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15 July 2019, Volume 38 Issue 4
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Pregnancy Outcomes of IVF-ET in Women Aged More Than 40 Years XIA Meng，DONG Juan，MA Long，WU Chun-xiang，CAI Ling-bo，LIU Jia-yin 2019, 38 (4):  269-275.  Abstract ( 1516 )   PDF (1100KB) ( 9480 )   Objective：To investigate the pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) therapy in women aged ≥ 40 years, so as to provide a clinical reference for the fertility counseling the individualized assisted reproductive treatment (ART) for those ageing women. Methods：The clinical data of 2 467 women aged 40 and older years who used autologous oocytes in ART cycles between January 2015 and December 2017 in our center were retrospectively analyzed. Results：In the IVF-ET cycles, the retrieved oocytes were decreased with increased age in women aged ≥40 years (the average retrieved oocytes in women aged 40-48 years were 2.97, 2.69, 2.17, 2.01, 1.77, 1.61, 1.68, 1.29 and 1.00; when compared the 44-48 years′ group and the 40-43 years′ group, P＜0.05). In particular, the embryo development potential was decreased significantly, especially in women aged ≥44 years (the percentage of blastocyst formation in women aged 40-48 years were 48.90%, 43.72%, 33.67%, 34.29%, 24.39%, 21.14%, 26.32%, 16.67%, and 0%; when compared the 44-48 years′ group and the 40-43 years′ group, P＜0.05). There were a total of 518 cases with fresh embryo transfer cycles. The clinical pregnancy rate (in women aged 40-48 years, were 26.92%, 21.15%, 20.79%, 10.96%, 18.87%, 11.11%, 5.88%, 0% and 0%; when compared the 43-48 years′ group and the 40-42 years′ group, P＜0.05), the implantation rate (in women aged 40-48 years, were 23.65%, 19.51%, 17.70%, 8.54%, 7.49%, 10.81%, 5.56%, 0% and 0%; when compared the 43-48 years′ group and the 40-42 years′ group, P＜0.05) and the live-birth rate (in women aged 40-46 years, were 18.46%, 10.58%, 9.90%, 5.48%, 5.66%, 2.78%, and 5.88%; when compared the 43-46 years′ group and the 40-42 years′ group, P＜0.05) were decreased with age, while these parameters in women aged over 43 years were worse. The abortion rate was increased significantly in women aged ≥44 years (in women aged 40-45 years, were 31.43%, 50.00%, 52.38%, 50.00%, 70.00%, and 75.00%; when compared the 44-45 years′ group and the 40-43 years′ group, P＜0.05), while there was only one case of pregnancy and delivery in all woman aged 46 years, and no successful pregnant case in those women aged 47 and 48 years. The pregnancy rate, implantation rate and live birth rate in the AMH≤1.0 ng/mL group were significantly decreased than those in the AMH＞1.0 ng/mL group (27.04% vs. 14.74%, 22.99% vs. 13.50%, and 15.88% vs. 7.37%; all P＜0.05), while the abortion rate was increased significantly (41.27% vs. 50.00%, P＜0.05). Conclusions：The fertility was declined gradually with the increased age in women aged ≥40 years. It is still worthy to do ART in women aged 40 43, especially in women with potential ovarian reserve (AMH＞1.0 ng/mL). However, in principle, ART treatment should not be recommended for women aged over 44 years, and oocytes donation or adoption should be strongly recommended for those women aged over 46 years and with the exhausted ovarian function. Related Articles | Metrics

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Cytomegalovirus Infection and the Outcome of IVF-ET LI Chu-yu，CAI Ling-bo，ZENG Qiao，LIU Jia-yin 2019, 38 (4):  276-278.  Abstract ( 1489 )   PDF (735KB) ( 9152 )   Objective：To investigate the effect of cytomegalovirus (CMV) infection on the pregnancy outcomes of IVF/ICSI treatment. Methods：The data of 59 536 patients who underwent ART treatment in our center between August 2005 and January 2018 were retrospectively analyzed. These patients were divided into two groups: the CMV IgG positive group (n=94) and the CMV IgG negative group (n=26 483). The pregnancy outcomes were compared accordingly. Results：There were no significantly differences in the age, infertile duration, body mass index, base level of FSH between the two groups (all P＞0.05). The number of retrieved oocytes, the number of 2PN after IVF, the rate of biochemical pregnancy, and the rate of clinical pregnancy in the CMV IgG positive group were significantly lower than those in the CMV IgG negative group (all P＜0.05). Conclusions：The number of retrieved oocytes, the number of 2PN after IVF, the rate of biochemical pregnancy, and the rate of clinical pregnancy could be lowered in those patients with the history of CMV infection. The CMV positive infection may affect the clinical outcomes of IVF/ICSI treatment. Related Articles | Metrics

