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15 September 2019, Volume 38 Issue 5
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The Influential Factors on Clinical Outcomes of Artificial Insemination with Donor Sperm NI Li-li，WANG Jing，ZHANG Yan，DIAO Fei-yang，MA Xiang，LIU Jia-yin 2019, 38 (5):  357-361.  Abstract ( 2382 )   PDF (854KB) ( 11006 )   Objective：To investigate the influential factors on the clinical outcomes of artificial insemination with donor sperm (AID). Methods: The data of 4 067 AID cycles from 1 810 couples between January 2012 and April 2017 were retrospectively analyzed, to investigate the effects of women′s age, female infertility factors, therapeutic regimen, insemination timing and the numbers of treatment cycle on the AID outcomes. Results: ①Both clinical pregnancy rates and live birth rates were decreased with women′s age (both P＜0.05).②Women with ovulation failure, postoperative pelvic endometriosis or pelvic inflammatory disease had comparable clinical outcomes to those infertile women with pure male factors of husbands (all P＞0.05）. ③There were no significant differences in clinical pregnancy rate, abortion rate or live birth rate among natural cycle, clomiphene cycle, letrozole cycle and pure Gn cycle (both P＞0.05), while the rates of multiple pregnancy in clomiphene and letrozole cycle were significantly higher than that in natural cycle (both P＜0.001). ④Insemination before or after ovulation didn′t affect the clinical outcomes of AID in both natural cycle and ovulation induction cycle (both P＞0.05). ⑤Both cumulative pregnancy rate and cumulative live birth rate were significantly increased with the numbers of treatment cycle within the first 4 cycles (both P＜0.05), but no longer increased visibly since the fifth cycle (both P＞0.05). Conclusions: Women′s age was an important factor of the success of AID. We found in this paper that other factors of female infertility and insemination timing could not significantly affect the clinical outcomes of AID. IVF treatment should be considered for those women who did not get pregnancy after 3 or 4 AID treatment cycles, or those women aged over 40 years. Related Articles | Metrics

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Analysis of Gene Mutation in Children with Methylmalonic Acidemia Complicated with Homocysteinemia JIA Li-yun，FENG Ji-zhen，WANG Xi，MA Cui-xia，FENG Lu-lu 2019, 38 (5):  362-366.  Abstract ( 2608 )   PDF (1018KB) ( 10704 )   Objective：To analyze the mutation type and mutation frequency of methylmalonic acidemia and homocystinemia in children, and to explore the relationship between genotype and phenotype. Methods: A total of 113 810 newborns in Shijiazhuang city were screened for acylcarnitine spectrum by tandem mass spectrometry, and analyzed by gas chromatography-mass spectrometry (GC-MS) and vitamin B12 absorption test. The MMACHC and HCCFC1 gene mutations were analyzed using second-generation sequencing technology, and further characterized using Sanger sequencing. Results: 25 newborns with methylmalonic acidemia were diagnosed, of which 11 cases were genetically tested, 3 cases were of MMA simple type and 8 cases combined type. A total of 11 gene mutation sites were detected, of which 8 mutation sites have been reported: C.666C＞A, C.482G＞A, C.656_658delAGA, c.609G＞A, C.80A＞G, C.394C＞T, C.440_441del and C.599G＞A. 3 novel mutations sites were identified: C.239A＞G, C.4535A＞T and C.4442C＞T. The mutation frequency analysis showed that C. 482G＞A was more common, and mutation frequency was 0.25. The follow-up visit showed that 1 case of 8 patients died, the genotype was C.656_658delAGA/C.440_441del, and that 3 cases stunted, the genotypes were C.599G＞A/C.656_658delAGA/C.4535A＞T, C.609G＞A/C.609G＞A，C.80A＞G/C. 394C＞T. The remaining cases showed no abnormalities. Conclusions: The mutations of MMACHC and HCFC1 were analyzed in 8 cases with combined MMA, and C.482G＞A was more common. Combined with clinical symptoms and prognosis, the C.656_658delAGA /C.440_441del genotype is more pathogenic, the C.599G＞A/C.656_658delAGA/C.4535A＞T and C.80A＞G/C.394C＞T have poor prognosis. The gene mutation site C.656_658delAGA is highly pathogenic and poor prognosis. The prognosis of the mutation site C. 482G＞A is relatively better. Neonatal tandem mass spectrometry screening can detect children with methylmalonic acidemia early, and the identification of gene mutations can provide evidence for family reproductive guidance, prenatal diagnosis and prognosis. Related Articles | Metrics

