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15 July 2018, Volume 37 Issue 4
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Anxiety and Depression in Patients with Polycystic Ovary Syndrome and Relevant Factors ZHANG Li-li，MA Jiang，ZHANG Cheng，ZHENG Dong-xue，LIU Xin-min，ZHOU Xue-zhong 2018, 37 (4):  269-272.  Abstract ( 1609 )   PDF (785KB) ( 8620 )   Objective：To investigate the anxiety and depression in patients with polycystic ovary syndrome (PCOS) and the related factors, and to analyze the relationship between the anxiety and depression and the change of electroencephalogram function. Methods：A total of 58 patients with PCOS who were treated at gynecological outpatient department of Guang′anmen Hospital of China Academy of Chinese Medical Sciences from December 2016 to March 2017 were enrolled as the PCOS group, and 35 age-matched normal women as the control group. The questionnaire, self rating anxiety scale (SAS), self rating depression scale (SDS), life events scale (LES) and social support scale (SSRS) for all objects, as well as the dyadic regulation scale (DRS) for those married objects (n=38 and 7, respectively), were used in this study. The brain electrical activity mapping (BEAM) was used to evaluate the electroencephalogram function. Results：The scores of SAS and SDS in the PCOS group were significantly increased than that in the control group (P=0.000). Compared with the control group, the PCOS group had significantly higher score of LES (Z=－2.217, P=0.027), specifically the subscores of life negative events and family-related questions (all P＜0.05). However, there were no significant differences between the two groups in the scores of positive events and work-learning problems and social or other problems in negative life events (all P＞0.05), and also no difference in the score of SSRS (P＞0.05). There were no significant difference in the score of DRS in those married objects between the two groups (P＞0.05). The rate of abnormal BEAM were significantl increased in the PCOS group than in the control group (Z=－5.447, P＜0.01). The PCOS group had the increased brand power of slow δ and θ waves (P＜0.05). There were a significant positive correlation between the BEAM and SAS and SDS (rs=0.447, P=0.000; rs=0.318, P=0.002) and a positive correlation between SAS and SDS (r=0.706, P=0.000) in the PCOS group. Conclusions：PCOS patients had obvious anxiety and depression, and the interplay between anxiety and depression. These negative emotions were related to the negative life events coming from their family. The long-term of negative emotions may affect their electroencephalogram function. Related Articles | Metrics

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The Effect of Weight Loss on the Success Rate of Intrauterine Insemination in Patients with Polycystic Ovary Syndrome LIU Pan, ZHAO Min-ying, GUO Li-na, SUN Xiao-hui, WANG Su-gai 2018, 37 (4):  273-276.  Abstract ( 1336 )   PDF (826KB) ( 8584 )   Objective：To assess the effect of weight loss on the success rate of intrauterine insemination（IUI） in patients with polycystic ovary syndrome (PCOS). Methods: The clinical data of PCOS patients undergoing IUI-husband semen treatment were collected between January 2013 and June 2017 in our hospital. Among them, 180 patients with body mass index (BMI) greater than or equal to 24 kg/m2 had a total of 336 cycles. According to the pretreatment, patients were divided into the weight loss group, the drug group and the no-preconditioning group (control group). The weight loss group was divided into three subgroups according to the weight loss ratio: 5%≤weight loss＜10% as the subgroup 1, 10%≤weight loss＜20% as the subgroup 2, and weight loss ≥20% as the subgroup 3. The levels of hormones, the pregnancy rate and the abortion rate were compared. Results: The difference of LH, LH/FSH and T difference between the four groups were statistically significant (P＜0.01). The LH difference, LH/FSH difference and T difference in the subgroup 1, the subgroup 2 and subgroup 3 increased gradually, and the difference were statistically significant (P＜0.05). The LH difference and T difference in the drug group were less than the subgroup 3, but higher than the subgroup 1 and subgroup 2 (P＜0.05). There was no significant difference in the LH/FSH difference between the drug group and the subgroup 3, but the LH/FSH difference in the drug group was higher than that in the subgroup 1 and subgroup 2 (P＜0.05). The pregnancy rates in the subgroup 2，the subgroup 3 and the drug group were significantly higher than that in the control group and the subgroup 1 (P＜0.05). There was no statistical difference in the pregnancy rate between the subgroup 2, the subgroup 3 and the drug group (P＞0.05). The abortion rates in the subgroup 3 and the drug group were significantly lower than those in the control group and the subgroup 1 (P＜0.05). There was no significant difference in the abortion rate between the subgroup 2, subgroup 3 and the drug group (P＞0.05). Conclusions: With the increase of weight loss ratio, the LH, LH/FSH and T values are decreased correspondingly. When weight loss is more than 10%, the pregnancy rate of IUI treatment after ovulation induction is significantly improved. A significant reduction in the abortion rate requires weight loss at least 20%. Related Articles | Metrics

