnant Outcome of Different Blastocyst Culture Time after Thawing of Vitrificated Cleaved Embryos CHEN Xi-xi，LI Shu-zhen，LI Ping，GUO Jiang-hua，LIANG Hui-hong 2018, 37 (3):  212-216.  Abstract ( 1424 )   PDF (871KB) ( 8614 )   Objective：To investigate the optimum blastocyst culture time after thawing of vitrificated cleaved embryos and its effect on pregnant outcome. Methods：477 patients conducting 520 cycles of blastocyst culture after thawing of vitrificated cleaved embryos were retrospectively analyzed. According to the blastocyst culture time after thawing, 520 cycles were grouped into two groups: Group D2 (the warming time: 15-16 o′clock in D2) and Group D3 (the warming time: 8-9 o′clock in D3). In both groups, blastocysts were observed on 8-9 o′clock in D5/D6. Therefore the culture times were 65 h in Group D2 and 48 h in Group D3 in D5, and 89 h and 72 h in D6. Results：There were no significant differences between Group D2 and Group D3 in the blastocyst formation rate (48.10% vs. 46.59%), good quality blastocyst formation rate (39.70% vs. 34.22%), clinical pregnancy rate (70.08% vs. 69.48%), biochemical pregnancy rate (7.48% vs. 7.98%) and implantation rate (55.93% vs. 58.06%) (P＞0.05). The blastocyst formation rates of good and non-good embryos were (30.37% vs. 13.28%) and (62.64% vs. 40.14%) in 48 h and 65 h, respectively (P＜0.05). However, the blastocyst formation rates of good and non-good embryos were (32.32% vs. 27.59%) and (2.17% vs. 2.06%) in 72 h and 89 h respectively (P＞0.05). The clinical pregnancy rates and implantation rates were showed: 48 h group＞65 h group＞72 h group＞89 h group, and the biochemical pregnancy rates were showed: 89 h group＞48 h group＞65 h group＞72 h group, although there were non-significant differences in those rates among groups (P＞0.05). Conclusions：We can warm the vitrificated cleaved embryos at 15-16 o′clock in D2 or at 8-9 o′clock in D3. Majority of formed blastocysts can be transplanted into uterus in D5, if the vitrificated cleaved embryos were warmed at 15-16 o′clock in D2. The blastocysts of good quality embryos can be formed in D5 or D6, however those non-quality embryos could spend more time to form blastocysts until D6. Related Articles | Metrics

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Clinical Analysis of Da Vinci Robotic-Assisted Laparoscopic Myomectomy SHUAI Yu，JI Mei，ZHAO Zhao，LI Shun-shuang，LI Yue, XU Peng-lin 2018, 37 (3):  217-220.  Abstract ( 1621 )   PDF (770KB) ( 8682 )   Objective：To investigate the safety, feasibility of the Da Vinci robotic-assisted laparoscopic myomectomy. Methods: A retrospective analysis was made on the clinical data of 45 cases of myomectomy at First Affiliated Hospital of Zhengzhou University from January 2016 to December 2017, including 18 cases of the robotic group, 27 cases of the laparoscopic group. The robotic group included 2 cases of broad ligament fibroids and 4 cases of cervical fibroids. The laparoscopic group included 2 cases of broad ligament fibroids and 5 cases of cervical fibroids. The clinical parameters were compared between the two groups. Results: The operation time in the robotic group (131.17±25.26) min was longer than that in the laparoscopic group (104.30±24.43) min (P＜0.05). The difference of the actual operating times of the two groups [(109.00±21.64) min vs. (104.30±24.43) min] was not significant (P＞0.05). The robotic group was superior to the laparoscopic group in terms of intraoperative blood loss [(50.56±21.95) mL vs. (73.33±26.38) mL] and postoperative exhaust time [(27.00±5.50) h vs. (33.33 ±5.14) h] (P＜0.05). There was no significant difference in the postoperative hospital stay between the two groups [(4.28±1.12) d vs. (5.00±1.24) d] (P＞0.05). As for the myomectomy in the special parts of uterus, there were no significant differences in the operation time, actual operating time and postoperative hospital stay between the two groups (all P＞0.05). The robotic groups had less intraoperative blood loss and shorter postoperative exhaust time (P＜0.05). Conclusions: Compared with laparoscopic surgery, the Da Vinci robotic-assisted laparoscopic myomectomy has the advantages of less bleeding and faster postoperative recovery, especially in myomectomy in the special parts of uterus. Related Articles | Metrics