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Effects of Regimens OPU-ICSI with Different Intervals on the Clinical Outcomes of Fresh Embryo Transfer in GnRH Antagonist Cycle 2019, 38 (5):  367-369.  Abstract ( 2354 )   PDF (795KB) ( 10749 )   Objective：To compare the effects of two different ICSI insemination times on the reproductive outcomes of fresh embryo transfer (FET) in gonadotropin-releasing hormone (GnRH) antagonist cycles. Methods：531 cycles of FET after the GnRH antagonist protocol were divided into two groups according to the interval time between OPU and ICSI, the group one (n=101) that the OPU-ICSI interval was ranged from 38～40 h and the group two (n=430) was 41～43 h. The differences of oocyte maturation rate, embryo quality and pregnancy outcomes between the two groups were analyzed retrospectively. Results：The oocyte maturation rate was significantly lower in the group one when compared with the group two (P＜0.05), and the miscarriage rate in group one was significantly higher (P＜0.05). There was no significant differences in the fertility rate, cleavage rate, available embryo rate, high-quality embryo rate, implant rate and pregnancy rate between the two groups (P＞0.05). Conclusions：Our results indicate that there are relatively consistent embryo quality and clinical pregnancy rate in the timing of ICSI ranged from 38～43 h. As for the finding that the miscarriage rate could be higher if the ICSI time was earlier than 40 h in the FET cycle of GnRH antagonist protocol, we think that more studies with large samples and the detailed grouping may be necessary.ds: 531 patients were divided into two groups according to times between hCG and ICSI from January 2016 to May 2018. The hCG-ICSI interval ranged from 38h to 40h was group one (including 101 cases) and 41h-43h was group two (including 430 cases). The differences of oocyte maturation rate, quality of embryo and reproductive outcomes between the two groups were analyzed retrospectively. Result: The oocyte maturation rate of Group one was significantly lower than Group two (P<0.05), furthermore miscarriage rates when ICSI was performed 38-40 hours in Group one was significantly higher than Group two(P<0.05). There was no significant difference in fertility rates, cleavage rates, available embryo rates, high-quality embryo rates, implant rates and pregnancy rates between the two groups (P>0.05). Conclusion: Our results indicate that the effective window of time for insemination by ICSI might be wider than previously thought, while we also noted that the higher miscarriage rate was obtained after the earlier injection in the fresh embryo transfer cycle of GnRH antagonist. Related Articles | Metrics

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Effects of Dehydroepiandrosterone on the Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection-Embryo Transfer for the Patients with Poor Ovarian Response GAO Rui-fan, TU Zeng-rong, WANG Li-yuan, DUAN Rui-yun 2019, 38 (5):  370-373.  Abstract ( 2436 )   PDF (810KB) ( 10782 )   Objective：To investigate the effects of dehydroepiandrosterone（DHEA） on the clinical outcomes of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer （IVF/ICSI -ET）in the patients with poor ovarian responsiveness (POR). Methods: A total of 205 patients with POR who underwent in vitro fertilization and embryo transfer in our Center were enrolled in this study. The patients were randomly divided into three groups；Group A consisted of 69 patients who received DHEA 25 mg orally three times a day for one month, Group B consisted of 64 patients who received DHEA 25 mg orally three times a day for three months，and Group C consisted of 72 patients who did not receive DHEA pretreatment. The levels of follicle stimulating hormone (FSH), stradiol (E2), anti-Mullerian hormone (AMH) and antrol follicle count (AFC) were measured on the third day of menstruation after pretreatment. Routine short-term protocol (GnRHa+Gn) was used for the controlled ovarian hyperstimulation (COH). The number of eggs retrieved, fertilization rate, high quality embryo rate, embryo implantation rate, clinical pregnancy rate, early spontaneous abortion rate, cycle cancellation rate were compared among the three groups. Results: In the group A, there were no significant differences in the levels of FSH, E2, AMH and AFC when compared before and after DHEA pretreatment. In the group B, the levels of FSH and E2 were significantly decreased, while the levels of AMH and AFC increased, after DHEA pretreatment (all P＜0.05). There was no significant difference in the Gn amount among the three groups. There were no significant differences in the number of eggs retrieved, cleavage rate, fertilization rate, high-quality embryo rate, embryo implantation rate, clinical pregnancy rate, early spontaneous abortion rate and cycle cancellation rate when compared between the group A and the group C (all P＞0.05). Interestingly, the number of eggs retrieved, high quality embryo rate, embryo implantation rate in the group B after DHEA treatment were significantly increased than those in the group C (P＜0.05). Conclusions: DHEA can improve the ovarian reserve function and the clinical outcome of IVF-ET for the patients with POR, and the therapeutic effects are dependent on the duration of DHEA pretreatment. Related Articles | Metrics