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Clinical Analysis of 12 Cases of Twin Pregnancy and Selective Fetal Reduction During Second Trimester XU Yu-ping，JIANG Xiao-hua，YUAN Jing，FANG Hui-qin，YANG Meng-nan，XING Qiong，WEI Zhao-lian，CAO Yun-xia 2019, 38 (4):  279-282.  Abstract ( 1682 )   PDF (751KB) ( 9203 )   To investigate the safety, effectiveness and the influence factors of selective reduction during the second trimester in patients with twin pregnancy. We retrospectively analyzed the data of 12 patients with twin pregnancy who conducted the selective reduction during their second trimester. Each case was due to the structure or chromosomal abnormalities in one of two fetuses. Conditions during the surgery, gestational complications, obstetric outcomes and neonatal conditions after the surgery were assessed. All the patients were successfully conducted the selective reduction. Among the 12 patients, 4 cases had term birth baby, 3 cases had preterm birth baby, 1 case had late abortion but fetal survival, 1 case had a miscarriage and 3 cases had unbroken gestation. The average gestational weeks in those who had delivered babies (3 cases were caesarean section and 5 cases were natural delivery) were 34+1. The mean weight and height of the neonates were (2 290.00±963.52) g and (44.88±6.01) cm. No defects were found in the newborn babies. In conclusion, the selective reduction during the second trimester is safe for those patients with coexisted abnormal and normal fetus. This operation will reduce the maternal and fetal complications, as well as prevent effectively the birth of babies with congenital defect. Related Articles | Metrics

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Needs & Demands of Management and Health Care for Middle-Aged and Elder Women with Menopause Syndromes 2019, 38 (4):  283-286.  Abstract ( 2324 )   PDF (774KB) ( 10933 )   Objective：To investigate the demand of treatment and health care of menopausal syndrome in middle-aged and old women, and the menopause-related knowledge, so as to provide the scientific guidance for the clinical health care of menopause. Methods：A stratified random cluster sampling was used to select women aged 40 to 60 years in Tianjin, to conduct a questionnaire survey. Results：A total of 2 400 eligible women were investigated in this study, and 2 018 eligible questionnaires were collected (the eligible rate, 84.08%). Of the 2 018 women interviewed, 1 212 were naturally menopausal, with an average age of (49.73±3.53) years. A survey of 1 623 cases of menopausal transition, early and late menopause showed that 9.61% (156/1 623) of women were receiving the treatment of menopausal syndrome, 69.23% (108/156) of whom received traditional Chinese medicine, and only 9.62% (15/156) received hormone therapy. 42.27% (686/1 623) women thought that menopausal syndrome needed treatment, 72.01% (494/686) of them tended to be treated with traditional Chinese medicine, but not with hormone alone. 65.06% (1 056/1 623) women received the education on menopause-related health knowledge, 61.27% (647/1 056) women got health knowledge from the media, 15.53% (164/1 056) women from medical institutions. Totally, 66.67% (1 082/1 623) women wanted to know about the health care-releted knowledge. Conclusions：Middle-aged and old women are eager to know about menopause. However, the professional guidance from medical institutions is insufficient. Compared with hormone replacement therapy, traditional Chinese medicine therapy has a higher acceptance in Chinese women. References | Related Articles | Metrics

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Tubo-Ovarian Abscess with Hypothyroidism, Misdiagnosed as Ovarian Cancer: A Case Report MA Shuai，WANG Min，YANG Chao，GUO Yu-jing，WANG Hui-fei，JIA Zan-hui 2019, 38 (4):  287-289.  Abstract ( 1732 )   PDF (771KB) ( 9240 )   Tubo-ovarian abscess (TOA) is one of the most serious pelvic inflammatory diseases in women. The early manifestation of the disease is fever. With the progress of the disease, it gradually evolves into acute abdomen. The severity of clinical manifestations in patients with hypothyroidism depends on the duration and severity of thyroid hormone deficiency. Severe patients may suffer from chronic diseases such as emotional and cognitive impairment, cardiac enlargement, intestinal obstruction, malignant anemia, coelomic effusion and metabolic disorders. When TOA and hypothyroidism occur together in a patient, it is easy to be misdiagnosed as the advanced ovarian malignant tumor. In this paper, we report a case of TOA combined with hypothyroidism that was misdiagnosed as malignant ovarian tumor, in order to improve the understanding, diagnosis and treatment of this complex disease. Related Articles | Metrics