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Effects of Sildenafil Citrate on Pregnancy Outcomes in Frozen Embryo Transfer Patients after Resection of Intrauterine Adhesion LI Xin, LING Xiu-feng, ZHAO Chun, CHEN Meng-qian, JI Xiao-yuan, JI Hui, SU Yan 2018, 37 (4):  277-280.  Abstract ( 1768 )   PDF (744KB) ( 8688 )   Objective：To investigate the effects of sildenafil citrate on the pregnancy outcomes of frozen embryo transfer (FET) in patients after the resection of intrauterine adhesion (IUA). Methods: A total of 310 infertile patients receiving FET who were diagnosed as IUA  between January and December 2017, and resected IUA under hysteroscopy before their FET treatment, were included. The 190 cases in the control group were given the FET cycle with hormonal replacement, while the 120 patients in the test group were given the above FET cycle combined with sildenafil citrate. After the menstruation was clean, 50 mg of sildenafil citrate was administrated vaginally every day until the transplantation. Firstly, the gestational outcomes were compared between the two groups. Each group was subdivided into two subgroups: a gentle IUA subgroup and a medium-severe IUA subgroup. The gestational outcomes were then compared again. Results: The clinical pregnancy rate in the test group was significantly higher than that in the control group[50.83% (61/120) vs. 34.74% (66/190), P＜0.05]. However, there was no significant difference in the embryo implantation rate between the two groups [31.17% (72/231) vs. 21.82% (79/362), both P＞0.05]. There was no significant difference in the clinical pregnancy rate or embryo implantation rate between the two gentle IUA subgroups. However, The clinical pregnancy rate [44.78% (30/67)] and the embryo implantation rate [28.46% (37/130)] in the medium-severe IUA subgroup of the test group were significantly higher than those in the medium-severe IUA subgroup of the control group (both P＜0.05). No significant differences were found in the miscarriage rate and the ectopic pregnancy rate between the two groups (P＞0.05). Conclusions: Sildenafil citrate can improve the endometrial receptivity after IUA, and can significantly increase the pregnancy rate of FET in those medium-severe IUA patients. Related Articles | Metrics

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The Clinical Outcomes of Modified Natural-Cycle for Ageing Women with Poor Ovarian Responder During IVF-ET LIU Shan，BAO Li-li，FENG Xiao-ye，WANG Dong-xue，YANG Bo 2018, 37 (4):  281-284.  Abstract ( 1319 )   PDF (751KB) ( 8635 )   Objective：To analyze the clinical outcomes of the modified natural-cycle for ageing women with poor responder who failed to get pregnancy in the first in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) of minimal ovarian stimulation, and to discuss the treatment protocols of ageing women with poor ovarian reservation. Methods：This is a retrospective study. A total of 25 ageing women with poor ovarian reservation who failed to get pregnancy the first IVF/ICSI-ET cycle with minimal stimulation protocol were changed to the modified natural-cycle in our center from January 2016 to June 2017. The level of serum E2, the follicle size on the trigger day, the number of oocytes retrieved, the rate of oocyte maturation, the fertilization rate, the high quality embryos rate, and the clinical pregnancy rate, the miscarriage rate and the ectopic pregnancy rate were compared in the self-controlled design. Results：There were significant differences in the average diameter of follicle and the E2 level on the trigger day between the modified natural-cycle group and the minimal stimulation cycle group [(19.8±1.3) mm vs. (17.8±1.0) mm, (582.1±165.9) pmol/L vs. (681.4±99.1) pmol/L, both P＜0.05]. Although the number of oocytes retrieved in the modified natural-cycle group [(1.0±0.0) vs. (2.7±1.4)] was lower than that in the minimal stimulation cycle group, the rate of oocyte maturation (100%), the fertilization rate (100%) and the high quality embryos rate (80%) were significantly higher than that in the minimal stimulation cycle group (80.6%, 81.5% and 36.4%, all P＜0.05). Conclusions：The modified natural-cycle can make the almost same outcomes as the minimal stimulation cycle by the improved significantly quality of the embryo in those ageing women with poor ovarian reservation, although the number of oocytes retrieved was even lower in their modified natural-cycles. Related Articles | Metrics