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Comparison of In Vitro Fertilization-Embryo Transfer Outcomes between GnRH Antagonist Protocol and Mild Stimulation Protocol in Poor Ovarian Responders ZHOU Li-na，CHEN Wei，WU Yu，GAO Xiao-hong 2019, 38 (5):  374-377.  Abstract ( 2584 )   PDF (824KB) ( 10811 )   Objective：To compare the effects of gonadotropin-releasing hormone (GnRH) antagonist protocol and clomiphene citrate (CC) mild stimulation protocol on the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) in patients with poor ovarian response (POR). Methods：The clinical data of 432 IVF/ICSI cycles of POR patients from January 2015 to December 2017 in our department were retrospectively analyzed. According to the ovarian stimulation protocol, those cycles were divided into the GnRH antagonist group (n=248 cycles) and the CC mild stimulation group (n=184 cycles). Results：There were no significant differences in age, basic FSH, BMI and duration of infertility between the two groups (P＞0.05). Compared with the CC mild stimulation group, the GnRH antagonist group had the increased values of the Gn duration, Gn dosage, endometrium thickness, number of oocytes retrieved, number of transferable embrys, and fresh embryo transfer rate (P＜0.05), and the decreased cycle cancellation rate (P＜0.05). There were no significant differences in the estradiol level on trigger day, the number of embryos transferred, the number of high-quality embryos transferred, embryo implantation rate, pregnancy rate, ongoing pregnancy rate and live birth rate between the two groups (P＞0.05). Conclusions：GnRH antagonist protocol can increase the numbers of oocytes and transferable embrys and the rate of fresh embryo transfer, and reduce the cycle cancellation rate in POR patients receiving IVF-ET. It can be used as one of the treatment options for POR patients. Related Articles | Metrics

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Clinical Analysis of Subdermal Implant Etonogestrel in 81 Cases WANG Yu-mei, CHE Ying 2019, 38 (5):  378-381.  Abstract ( 2226 )   PDF (751KB) ( 10766 )   Objective：To evalute the clinical application of subdermal implant Etonogestrel, so as to provide more data for the expansion of this contraceptive method. Methods: The clinical data of 81 women who volunteered to implant or take out Etonogestrel was retrospectively analyzed in our Department from January 2017 to September 2018. The adverse reactions related to Etonogestrel were collected by the centralized-telephone follow-up visit in December 2018, including the implant timing, reasons for the implantation, menstruation disturbance and treatment, the use condition and others. Results: There was no significant difference in the time of amenorrhea and irregular vaginal bleeding after implantation of Etonogestrel (P＞0.05); there were no significant differences in the causes of placement, the treatment of adverse reactions and the induced obesity between the removal group (the group A) and the using group (the group B) (all P＞0.05). However, the therapeutic effect of adverse reactions in the group B was better than that in the group A (P＜0.05). Interestingly, there was no significant difference in the removal rate between the two groups: the group of implantation for contraception and the group of implantation for the treatment of adenomyosis dysmenorrhea symptom (P＞0.05). Condom was the most common method following the removal. Conclusions: Subdermal implant Etonogestrel is a reliable contraceptive, meanwhile there is treatment effect on ameliorating dysmenorrhea symptoms of adenomyosis. The change of menstrual pattern would be limited with the prolongation of placement time. The main factor affecting the removal of Etonogestrel is the therapeutic effect of menstrual changes. Therefore, the improvement in the therapeutic effect of menstrual changes will be helpful for the extented application of subdermal implant Etonogestrel as a long-term and safe contraceptive method. Related Articles | Metrics