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Outcomes of Multiple Pregnancy in A Couple Carried Maple Syrup Urine Disease Gene: A Case Report and Literature Review CHEN Juan，ZHANG Yan，DONG Qu-long，SHI Hai-xia 2019, 38 (4):  289-292.  Abstract ( 1451 )   PDF (762KB) ( 9185 )   Maple syrup urine disease, a rare hereditary disease, is due to the lack of branched-chain α-ketoaciddehydrogenase complex caused by abnormal gene expression. It occurs mostly in neonates or infants, and brain is the main organ involved, often manifested as mental or neurological symptoms. Severe cases can cause death of children. The clinical treatment is extremely difficult. Therefore, this disease seriously affects the outcomes of women reproductive health. This paper reports the outcomes of multiple pregnancy in a couple who both carried maple syrup urine disease gene, while reviews the literatures related to maple syrup urine disease. The discussion of the etiology, pathogenesis, clinical manifestations, diagnosis and treatment of the disease is very useful for us to broaden the vision, to be alert to this disease in future, and to do the early genetic testing and accurate genetic counseling for suspicious pregnant women in clinical work. Related Articles | Metrics

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Re-Pregnancy after Tubal Sterilization：Two Cases′ Report and Literature Review LIU Hong-qing，RAN Li-wei，DONG Qu-long，ZHANG Yan，LI Xu，SHI Hai-xia 2019, 38 (4):  293-295.  Abstract ( 1328 )   PDF (697KB) ( 9091 )   Tubal sterilization is one of the most commonly used and long-term contraceptive methods for women, including bilateral salpingectomy, tubal occlusion and tubal ligation. These procedures with own characteristics can be implemented in the laparoscopic, hysteroscopic or surgery way. Among these procedures, salpingectomy has the irreversibility of fallopian tube reconstruction with a remarkable contraceptive effect, while tubal occlusion and tubal ligation have the reversibility of fallopian tube reconstruction with a certain rate of contraceptive failure. The etilogical mechanisms of contraceptive failure are In this paper, we report two cases of re-pregnancy after tubal sterilization, and reviewed the tubal sterilization and contraceptive failure. In conclusion, the re-pregnancy after tubal sterilization should be alarmed and treated accurately. Related Articles | Metrics

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A Case Report of Complete Hydatidiform Mole in Twin Pregnancy after IVF-ET FANG Fang，GUO Zhe-xuan，LIAO Hui-hui 2019, 38 (4):  296-300.  Abstract ( 1390 )   PDF (3676KB) ( 9212 )   The clinical data of a pregnant woman with a complete hydatidiform mole after in vitro fertilization and embryo transfer (IVF-ET) were retrospectively analyzed. This patient was a twin pregnancy with a large amount of vaginal bleeding in the early stage of pregnancy. She had been initially misdiagnosed as threatened abortion due to the absence of typical manifestations of hydatidiform mole by B-mode ultrasonography. After one month of treatment, the diagnosis of twin pregnancy with a hydatidiform mole was made by the result of B-mode ultrasonography combined with the value of human chorionic gonadotropin (hCG). The uterine curettage was performed under the guidance of B-mode ultrasonography. Histopathological examination showed a partial hydatidiform mole, and chromosome examination showed a complete hydatidiform mole. After operation, with the treatment of traditional Chinese medicine, the level of hCG decreased significantly, and the patient did not report any symptoms in the follow-up. Prenatal diagnosis is extremely important for the diagnosis. The pathological diagnosis cannot be the diagnostic criteria for identifying complete moles and partial moles. For the treatment of a twin pregnancy with a hydatidiform mole, comprehensive consideration should be suggested. In principle, the pregnancy should be terminated in time for one partial hydatidiform mole of the twin, and the individualized diagnosis and treatment should be suggested for one complete hydatidiform mole of the twin. Related Articles | Metrics