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The Cryopreservation Effects of Two Freezing Methods on Human Ovarian Tissue ZHANG Na, ZHANG Cong, ZHANG Hui, JIA Xin-zhuan, ZHANG Yi, TANG Lan 2018, 37 (4):  285-287.  Abstract ( 1313 )   PDF (762KB) ( 8583 )   Objective：To evaluate the cryopreservation effects of the programmed freezing and the vitrification freezing on human ovarian tissue. Methods: Human ovarian tissue specimens of 19 endometrial carcinoma cases were collected. The tissue specimen was divided into two parts: one was cryopreserved with the programmed freezing (the group A), and another with the vitrification freezing （ｔhe group B）． 38 SCID nude mice（transplanted host）were equally divided into two groups，and the thawed human ovarian tissues from the two groups were transplanted to jugular subcutaeous. The day of transplanted host received ovariectomy was defined as D0, while the day of human ovarian tissue transplanted defined as D21. The vaginal cytology examination of transplanted host was performed daily for observation of estrous cycle until D63. The levels of serum AMH on D0, D21, D42 and D63 were measured using ELISA. Results: The estrous cycle of the ovariectomy mice disappeared. A total of 14 transplanted hosts in two groups recovered the estrous cycle up to D63，and there was no significant difference between the two groupｓ （８ in the group A and 6 in the group B, P＞0.0５）． However, the recovering time of the estrous cycle in the group A was significantly shorter than that in the group B [(16.38±1.60) d vs. (18.33±1.21)d, P＜0.05]． There were no significant differences in the AMH levels on D0, D21, D42 and D63 between the two groupｓ （Ｐ＞0.05）． The AMH level on D21 was significantly lower than that on D0 in the group A or B (all P<0.05). The AMH level in those transplanted hosts who had recovered estrous cycle on D42 and D63 was recovered but did not return to the level on D0, while the AMH level in the transplanted hosts who had not recovered their estrous cycle on D42 and D63 did not rebound and was still significantly lower than that on D0. Conclusions: Both the programmed freezing and the vitrification freezing can effectively preserve ovarian tissue. Related Articles | Metrics

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Influence of Chromosomal Polymorphism on Clinical Outcomes of Assisted Reproduction GUO Yu-ying, DAI Fang-fang, ZHENG Bo, GUO Ying, ZHAO Hui-xia 2018, 37 (4):  288-291.  Abstract ( 1189 )   PDF (735KB) ( 8585 )    Objective：To explore the relationship between chromosomal polymorphism of the infertile couples and the outcomes of IVF/ICSI-ET. Methods: The chromosome karyotype analysis of 1 318 infertile couples received IVF/ICSI-ET was performed in our center from September 2015 to November 2016. The couples with either male or female chromosome polymorphism were enrolled as the study group，while the couples with normal chromosome karyotypes were served as the control group. The outcomes of IVF/ICSI-ET of two groups were compared. Results: The occurrence of miscarriage history in the study group was significantly higher than that in the control group (24.64% vs. 15.65%, P=0.007). The rate of high-grade blastocysts in the male polymorphic couple was significantly lower than that in the woman′s chromosomal polymorphism (18.11% vs. 29.03%, P=0.016) or the control group (18.11% vs. 23.81%, P=0.017). Conclusions: The infertile couples with chromosomal polymorphism have higher rate of previous miscarriage history, and the embryos from male chromosomal polymorphism  might have relatively low development potential. However, their outcomes of IVF/ICSI-ET are similar to those with normal chromosome karyotypes. Related Articles | Metrics