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Effect of Dietary Patterns on Semen Quality: A Meta-Analysis HUANG Jia-lyu, LIN Jia-ying, CAI Ren-fei, SONG Ning, KUANG Yan-ping 2019, 38 (5):  382-388.  Abstract ( 1528 )   PDF (1313KB) ( 9541 )   Objective：To evaluate the effect of dietary patterns on semen quality by a meta-analysis. Methods: This study was conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. All of observational studies assessing the association between dietary patterns and semen quality parameters were searched by PubMed, EMBASE, Web of Science and the Cochrane library databases from inception to June 2018. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, followed by data extraction and quality evaluation. The Stata 12.0 software was used for Meta-analysis. Results: A total of 7 literatures involving 1 873 participants were included. The Meta-analysis results showed that the healthy dieatry pattern was associated with the increased sperm concentration (SMD=0.20, 95%CI: 0.07-0.33, P=0.003), count (SMD=0.27, 95%CI: 0.07-0.46, P=0.008) and progressive motility (SMD=0.46, 95%CI: 0.24-0.69, P＜0.001), and that it was not associated with semen volume (SMD=-0.20, 95%CI: -0.82-0.42, P=0.525), sperm morphology (SMD=-0.01, 95%CI: -0.14-0.12, P=0.890) and total motility (SMD= -0.10, 95%CI: -0.55-0.36, P=0.680). Conclusion: The healthy dietary pattern is beneficial to improve semen quality. Related Articles | Metrics

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Pregnancy Outcomes in Six Patients with Dichorionic Twins and Premature Rupture of Membranes Following Selective Fetal Reduction During Early Midterm GONG Meng, HUANG Qin, ZHANG Lu, LI Chun-yan, MING Lei 2019, 38 (5):  389-392.  Abstract ( 1644 )   PDF (743KB) ( 9252 )   Objective：To study the pregnancy outcome after selective fetal reduction in bichorionic twin pregnancies complicated by extremely preterm premature rupture of membranes in one sac, its main purpose is to provide some clinical data for the treatment of patients with very early premature rupture of membranes. Methods: This is a retrospective study of 6 patients who underwent selective fetal reduction for multiple gestations at the Reproductive Center of Renmin Hospital of Wuhan University from January 2012 to February 2018. All patients were conceived by IVF or ICSI. Results: Selective fetal reduction was performed successfully in 6 cases. One of six abnormal fetuses was the right one, one case was the left and the rest was lower fetus. The fluid breakage occurred within 24 hours and stopped within 8 days after fetal reduction. One women had oligohydramnios in the third trimester, one patient occurred premature rupture of premature rupture of membranes, and one patient had gestational diabetes mellitus during pregnancy. Of the 6 patients who underwent selective fetal reduction, one had preterm labor at 34+6 gestation weeks, while the other 5 were full-term delivery, of which 4 patients had cesarean section and 2 patients had vaginal birth. The six neonatal weight was 2 200-3 400 g, 4 were male infants, while 2 were female. Except for premature infants with lung infection, the other newborns had no complications. Conclusions: It recommends to expectant treatment for patients of dichorionic twins complicated by extremely preterm premature rupture of membranes of one sac performed selective fetal reduction. However, large sample studies are still needed to confirm this conclusion. Related Articles | Metrics

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Modifications of Molecular Expression after Vitrification on Human Oocytes WANG Sai-sai，JIN Hai-xia 2019, 38 (5):  393-396.  Abstract ( 1262 )   PDF (776KB) ( 8971 )   The oocyte cryopreservation as an important technology of in vitro fertilization (IVF), is also the main way to preserve female fertility. Oocyte cryopreservation is easy to cause irreversible damage to oocytes. The cumulus cells (CCs) play an important role in the in vitro maturation (IVM) of oocytes. However, the cryopreservation could also damage CCs besides oocytes. It is known that vitrification/thawing may have potential effects on oocytes (including mature and immature oocytes). These effects could include the changes of some important molecules related to the cellular events during oocyte development and maturation, such as oocyte maturation (GDF9, BMP15), apoptosis (Bax, Bcl-2), cytoskeleton (CK8, ACTB), cell cycle (CCNA1, MCM10), gap junction (GJA1), developmental capacity (HDAC1, STAT3, SMARCAL1 and DNMT3B), lipid metabolism (cGMP), etc. The changes of those molecules before and after the oocyte vitrification were summarized in this review, which provide us a theoretical and experimental basis for improving the oocyte vitrification. Related Articles | Metrics