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Preimplantation Genetic Testing in Technology: Present and Future CHEN Huan，WU Wei 2019, 38 (4):  300-304.  Abstract ( 1662 )   PDF (812KB) ( 9107 )   With the development of sequencing technology, preimplantation genetic testing (PGT) technology has been more widely used in assisted reproductive technology (ART). Comparing with traditional amniocentesis and villous biopsy, PGT as the earliest form of prenatal diagnosis can detect embryonic monogenic genetic diseases, chromosome structure and number abnormalities, gene locus mutations, and so on. PGTs can be used to obtain the genetic information of embryos, so that those embryos with congenital diseases can be avoided to transfer, such as the embryos with chromosomal defects or rearrangements. The clinical application guidelines and the committee opinion of the use of PGT have been published by many health organizations. With the discovery of DNA in blastocyst fluid and embryo culture media for gene analysis, noninvasive preimplantation genetic screening (NIPGS) is possible, and NIPGS has a broad application prospect in the field of assisted reproduction. In this paper, the progress of PGT, especially NIPGS, was reviewed, including advantages, disadvantages and its scope of application, so as to provide insights for the clinical. Related Articles | Metrics

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Influence of Phthalate and Wnt Pathway on Gametogenesis and Embryonic Development WANG Chen-xi，HUANG Qiao-yao，MA Tian-zhong 2019, 38 (4):  305-308.  Abstract ( 1161 )   PDF (812KB) ( 9078 )   Phthalates (PAEs) are widely used as additives in food, building materials, medical and other industries. Because PAEs are difficult to form strong covalent bonds, they will continue to leak into the environment and be absorbed during people's daily life. As a large class of environmental endocrine disruptors that disrupt reproductive endocrine, PAEs affect gametes and embryo development strongly. The factors of Wnt family participate in the regulation of tissue differentiation, growth and development via multiple mechanisms such as affecting gene expression and inducing cell proliferation. This paper reviews the biochemical character, endocrine disruption mechanisms and pollution conditions of PAEs, and the related Wnt signaling pathways that may affect gametes and embryo development. Related Articles | Metrics

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Reproductive Toxicity of Polyfluorinated Chemicals: A Mini Review MA Xue-qian，YE Ying-hui 2019, 38 (4):  309-312.  Abstract ( 1293 )   PDF (773KB) ( 9049 )   Polyfluorinated chemicals (PFCs) are a series of endocrine disruptors (EDCs) generated from industrial production and existing in environment of daily life. PFCs can be accumulated in animal tissues, and perform reproductive toxicity through different mechanisms such as disrupting steroidogenesis, inducing apoptosis of reproductive cells and acting as antagonism of hormone receptors. In male, PFCs were found to be associated with the decreased sperm quality and concentration, and the increased rate of sperm deformation, and to disturb sexual hormones such as testosterone. In female, PFCs increased in blood or follicular fluid were related to the decreased fertility. Moreover, the exposure to PFCs during pregnancy may affect the health and fertility of offspring. The molecular mechanisms of this kind of chemicals have been studied in many animal experiments. In conclusion, we should pay attention to the reproductive toxicity of PFCs. Related Articles | Metrics

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Sorbitol Metabolism Bypass and Reproduction LI Ling-jun，ZHANG Yue-xin，CUI Yu-gui 2019, 38 (4):  313-317.  Abstract ( 1204 )   PDF (823KB) ( 9080 )   The polyol pathway, one of the glucose metabolic pathways, is activated with the elevated level of blood glucose. The accumulated sorbitol and fructose, as well as the imbalanced oxidative stress, are closely related to many diseases when this pathway was highly activated. There are clear relationship between the highly-activated polyol pathway and diabetic complications such as diabetic ophthalmopathy, nephropathy and neuropathy. And the highly-activated polyol pathway can increase the ischemia/reperfusion (I/R) damage of heard or brain, cancer invasiveness, and the neuropathy of Alzheimer′s disease. In recent years, animal experiments showed that the sorbitol pathway also played some important roles in the reproductive system, such as spermatogenesis and sperm maturation, the inhibition of meiosis induced by hormones, and the regulation of mouse oocyte maturation. The sorbitol metabolism pathway and its research progress in reproduction were reviewed in this paper. Related Articles | Metrics