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The Rate of Sex Chromosomal Mosaicism in Prenatal Diagnosis and Clinical Outcomes LI Xian-zheng，XU Ling，HU Jing-jing，LIU Yuan，LI Xing 2018, 37 (4):  292-296.  Abstract ( 2636 )   PDF (784KB) ( 8737 )   Objective：To analyze the rate of sex chromosomal mosaicism in our prenatal diagnosis at the second trimester, and the pregnant outcomes of those fetuses with sex chromosomal mosaicism. Methods: The data of prenatal diagnosis by the karyotype analysis of amniotic fluid, from January 2016 to December 2017, were retrospectively analyzed. The pregnant outcomes of 35 fetuses with sex chromosomal mosaicism were then analyzed. Results: The detection rate of sex chromosomal mosaicism was 0.34% (35/10 341), including three types of mosaicism: mos 45,X/46,XX (17); mos 45,X/46,XY (8); 45,X and other abnormal karyotype mosaic (10). In those cases of sex chromosomal mosaicism, the indications of prenatal diagnosis were the numerical abnormality of sex chromosome by NIPT, the high risk by Down screening, abnormal ultrasound and the advanced maternal age, in which their rates of pregnant termination were 86%(12/14), 83%(5/6), 75%(6/8) and 29%(2/7). Conclusions: It is necessary to confirm further the prenatal diagnosis of sex chromosomal mosaicism by CMA, FISH or the cord blood karyotype analysis as well as ultrasound, so as to provide the scientific and effective reference for prenatal genetic counseling. Related Articles | Metrics

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Analysis of Karyotype in 273 Couples with History of Aneuploidy Children ZHUANG Jian-long，ZENG Shu-hong，JIANG Yu-ying，ZHUANG Qian-mei，WANG Geng，WANG Yuan-bai 2018, 37 (4):  297-299.  Abstract ( 1268 )   PDF (872KB) ( 8660 )   Objective：To analyze the karyotype in those couples who had one or more aneuploidy children. Methods：The G-banding was used to analyze the chromosome karyotype in 273 couples with the history of aneuploidy children (the test group) and 116 normal couples (the control group). The C-banding was also used if necessary. Results：In the test group, there were 72 chromosomal abnormalities including 4 structural abnormalities(the detection rate 1.46%), and 68 chromosome polymorphisms (the detection rate 24.91%). The detection rate of chromosome polymorphisms  was 25.10% (64/255) if excluding those samples from ageing women. In the control group, only one structural abnormality was found, and 5 chromosome polymorphisms were found (the detection rate 4.31%). There was significant difference in the detection rate of chromosome polymorphisms between the two groups (P＜0.05). Conclusions：There was a higher rate of chromosomal polymorphisms in those couples with the history of a or more aneuploidy children, suggesting us to pay more attention to the karyotype of those couples. Related Articles | Metrics

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Effect of Low-Molecular-Weight Heparin on Pregnancy Outcomes in Patients with Preeclampsia History LI Sai, GUO Zhen, ZHOU Huan-huan 2018, 37 (4):  300-302.  Abstract ( 1204 )   PDF (703KB) ( 8603 )   Objective：To investigate the effect of different doses of low-molecular-weight heparin on the pregnancy outcomes in those patients with preeclampsia history. Methods：The clinical data of 96 cases of re-pregnancy with preeclampsia history in our hospital were retrospectively analyzed. All patients were preventively treated with low-molecular-weight heparin, including 42 cases of group A (the low dose group, low molecular-weight-heparin calcium 2 500 U), 54 cases of group B (the high dose group, low-molecular-weight heparin calcium 5 000 U). The pregnancy outcomes, the blood coagulation function and renal function between the two groups were compared. Results：The pregnancy times of re-pregnancy in the two groups were longer than those of the previous pregnancy, and the incidences of severe complications were also significantly lower (both P＜0.05). However, there was no significant difference in the intrapartum and postpartum 24 h bleeding volume, when compared the re-pregnancy with the previous pregnancy (P＞0.05). There were no significant differences in pregnancy time, intrapartum and postpartum 24 h bleeding volume of re-pregnancy or the previous pregnancy, and the rates of severe complications, when compared between the two groups (P＞0.05). There was no significant difference in the incidence of preeclampsia between the two groups (16.67% vs. 22.22%, χ2=0.459，P=0.497). The rates of fetal growth restriction and neonatal asphyxia of re-pregnancy were lower than those of the previous pregnancy in the two groups, the rate of neonatal survival of re-pregnancy was higher than those of the previous pregnency (P＜0.05). There was no significant difference in perinatal outcome between the two groups (P＞0.05). There were no significant difference in PT, APTT, FIB, BUA and SCr between the two groups (P＞0.05). It was noteworthy that the 24 h urinary protein in the group B was significantly lower than that in the group A (P＜0.05). Conclusions：Prophylactic use of low-molecular-weight heparin improves maternal and perinatal outcomes of re-pregnancy in those women with preeclampsia history. The higher dose of low-molecular-weight heparin can be advised so as to lower the 24 h urinary protein. Related Articles | Metrics