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Research Progress on Diagnostic Criteria for Recurrent Implantation Failure LIU Dao-ying, ZHANG Jian-wei 2019, 38 (5):  397-400.  Abstract ( 1299 )   PDF (771KB) ( 9265 )   Recurrent implantation failure (RIF) is an important influence factor of the development of assisted reproductive technologies (ART). At present, the diagnostic criteria for RIF are still not uniform. Based on the literature review, we summarized 12 diagnostic criteria of RIF that published since 2005 and discussed four controversial issues including the number of embryo transfer cycles, the quantity and quality of transferred embryos, the stage of transferred embryos and type of transfer cycles, and the female age. There were differences in the number of embryo transfer cycles (2, 3, 4, 5 and 6 cycles), mainly in the dispute between 2 and 3 cycles, which showed a decreasing trend. There were differences in the number of transferred embryos (3、4、5、8、10 transferred embryos), which also showed a decreasing trend. High quality embryos or blastocysts were selected for transplantation by the morphology or time-lapse photography. The types of transfer cycles include fresh embryo transfer and frozen embryo transfer. The age should be limited due to its effect on the ovarian function and embryo quality. It is generally recognized that the factors of RIF definition include infertile women aged ＜40 years, 3 or more cycles of transplantation (including fresh embryo transplantation and freeze-thaw embryo transplantation), 4 or more high-quality embryos transferred, and no one pregnancy. The inconsistency of diagnostic criteria hinders the progress of RIF treatment. Therefore, it is urgent to carry out the high-quality research and to formulate a standardized RIF diagnostic criterion. Related Articles | Metrics

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Fetal-Derived Premature Ovarian Failure and Intrauterine Programming Mechanism GONG Xiao-han，WANG Hui，XU Dan 2019, 38 (5):  401-406.  Abstract ( 1241 )   PDF (860KB) ( 9104 )   Ovarian structure and functions are important for female fertility. The development and maturation of reproduction, and maintains of ovarian function and fertility, are mainly regulated by the hypothalamic-pituitary-ovarian (HPO) axis and the local factors of ovary, such as transforming growth factor-β (TGF-β), epidermal growth factor (EGF) and insulin-like growth factor (IGF). It was reported that the adverse maternal environment during pregnancy (such as prenatal xenobiotics exposure, maternal nutrition disorder and disease, etc.) was associated with the reproductive development in offspring, which would lead to diminished ovarian reserve such as premature ovarian failure (POF) in some adult offspring. The mechanism of fetal-derived POF is related to the theory of "intrauterine programming"，including they abnormalities of neuroendocrine programming and epigenetic modification. In this review, we discussed the intrauterine programming mechanism of fetal-derived POF, and the potential markers of early warning, prevention and treatment of this disease. Related Articles | Metrics

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Hormones and Their Receptors in the Regulation of Sertoli Cell Function ZENG Yu-qi，ZHANG Xiao-li，ZHU Ke-yu，YUAN Tian-yi，OUYANG Wen-jun，LIU Yue，DING Zhi-de 2019, 38 (5):  407-412.  Abstract ( 1323 )   PDF (847KB) ( 9027 )   Sertoli cells, the only somatic cell in seminiferous tubule, play an important role in the process of spermatogenesis. The functions of Sertoli cells are regulated by several hormones. For example, follicle-stimulating hormone (FSH) can regulate the cell proliferation and facilitate the cellular communication, and contribute to form the blood-testis barrier (BTB) as well. Androgen can down-regulate the level of anti-Müllerian hormone (AMH) to promote the development of Sertoli cells and maintain the integrity of BTB. Estrogen can induce apoptosis and survival of Sertoli cells at different doses, and regulate the expression of aquaporin and further to affect the BTB construction. In this paper, we reviewed the influences of hormones and their receptors on the structure and function of Sertoli cells and the specific molecular mechanisms. We think that it is available for both understanding the normal processes of spermatogenesis and developing possible treatment of male infertility caused by spermatogenic disorders. Related Articles | Metrics