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Analysis on Contraceptive Knowledge and Related Factors of Migrant Population in Chengdu LI Yi-ran, WU Jun-qing, LI Yu-yan, ZHAO Rui, ZHOU Ying, JI Hong-lei, YU Lin-lin 2018, 37 (3):  221-224.  Abstract ( 1237 )   PDF (782KB) ( 8613 )   Objective：To investigate the knowledge status of contraception in the migrant population, so as to explore the factors related to contraceptive knowledge in the migrant population. Methods: A stratified cluster sampling method was used in this study. In the factory, construction site and service site of Chengdu Wuhou District and Chenghua District, 2 124 were randomly selected as the research object of the migrant population. Results: There were significant differences in the average score of contraception knowledge related to the marital status, sex, education background, average monthly earnings, census register, mode of living, regularity of sexual activity, and whether to take contaceptives (all P＜0.05). The score of contraception knowledge was severally related to age, sex, education background, average monthly earnings, census register, and whether to take birth control. Compared with the objects aged 20 to 29 years, the objects aged 40 to 49 years gained low score of contraceptive knowledge. Compared with women, male objects gained low score. Compared with the objects with the bachelor or higher degree, those objects with junior education even gained higher score. Compared with the objects with monthly income≥7 000 yuan in last year, the objects with monthly income ＜1 000 yuan gained low score of contraceptive knowledge, while those objects with monthly income 5 000-6 999 yuan gained higher score. Interestingly, the rural objects gained higher score than the urban objects. It was understandable that those objects who took contraceptives gained higher scores than the objects who did not take contraceptives (all P＜0.05). Conclusions: Concern of the contraceptive knowledge in the migrant population of male, middle and elderly age, well-education, high-income or low-income, not take contraceptives and urban population is obviously inadequate, suggesting that the contraceptive knowledge should be further popularized. Related Articles | Metrics

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Factors Related to Complete IUD Perforation in 56 Cases ZHANG Min，YANG Yue-hua，XU Hao-qin 2018, 37 (3):  225-227.  Abstract ( 1212 )   PDF (730KB) ( 8554 )   Objective：To investigate the factors of the complete intrauterine device (IUD) perforation, and to evaluate the safety of IUD in clinical application. Methods：A total of 56 cases of the complete IUD perforation were included in this study. The clinical characters and the related factors were analyzed. Results：In all of the 56 cases, 20 cases (35.71%) were found that the IUD insertion time was on the lactation period, and 24 cases (42.86%) used IUD for the first time. Abdominal pain was the main symptom in 25 cases (55.36%). IUD was translocated into the bladder in 10 cases(17.86%). Ectopic IUD was successfully removed by laparoscopy in 22 cases (39.29%). Conclusions：Many factors, such as the IUD model, using span and use for the first time, could be related to the complete IUD perforation. Women using IUDs for the first time should have the regular follow-up visit. Abdominal pain in those IUD users should be noticed during the routine follow-up visit. Related Articles | Metrics