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Long Noncoding RNAs in Polycystic Ovary Syndrome HE Jun-jian，MA Xiao-xin 2018, 37 (4):  303-306.  Abstract ( 1213 )   PDF (740KB) ( 8571 )   Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disease, but its pathogenesis is still not very clear. Long noncoding RNAs (lncRNAs) are a class of non-coding RNAs with more than 200 nucleotides in length. Some sequencing studies found the differential expression of lncRNAs in the peripheral blood leukocytes, cumulus and granulosa cells of PCOS patients, such as CTBP1-AS, steroid receptor RNA activator (SRA), lncRNA-low expression in tumor (lncRNA-LET) and growth arrest specific 5 (GAS5), etc. Further studies found that these differentially expressed lncRNAs may be involved in steroid production, steroid receptor activity, obesity and insulin resistance (IR), the proliferation, migration and apoptosis of granulosa cells, and the development of oocytes. All of these pathophysiological mechanisms are related to PCOS pathogenesis and developemnt. Here we review the research progress of lncRNAs in PCOS, in order to provide new ideas for the study and treatment of PCOS. Related Articles | Metrics

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Relationship Between Gut-Brain Axis and Polycystic Ovary Syndrome WEN Qi-dan, HUANG Shi-ya, LI Juan, MA Hong-xia 2018, 37 (4):  307-311.  Abstract ( 1233 )   PDF (797KB) ( 8622 )   Polycystic ovary syndrome (PCOS), a common endocrine disorder, is often accompanied by hyperandrogenemia, ovulatory disorder,  insulin resistance and obesity. In recent years, a large number of studies have found that obesity is closely related to PCOS, and that more than 60% of PCOS patients are overweight or obese. The regulation of appetite and energy intake is very important for maintaining energy balance and body weight. The gut-brain axis is a two-way communication system between the gut bacteria and the brain. Gastrointestinal system can be involved in the gut-brain interaction by producing brain-gut peptide, mainly includes the ghrelin, GLP-1, CCK and PYY. In addition, the changes of gut microbial and its interaction with the gut-brain axis may be involved in the pathogenesis of PCOS. This paper focuses on the possible mechanism of the gut-brain axis involved in the pathogenesis of PCOS, and the related and potential treatment methods of PCOS. Related Articles | Metrics

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Application of N-acetyl-L-cysteine in Polycystic Ovarian Syndrome WANG Yang，LU Chao-yi，QIAN Yun，WANG Hui 2018, 37 (4):  312-316.  Abstract ( 1744 )   PDF (798KB) ( 8587 )   Polycystic ovary syndrome (PCOS), one of the most common endocrine disorders and one of the leading causes of female infertility, was characterized by oligo-ovulation, anovulation and hyperandrogenism. In addition, PCOS is a risk factor of endometrial hyperplasia, type II diabetes, hypertension and dyslipidemia. Treatment with metformin (MTF) is effective to PCOS patients. However, there are gastrointestinal side effects, hypoglycemia and the increased level of serum homocysteine in some PCOS patients treated with MTF for long term. N-acetyl-L-cysteine (NAC) is an acetylated variant of L-cysteine containing sulfhydryl groups. It has been showed that NAC can decrease the levels of serum androgen and free testosterone, decline the insulin resistance, work as an euglycemic agent, decrease the level of reactive oxidative stress (ROS) in body, and eventually play a role in ovulation induction in women with PCOS. In recent years, more and more studies have showed that NAC could have some supportive curative efficacy in PCOS patients. Here we review the role and mechanism of NAC in the treatment of PCOS. Related Articles | Metrics