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The Effects of Arecoline on Reproductive and Urinary Systems ZHOU Si-an, LIU Si-wei, JIN Li-xing, LONG Yi-jing, ZHAO Ling-yi, QUAN Yan-mei, DING Zhi-de 2019, 38 (5):  413-417.  Abstract ( 1458 )   PDF (785KB) ( 8987 )   Recently, the researches on betel nut are not only focused on oral damage and carcinogenicity, but also extended to the negative effects on other main organs and systems. It has been showed that arecoline, one of the main biological ingredients of betal nut, affects male and female reproductive system and urinary system, and gestation and fetus. In the male reproductive system, arecoline induced oxidative stress by increasing reactive oxygen species (ROS). Also, arecoline interfered with the immune system by upregulating pro-inflammatory factors and inducing high-expression of cyclooxygenase-2 (COX-2), which caused the damage of sperm structure and function. In addition, arecoline stimulated Leydig cells to secrete excessive testosterone in the testis. In the female reproductive system and gestation, arecoline induced oocyte impairment. Long-term chewing betel nut in pregnant women can affect the neonatal birth outcomes such as low birth weight and premature death. Besides, animal models revealed that arecoline had embryo toxicity and some severe effects on embryo development. In the urinary system, arecoline was responsible for the pathogenesis of chronic kidney disease (CKD) and the development and deterioration of bladder cancer. This review is helpful for us to understand the toxic damage of arecoline on both reproductive and urinary systems. Related Articles | Metrics

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The Roles of FSH Receptor in Placental Angiogenesis and Pregnancy Maintenance WANG Shu-ke，ZHENG Mei-ling 2019, 38 (5):  418-421.  Abstract ( 1000 )   PDF (735KB) ( 8982 )   The follicle stimulating hormone receptor (FSHR) was thought to be expressed in ovarian and testis tissues in the past. However, it has been found in the whole reproductive system, including endometrium, uterine myometrium and fallopian tube. FSHR participated in the regulation of steroidogenesis, uterine myometrium contraction and reproductive endocrine. Other studies suggested that the FSHR expressed in the endothelial cells of blood vessels in tumor and placenta played an important role in stimulating angiogenesis. In normal pregnancy, the proper development of placenta vasculature after implantation is essential for the embryonic development. The disorder of angiogenesis, and poor blood supple at early stage, is one of the factors of spontaneous miscarriage. The poor blood supply in the middle and late stages of pregnancy may lead to premature delivery, fetal growth restriction, pregnancy-induced hypertension and other complications. We summarized the roles of FSHR, as well as the research progress, in female reproductive system and placental angiogenesis during pregnancy. Related Articles | Metrics

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Long Non-Coding RNA and Endometriosis CUI Liang-yi, WANG Dan-dan, CHEN Si-lei, YANG Qing 2019, 38 (5):  422-425.  Abstract ( 995 )   PDF (759KB) ( 9036 )   Long non-coding RNAs (lncRNAs) are a class of RNAs that are more than 200 nucleotides in length but have low protein-coding potential. As important members of the non-coding RNA (ncRNAs) family, lncRNAs play a regulatory role in many important diseases. Endometriosis (EMs) is a gynecological disease that seriously harms the health of women of childbearing age, which is closely related to lncRNAs. The current study found that many lncRNAs are differentially expressed in EMs tissues. Further studies have found that lncRNAs are involved in the risk factors of EMs, and that lncRNAs promote the epithelial mesenchymal transition of EMs. LncRNAs are also involved in the regulation of proliferation, migration and cell cycle of EMs cells, and affect the fertility of patients with EMs. By screening patients′ serum and tissue samples, some of lncRNAs have been found to be potential molecular biomarkers for the diagnosis of EMs. In this article, the research progress of the relationship between lncRNAs and EMs was discussed, in order to provide new ideas for the diagnosis and treatment of EMs. Related Articles | Metrics