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Effectiveness of the Contraceptives Used Immediately after Repeated Abortion in 1 251 Cases FAN Bao-guang，ZHANG Yue-hong，HAN Mei，GONG Yun-xia，WANG Bin-hong，DENG Lei 2018, 37 (3):  228-230.  Abstract ( 1234 )   PDF (744KB) ( 8666 )   Objective：To evaluate the effectiveness of the immediate implementation of contraceptives after repeated abortion. Methods: With informed consent, contraceptives were implemented in 1 251 cases of repeated abortion during or after the post-abortion care (PAC) service. The clinical application and side effects of contraceptives were followed up.  Results: All of those women who received the PAC service after repeated abortion adopted the immediate contraceptives on their own. The rate of sustaining usage in the combined oral contraceptives (COC) group was 31.2% after 12 months of follow-up visit. Only three women in the intrauterine system (IUS) group removed the devices after 12 months of follow-up visit due to the fertility requirement. There were 19, 13 and 17 women who changed from COC to IUS after 3, 6 and 12 months of follow-up visit. Analogously, there were 6 women who removed intrauterine device (IUD), and one who had ectopic pregnancy in the IUD group. There were 23, 31 and 19 women who changed from COC to IUD after 3, 6 and 12 months of follow-up visit. During the whole follow-up visit, some adverse reactions, such as irregular vaginal bleeding, amenorrhea, hypomenorrhea, hypermenorrhea, the ring moved-down and waist soreness and discomfort, were effectively treated. Conclusions: Scientific and effective PAC can effectively avoid repeated abortion and protect female reproductive health. References | Related Articles | Metrics

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Oocyte Activation Deficiency：Causes and Countermeasures ZHANG Ao，LUO Chen，LI Xin-xin，QUAN Song 2018, 37 (3):  234-237.  Abstract ( 1605 )   PDF (825KB) ( 8529 )   Oocyte activation deficiency (OAD) refers to the failure of the evoking calcium oscillations which orchestrates a series of key events, such as the resumption of meiosis, extrusion of polar body, exocytosis of cortical granules and the formation of pronuclei after the spermatozoon is engulfed by the oocyte cytoplasm. These events are essential for the following embryogenesis. Both the defect of sperm and oocyte may cause OAD. Assisted oocyte activation (AOA) and the recombinant protein recombinant human phospholipases C zeta (rhPLCζ) injected into oocyte can significantly improve the fertilization outcome of OAD oocyte undergoing intracytoplasmic sperm injection (ICSI). In this paper, the causes and countermeasures of OAD were discussed. Related Articles | Metrics

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Disorder of Complement System in Recurrent Spontaneous Abortion ZHAO Xiao-xuan，ZHANG Rui，LI Na，CHEN Lu，LI Da-zhi，FENG Xiao-ling 2018, 37 (3):  238-242.  Abstract ( 1343 )   PDF (2301KB) ( 8605 )    The unexplained recurrent miscarriage is a research hotspot in the worldwide medicine, and the immune factors of recurrent abortion have been presently focused. The complement system, as an important component of innate immunity, plays a complex and delicate role in pregnancy. A certain extent of activation of complement components is necessary for the normal development of the fetus and pregnancy appendages during pregnancy. The excessive activation of complement system on the maternal fetal interface can lead to embryo loss by the multiple mechanisms of placental development defect, inflammatory injury, and disorder of specific cellular immune. Therefore, dysfunction or excessive activation of the complement system is a risk factor for recurrent miscarriage. In this review, we reviewed the study progress of complement system in normal pregnancy and recurrent spontaneous abortion, in order to provide a feasible reference for the immunotherapy of recurrent miscarriage. Related Articles | Metrics

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Chronic Inflammation in Pathogenesis of Polycystic Ovary Syndrome and Research Progress LI Zi-han，LI Xiu-yang，ZHANG Ning，ZHANG Jian-xia 2018, 37 (3):  243-246.  Abstract ( 1438 )   PDF (777KB) ( 8639 )   Polycystic ovary syndromes (PCOS), a common endocrine disorder in women of puberty and childbearing age, is characterized by ovulation disorder, insulin resistance (IR) and hyperandrogenemia (HA). It is one of the main causes of female infertility. Chronic inflammation is an important way of defense for the body. However, it is also one of the causes of metabolic diseases. Patients with PCOS have chronic and low-grade inflammation, because the levels of some inflammatory factors were abnormally increased in those patients. More and more evidences have suggested the close relationship between chronic inflammation and the pathogenesis of PCOS, although there is still some controversy. Many inflammatory factors were secreted during the pathophysiological duration of PCOS, which causes the chronic low-grade inflammation. New evidences suggested that chronic inflammation may be actually involved in obese, IR and HA in the early stage of PCOS. Some anti-inflammatory drugs have been used to improve the inflammatory microenvironment of PCOS in the clinical practice, with a definite effect. In this paper, the relationship between chronic inflammation and the pathogenesis of PCOS, as well as the research progress was reviewed. Related Articles | Metrics