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Immune Factors of Premature Ovarian Failure ZENG Fu-ling，SUN Wei-feng 2018, 37 (4):  316-319.  Abstract ( 1273 )   PDF (721KB) ( 8609 )   In recent years, the incidence of premature ovarian failure (POF) has been increasing year by year. It is well known that POF affects the life quality and fertility of those women of childbearing age. However, the causes of POF are complex, and the main factors are classified as iatrogenic factors, environmental factors, genetic factors, infectious factors, and immune factors, etc. A large number of POF cases were reported in patients with autoimmune diseases. The level of serum transforming growth factor β1 (TGF-β1) was decreased in patients with POF orrheumatoid arthritis, while the levels of inflammatory factors interleukin 21 (IL-21), IL-6 and IL-17 were increased. It was reported that those cytokines and inflammatory factors were involved in the follicular development and atresia. The diagnosis of autoimmune-related POF is based on the discovery of autoimmune antibodies and the combined autoimmune diseases. Interestingly, there is high similarity in the expression profile of those factors between POF and autoimmune diseases. Whether autoimmune-related POF has a common mechanism with autoimmune diseases needs more study. Related Articles | Metrics

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Functions and Research Progress of F-box Proteins in Ovary ZHAO Fei-yan, YANG Xiao-kui 2018, 37 (4):  320-323.  Abstract ( 1342 )   PDF (709KB) ( 8613 )   F-box proteins, a family of proteins widely distributed in the prokaryote and eukaryote, are involved in the regulation of fundamental biological progresses such as cell cycle control, apoptosis induction, cellular signal transduction, tumorigenesis, etc through ubiquitin proteasome system (UPS). Recent years, several studies have shown that there exist many kinds of F-box proteins in ovarian tissue. Disfunction of F-box proteins can result in reproductive and endocrine problems and diseases, such as follicular maldevelopment, premature ovarian failure and even ovarian cancer. With the research progress on intracellular ubiquitination, more and more mechanisms of F-box proteins related to ovarian function have been revealed, which may provide new treatment options for some ovarian diseases. This review briefly summarized the functions and research progress of F-box proteins in ovary. Related Articles | Metrics

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The Application of Growth Hormone and Dehydroepiandrosterone in Patients with Poor Ovarian Response: A Review HONG Bao-li, ZHOU Ping 2018, 37 (4):  324-328.  Abstract ( 1201 )   PDF (783KB) ( 8581 )   Poor ovarian response (POR) is the pathological state in which the response of ovaries to gonadotropin (Gn) stimulation is poor during the controlled superovulation (COH). With the development of society, women′s childbearing age postponed generally, and the "two-child policy" liberalized, the number of advanced women who want to have children has been increasing year by year. It is true that the incidence of POR is higher in women aged over 40 years. How to solve the fertility problem of POR patients is a hot topic in the field of assisted reproduction. Growth hormone and dehydroepiandrosterone have been tried as a pretreatment of Gn in those POR patients, which may improve the clinical outcomes of assisted reproductive technology. This article reviews the research progress of the clinical application of growth hormone and dehydroepiandrosterone in POR patients as a pretreatment of Gn. Related Articles | Metrics

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The Safety of Putrescine in Reproduction GAN Dong-ying, HU Yan-qiu 2018, 37 (4):  328-331.  Abstract ( 1323 )   PDF (719KB) ( 8585 )   Putrescine, a kind of diamine, widely exists in animal body and food. Putrescine plays a series of physiological and pathological roles by the interaction with DNA, RNA, ligands and membrane proteins. The level of putrescine is increased in the reproductive organs during pregnancy. It has been showed that putrescine is closely related to spermatogenesis, sperm movement, follicular development and ovulation. The effects of putrescine in aging women are included as follows: the reduced aneuploidy rate, the improved ooplasm maturation and oocytes antioxidant function. Putrescine is also related to the function of early placenta and the development of embryos, fetuses and infants. It is true that the level of putrescine must be regulated by dynamic equilibrium. If the level of putrescine exceed the certain range, or imbalanced, putrescine will be harmful. Although putrescine has been tried in the assisted reproductive process of animals, its safety is not clear enough. This paper outlines the safty, pharmacokinetics, genotoxicity and carcinogenicity of putrescine in the target organs, reproductive processes and embryo development, as a reference for the clinical trial of human natural and assisted reproduction in future. Related Articles | Metrics