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Research Advances on the Role of Zinc Transporter in Male Reproduction SHI Lei，JIANG Chen-yi，WU Wang-shu，ZHU Xin-ye，YU Cheng-xuan，LIU Yue，DING Zhi-de 2019, 38 (4):  318-322.  Abstract ( 1301 )   PDF (887KB) ( 9129 )   Zinc is a critical factor of sperm maturation. Zinc transfer is mediated by zinc transporters that are composed of two protein families, Zinc transporter (ZnT) and Zrt-, Irt-like protein (ZIP). In testis, Zinc transporters expressed on the membrane of germ cells participate in spermatogenesis and spermiogenesis. In addition, Zinc transporters are also involved in maintaining blood-testis barrier and testosterone biosynthesis. In epididymis, ZnTs expressed highly in epithelial tissues, and ZIP1, ZIP5, ZIP6 and ZIP8 distributed widely on the epididymal sperm surface, are contributed to the zinc absorption by sperm and sperm maturation. In prostatic epithelial cells, zinc is absorbed from blood via ZIP1 in order to maintain a high zinc level in prostate. On the other hand, zinc is reabsorbed from prostatic fluid via ZIP2, ZIP3 and ZIP4 to ensure the normal secretion of citrate, an important anti-oxidant. The role of zinc and zinc transporters in the male reproductive system was reviewed in this paper, which is helpful for us to understand male reproduction and male infertility. Related Articles | Metrics

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Progress of CircRNA in Female Reproductive System and Diseases ZHAO Hong-juan，JIANG Yuan-xin，WANG Yu 2019, 38 (4):  323-327.  Abstract ( 1171 )   PDF (794KB) ( 9043 )   With the development of RNA sequencing, cyclic RNA (circRNA) has been a research hot which is a member of the newly discovered RNA family. CircRNA is a kind of RNA with a special closed ring structure. Because of the special morphology, circRNA has some characteristics which are different from those of linear RNA. CircRNA is stable and conservative across species, and has tissue and cell specificity. CircRNA can act as the so-called microRNA (miRNA) sponge in the circRNA-miRNA-mRNA regulatory axis, regulating gene transcription and protein translation. Studies have found that the pathogenesis of female reproductive diseases may be closely related to the abnormality of circRNA. By studying the characteristics and mechanisms of various circRNA, circRNA may be used as a biomarker and prognostic indicator of disease in future. The article reviews the potential mechanisms of circRNA in female reproductive system and diseases. Related Articles | Metrics

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Effects of Activins on Ovarian Functions and Related Diseases LIU Chang，YANG Xiao-kui 2019, 38 (4):  328-331.  Abstract ( 1150 )   PDF (746KB) ( 9036 )   During the menstrual cycle, the ovarian function is maintained by a series of local growth factors and cytokines. Activin, an important member of the transforming growth factor-β (TGF-β) super family, is mostly produced by granulosa cells in the ovarian. Activin exerts its biological functions through the activin receptor-like kinase that activates SMAD signaling pathways or non-SMAD pathways. Activin plays an critical role in regulating ovarian functions through paracrine/autocrine signaling, including granulosa cells proliferation, follicular development and steroidogenesis. Besides, activin is associated with ovarian diseases. Abnormal expression of activins and their subunits was detected in ovarian cancer tissues which was implicated in the development of ovarian cancer. In addition, the imbalance between activins and their endogenous inhibitors may play an important part in the pathology of polycystic ovary syndrome (PCOS) and follicular dysplasia. This review summarized the regulatory effect of activins in ovarian function and related diseases. Related Articles | Metrics

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Etiology of Premature Ovarian Failure WU Jie-ying，HU Wei-hua 2019, 38 (4):  332-336.  Abstract ( 1169 )   PDF (893KB) ( 9071 )   Premature ovarian failure (POF) is an important cause of female infertility. However, the etiology and pathogenesis of POF is not very clear. Recent studies have shown that the etiological factors of POF include genetics, immune, iatrogenic and environmental factors. Genetic factor as an important factor of POF includes numerous abnormalities in chromosome number and structure as well as gene mutation. Immune factor may be due to the presence of antigens in ovaries or body fluids, so that antibodies produced in other parts of the body cause ovarian damage, or the abnormal hormone level caused by autoimmune diseases that may affect female endocrine. Iatrogenic factors of POF mainly include pelvic surgery history and postoperative chemoradiotherapy. In addition, some substances in the environment may damage the follicles and thus cause POF. Recent advances in the etiology of POF, especially in genetic and immunological factors, are reviewed so as to provide a useful reference for the treatment and prevention of POF. Related Articles | Metrics