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Ethical Consideration of Fertility Preservation Seeking of Elder Single Women WANG Meng-ping，GUO Yi-hong 2018, 37 (3):  247-251.  Abstract ( 1489 )   PDF (851KB) ( 8623 )   In recent years, human demand for fertility preservation has increased dramatically under the catalysis of social and personal factors such as the cancer and ovarian diseases increased year by year. More and more older single women seek "reproductive insurance". It is or will be a major challenge to meet this demand. For those older single women who demand for fertility preservation, the best way at present is to cryopreserve her oocytes at the suitable age by vitrification freezing method. However, there will be huge challenges from ethical, social and even legal controversy when the fertility preservation be used in older single women. This paper summarizes the application of egg freezing in older single women at present and the relevant ethical issues, as well as the possible solution, in order to promote the rational face of this problem. Related Articles | Metrics

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Progress in Diagnosis and Treatment of Retained Products of Conception LYU Shan-shan，ZHANG Hui-ying 2018, 37 (3):  252-256.  Abstract ( 1433 )   PDF (808KB) ( 8585 )   The retained products of conception (RPOC) is a presence of the intrauterine tissue related with pregnancy after the birth or termination of pregnancy. Ultrasonography is the principal method of RPOC diagnosis. The signals of blood flow are the main points of the ultrasonic diagnosis, with the characterizes of focal intrauterine membrane thickening, a intrauterine hyperechoic mass or a low-resistance arterial blood flow around the mass. The endometrial thickness and echo, as well as the ultrasound vascular grading, play an important role in the clinical diagnosis of RPOC, while hysteroscopy is the main method of the confirmed diagnosis. The differential diagnosis of this disease mainly includes arterial venous malformation and pregnancy trophoblastic disease, CT and MRI are helpful for the differential diagnosis. The treatment includes drug therapy and surgery. Mifepristone and misoprostol are of two common drugs for RPOC therapy. Surgical treatment has been gradually developed from the curettage under the guidance of ultrasound to the hysteroscopic focal clearance. With the advantages of high clearance rate and low incidence of complications, the hysteroscopic clearance is currently the main method of RPOC treatment. Related Articles | Metrics

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Effects of Physical Exercise on Male Reproduction: A Review ZHOU Wei-hang，CHEN Shao-an，YU Feng-hao，GAO Jun-da，LIU Yue，DING Zhi-de 2018, 37 (3):  257-261.  Abstract ( 1301 )   PDF (804KB) ( 8583 )   The effect of physical exercise on male reproduction is usually dual. Rational exercise is beneficial to reproductive endocrinology, whilst overload exercise usually damages male fertility. Physical exercise at a reasonable amount remarkably increases the levels of FSH, LH and T, improves the microenvironment of the testis, and alters the epigenetic modifications of sperm cells for the benefit of offspring. However, excessive exercise elevates the temperature of the testicular microenvironment, and the induced heat stress can impair the sperm structure and function that eventually lead to male infertility. Furthermore, excessive exercise can also inhibit the functions of GnRH neurons and pituitary and interfere in the secretion of reproductive hormones. Besides, physical exercise causes significant demethylation of genes related to sperm DNA CpG island, which affect the expressions of microRNAs and epigentics. The research progress of the effects of exercise on male reproduction and the underlying mechanisms were discussed in this review. Related Articles | Metrics