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Immunological Etiology of Recurrent Implantation Failure WANG Kang-xia, JIANG Huan-huan, XU Yu-ping, CAO Yun-xia 2018, 37 (4):  332-337.  Abstract ( 1309 )   PDF (804KB) ( 8285 )   The definition of recurrent implantation failure (RIF) usually refers to failure to achieve a clinical pregnancy after going through at least three fresh/frozen cycles or transfer of at least four good-quality embryos in a woman under the age of 40 years. Embryo implantation is a complex process of the recognition and fusion between mater and fetus. On one hand, embryonic trophoblasts can express embryonic antigen and secrete cytokines in order to escape the attack of maternal immune system. On the other hand, the specialized immune cells of maternal decidua are enriched to develop a unique immune microenvironment at maternal-fetal interface. Both of them are beneficial for embryo implantation. Any immunologic disorder of the maternal-fetal interface during implantation may lead to implantation failure. With the development of reproductive immunology, the role of immune factors in the establishment of endometrial receptivity has been paid more and more attention, and the use of immunomodulators to improve the pregnancy outcome of RIF has been reported. In this paper, we described the recent research progress in immunological etiology of RIF and the related therapy. Related Articles | Metrics

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Effects of Circadian Gene Bmal1 on Early Spontaneous Abortion XU Dan, WANG Yu-xia, ZUO Meng, ZHANG Wen-qian 2018, 37 (4):  338-341.  Abstract ( 1220 )   PDF (723KB) ( 8505 )   Brain and muscle arnt-like 1 (Bmal1) as one of the core genes of the clock geneis mainly expressed in the female reproductive system. The circadian rhythm of Bmal1 expression is involved in estrous cycle, ovulation, implantation, and the maintenance of pregnancy. The changed expression of Bmal1 is related to spontaneous abortion, possibly by a variety of mechanisms. Down-regulation of Bmal1 expression can decrease the expressions of matrix metalloproteinase 2/9 through SP1-DNMT1/DAB2IP pathway, which followed by the inhibition of trophoblast migration and invasion. The deletion of Bmal1 gene interferes with the transcription and translation of steroid synthesis-related genes in ovarian granulosa cells, which affects the secretion of pregnancy-related hormones and promotes the apoptosis of granulosa cells through PI3K/Akt/mTOR signaling pathway. The decreased expression of Bmal1 gene can cause the increased reactive oxygen species in ovary and fallopian tube, which can reduce oocyte fertilization, early embryo development and implantation potential, and eventually lead to embryo loss. In this article, the influence of Bmal1 on early spontaneous abortion was reviewed. Related Articles | Metrics

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Sperm Metabolism and Male Infertility PENG Yuan-hong, DING Zhi-de 2018, 37 (4):  342-346.  Abstract ( 1334 )   PDF (747KB) ( 8567 )    A variety of metabolism-related courses are involved in spermatogenesis and sperm maturation. Any metabolic abnormality will damage the sperm motility and fertilization, which eventually leads to male infertility. For example, the oxidative stress caused by the excessive production of reactive oxygen in sperm impairs the sperm motility and capacitation. In clinic, the metabolic profiling of seminal plasma in the infertile patients was different from that in the normal male, suggesting the abnormality of sperm development and maturation. This study indirectly showed that there is a potential relevancy between the abnormal metabolism of sperm and male infertility. In this review, we discussed sperm metabolism and the related pathways, sperm metabonomics and tests, the relationship between sperm metabolism and sperm motility, and male infertility. Related Articles | Metrics

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Possible Application of Raman Spectroscopy Detection in Assisted Reproduction LI Ru-nan, FEI Jia, GUO Xing-dao, SHEN Li-xia, ZHANG Gui-rong 2018, 37 (4):  347-352.  Abstract ( 1277 )   PDF (790KB) ( 8707 )   Assisted reproductive technology (ART) is the most effective therapy for those infertile couples. In ART therapy such as IVF/ICSI-ET, both sperm and egg should be treated and fertilized in vitro. The fertilized ovum was then cultured in vitro, and the high-quality embryo was singled out for transfer. Therefore, it is very important how to evaluate the quality of sperm, egg and pre-transfer embryos. Raman spectroscopy is a non-damage detection method with the characteristics of speedliness, high sensitivity and accuracy, because the target object is not previously treated and marked. Raman spectroscopy has been used in the rapid detection of damage of biological macromolecule such as protein, nucleic acid and lipid in recent years. There are three kinds of Raman spectroscopy technologies: surface-enhanced Raman spectroscopy, confocal Raman spectroscopy and Fourier transform Raman spectroscopy. This article briefly discussed the characteristics of Raman spectroscopy and the possible application in ART for the evaluation of quality of semen, ovum and embryo, which provided us a reference for the clinical application in future. Related Articles | Metrics