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Application of Proteomics Analysis in Different Specimens of Recurrent Spontaneous Abortion ZHANG Wen-qian，WANG Yu-xia，ZUO Meng，XU Dan 2019, 38 (4):  337-340.  Abstract ( 1044 )   PDF (739KB) ( 8997 )   Recurrent spontaneous abortion (RSA) is a common disease, but the etiology can't be fully explained. It is need to explore more deeply at molecular level. With the wide use of a series of complex proteomics techniques, many body fluids and tissues have been used in the etiological study of RSA. In this paper, the proteomic studies of different body fluids and tissues including follicular fluid, placental villi, blood and endometrium of patients with RSA in recent years were reviewed. Through comparing the characteristics of common clinical specimens one by one, we believe that plasma and endometrium are more suitable for the proteomic study of RSA etiology. This review is helpful for us to understand objectively the application of proteomics in the etiological study and early diagnosis of RSA. Related Articles | Metrics

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Research Progress on the Relationship between Environmental Endocrine Disruptors and Polycystic Ovary Syndrome LI Chang，ZHANG Ning 2019, 38 (4):  341-344.  Abstract ( 1225 )   PDF (784KB) ( 9147 )   Environmental endocrine disruptors (EED) widely exist in daily life, as a kind of exogenous chemicals that can interfere with hormonal behavior. EEDs can bind to different receptors in the human body, to enhance or inhibit the normal endocrine function through a variety of mechanisms, resulting in a variety of diseases. The etiology of polycystic ovary syndrome (PCOS) is complex. Previous studies have shown that the pathogenesis of PCOS is related to environmental factors. The epidemiological and basic experiments showed that EEDs were involved in the pathogenesis of PCOS. However, it is necessary to study furtherly the potential mechanism. In this paper, the relationship between EEDs and PCOS, as well as possible mechanism, was expounded. It provides a new clue for those people to block the development of PCOS by improving their lifestyle. Related Articles | Metrics

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Gut Microbiome and Endometrial Cancer WANG Yu-shan，MA Xiao-xin 2019, 38 (4):  345-348.  Abstract ( 1246 )   PDF (748KB) ( 9105 )   The intestinal flora (gut microbiome) perform many of the physiological functions required for host, such as the protection against invading pathogen, regulation of metabolism and development, maintain the homeostasis of immunity and the nervous system. Although the gut microbiome was influenced by age, diet, physical activity, hormonal cycles, antibiotics and radiotherapy, it is practically stable in healthy adults. In recent years, studies showed that many changes in the composition of gut microbiome were connected with the development of malignant tumor and other diseases such as inflammatory bowel disease, hypertension, polycystic ovary syndrome, obesity, diabetes, colorectal cancer, breast cancer and so on. It has been reported that endometrial cancer is associated with polycystic ovary syndrome, obesity, insulin resistance, hypertension, high estrogen level and age, while the destruction of gut microbiome homeostasis promotes the development of obesity, hypertension, polycystic ovary syndrome and high estrogen level. Therefore, there is a potential relationship between gut microbiome and endometrial cancer. In this review, we briefly summarize those studies on the gut microbiome in patients with endometrial cancer and discuss the possible mechanisms of tumorigenesis, so as to provide a reference for the future study on the diagnostic, therapeutic and prognostic strategies of endometrial cancer. Related Articles | Metrics

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Research Progress of Neoadjuvant Chemotherapy for Advanced Ovarian Cancer HU Dan，WANG Xin，ZHANG Jia-jun，YANG Yong-xiu 2019, 38 (4):  349-352.  Abstract ( 1170 )   PDF (770KB) ( 9004 )   Ovarian cancer is one of the three most common malignant tumors of female reproductive system. Because the ovary is located in the deep of pelvic cavity, and the onset of ovarian cancer is insidious, about 70%-75% of patients have reached the advanced stage when they have clinical symptoms, with the 5-year survival rate being less than 40%. Currently, the main treatment methods for ovarian cancer include surgery, chemotherapy, radiotherapy and biological immunotherapy. To improve the success rate of reducing and removing tumor cells of advanced ovarian cancer (AOC), the pelvic abdominal lymph nodes and metastasis are also cleanout in conventional surgery, besides removing uterus and annex. The surgical injury and complications are foreseeable. Therefore, 2-3 courses of neoadjuvant chemotherapy before surgery can be firstly administrated in those patients with poor general condition and many complications, patients with AOC at the stageⅢ C and Ⅳ confirmed by cytology, patients with the poor reduction rate of tumor cells underwent first conventional surgery, and those patients who are unsuited for immediate surgery due to their poor health condition. However, there is not a consensus on the application of neoadjuvant chemotherapy in the patients with AOC. In this review, we discuss the research progress of neoadjuvant chemotherapy and its clinical practice in patients with AOC. Related Articles | Metrics