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Research Progress on the Relationship between Vitamin D and Polycystic Ovary Syndrome LI Zhi-ru，YU Hai-rui，YANG Lin，XIANG Mei 2019, 38 (5):  426-429.  Abstract ( 1636 )   PDF (749KB) ( 9186 )   Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disease characterized by menstrual disorders, hyperandrogenism, insulin resistance and so on. Metabolic and reproductive dysfunction in PCOS patients often coexist. In recent years, studies have found that the level of vitamin D in patients with PCOS are generally lower than that in normal women. The effects of vitamin D on PCOS metabolism and reproductive dysfunction may be mediated by insulin resistance. Since vitamin D regulates gene transcription through vitamin D receptor (VDR), the effect of vitamin D on PCOS may be related to the VDR gene polymorphism, but there is ethnic difference in the correlation between VDR gene polymorphism and PCOS. The difference is more pronounced in Asian populations. The correlation between vitamin D and PCOS suggests that vitamin D supplementation may be beneficial for alleviating the metabolic abnormalities and fertility of PCOS. Related Articles | Metrics

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Exosomes in Chemotherapy Resistance of Ovarian Cancer YUAN Meng-qin, WANG Yan-qing, XIAN Shu, ZHANG Li, YANG Dong-yong, LIU Shi-yi, CHENG Yan-xiang 2019, 38 (5):  430-433.  Abstract ( 985 )   PDF (741KB) ( 8997 )   Ovarian cancer is a reproductive system malignant tumor with the highest mortality, and the main treatment of ovarian cancer is the surgery to cut out tumor tissues following with the auxiliary chemotherapy of taxol. Although most of the patients with ovarian cancer after operation are sensitive to the initial chemotherapy, the prognosis is poor due to their chemotherapy resistance. In recent years, exosome as a way of the material and information exchange between the cells has been a research hotspot. The exosome containing a variety of biological active substances are distributed in various body fluids. More and more studies showed that exosome was participated in many physiological procedures such as antigen presenting, immune response and tissue damage repair, and the occurrence and development of tumor such as tumor microenvironment. In addition, many studies have shown that exosomes could play an important role in the regulation of the chemotherapy resistance of ovarian cancer. Exosomes may be developed as a new therapy target for blocking the chemotherapy resistance and improving the prognosis of ovarian cancer. Related Articles | Metrics

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A Case Report of Abdominal Pregnancy LIU Yu-han，LI Li，DENG Gao-pi 2019, 38 (5):  434-437.  Abstract ( 1056 )   PDF (4352KB) ( 8986 )   Abdominal pregnancy is rare in the clinic, and the uterine ligament pregnancy is more rare in the literatures. We reported a case of uterine ligament pregnancy, and the related literatures were reviewed. The uterine ligament pregnancy is often accompanied by amenorrhea, or without history of amenorrhea, vaginal bleeding and lower abdominal pain. Mass rupture may occur early, with hemorrhage and shock, even life-threatening. Timely diagnosis of this disease, to avoid misdiagnosis and missed diagnosis, is depended on the β-hCG test, color ultrasound, magnetic resonance imaging (MRI) examination and surgical exploration, etc. The differential diagnosis should include tubal pregnancy, ovarian tumor, intrauterine pregnancy and so on. Laparoscopy surgery is main treatment of abdominal pregnancy, which is better for exposing surgical field, removing completely the lesions and reducing bleed. How to treat the placenta is the key of the laparoscopy operation of the abdominal pregnancy at intermediate and advanced stage. Related Articles | Metrics

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A Case Report of Ovarian Epithelioid Malignant Mesothelioma and Literature Review WANG Min, MA Shuai, ZHAO Zhe, WANG Yu-jia, ZHAO Shu-hui, YANG Shu-li 2019, 38 (5):  438-440.  Abstract ( 1144 )   PDF (686KB) ( 8964 )   Malignant mesothelioma (MM) is a clinically rare mesothelial cell origin tumor with high malignancy. It is more common in the pleural cavity and rare in the ovary. It is difficult to diagnosis before surgery and easy to confused with other malignant tumors of ovary, primary malignant mesothelioma of peritoneum, reactive mesothelioma and malignant tumors of gastrointestinal tract, therefore the diagnosis mostly depends on the postoperative pathology and is usually late with poor prognosis, to which clinicians must pay enough attention. In order to improve the understanding of the disease, we now analyze the data of a patient with ovarian epithelioid malignant mesothelioma, review the relevant literatures, and further explore the etiology, clinical tissue performance, immunohistochemistry, treatment and prognosis of MM to deepen the clinician understanding of the disease and improve the ability of diagnosis and treatment. Related Articles | Metrics