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15 March 2020, Volume 39 Issue 2
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Effects of Psychological Stress on Ovarian Oxidative Stress in Mice CHENG Rui，LIU Yan，YANG Hui，MA Rui-hong，XIA Tian 2020, 39 (2):  93-96.  Abstract ( 1287 )   PDF (648KB) ( 8992 )   Objective: To observe the the ovarian oxidative stress in mice undergoing different degrees of stimulation, as a theoretical reference for adjuvant psychotherapy of female infertility. Methods：Eighty female mice were randomly divided into 4 groups. The unpredictable stimulation at different degrees was given for 4 weeks continuously. The body weight and behavioral changes were observed to confirm whether the model of psychological stress was successfully prepared. The levels of serum SOD and ROS, the ovarian SOD activity and MDA, and the levels of ovarian SOD2, CAT and GSH-Px mRNAs were detected. Results：The body weight was decreasedin the psychological stress groups when compared with the control group, the immobility time and the central area retention time were prolonged, and the number of times entering the central area and the central area activity time were decreased. The level of serum ROS was increased, while the level of serum SOD was decreased. In the ovarian tissues, the activity of SOD was decreased and the level of MDA increased, while the activities of SOD2, CAT and GSH-Pxwere decreased. Conclusions：Psychological stress can reduce the desire for independent activities and exploration. The ROS accumulation can lead to oxidative stress and affect female reproductive function. References | Related Articles | Metrics

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Detective value of anti-nuclear antibodies, anti-cardiolipin antibodies and anti-β2 Detection of Antinuclear Antibody, Anticardiolipin Antibody and Anti-β2 Glycoprotein 1 Antibody in Patients with Moderate or Severe Endometriosis ZHANG Yuan, JIANG Chun-yan, WU Wei, MA Xiang, HUANG Jie, MAO Yun-dong, LIU Jia-yin, SHU Li 2020, 39 (2):  97-100.  Abstract ( 1377 )   PDF (292KB) ( 9053 )   Objective: To evaluate the detections of antinuclear antibody (ANA), anticardiolipin antibody (ACL) and anti-β2 glycoprotein 1 antibody (aβ2GP1) in patients with moderate and severe endometriosis before IVF/ICSI treatment. Methods：From January 2018 to April 2019, 86 patients with moderate and severe endometriosis (EMs group, 86 cases) and 82 women who were planned to undertake IVF/ICSI treatment due to male factors (control group, 82 cases) were collected as the subjects. The level of serum ANA was detected by immunofluorescence, and the levels of ACL and aβ2GP1 antibodies were detected by enzyme-linked immunosorbent assay. Results：The total positive rate of at least one antibody positive in the EMs group was 31.40% (27/86), while that in the control group was 12.19% (10/82). The difference between the two groups was statistically significant (P＜0.05); The total positive rate of ANA in the EMs group [5.81% (5/86)] was slightly higher than that in the control group [1.22% (1/82), but P＞0.05]. The total positive rate of ACL in the EMs group [13.95% (12/86)] was also slightly higher than that in the control group [6.10% (5/82), but P＞0.05]. Interestingly, the total positive rate of aβ2GP1 in the EMs group [16.28% (14/86)] was significantly higher than that in the control group [6.10% (5/82), P＜0.05]. Conclusions：The combined screening of serum ANA, ACL and aβ2GP1 is recommended for patients with moderate and severe endometriosis before IVF/ICSI treatment. The positive rate of aβ2GP1 in patients with moderate and severe endometriosis is high, which deserves clinical attention. References | Related Articles | Metrics

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Impact of Low Body Mass on IVF-ET Outcome XU Yue-ming，ZHANG Jie，YIN Li，LUO Zhuo-ye，HAO Gui-min 2020, 39 (2):  101-103.  Abstract ( 1214 )   PDF (480KB) ( 9059 )   Objective: To evaluate the effects of low body mass index (BMI) on in vitro fertilization-embryo transfer (IVF-ET) outcomes in fresh transfer cycles. Methods：A total of 8 171 cycles with conventional stimulation and fresh transfer in our IVF/ＩＣＳＩ center from January 2013 to October 2018 were included. Patients with BMI<18.5kg/m2 were considered to be underweight (n=774), and patients with normal BMI (18.5-23.9 kg/m2) were used as the control (n=7 397). Results：The biochemical pregnancy rate and implantation rate of the low BMI group were significantly lower than those of the control group (P＜0.05). There were no significant differences in the clinical pregnancy rate, early abortion rate and live birth rate between the two groups(P＞0.05). Conclusions：Low BMI is a negative factor of ART fresh transfer cycles. References | Related Articles | Metrics

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Application of Fluorescence in situ Hybridization in Prenatal Diagnosis of Chromosomal Mosaicism LI Xian-zheng，XU Ling，HU Jing-jing，LI Feng-zhen，CAI Chan-hui 2020, 39 (2):  104-108.  Abstract ( 1385 )   PDF (2342KB) ( 9260 )   Objective: To explore the application of fluorescence in situ hybridization (FISH) in the prenatal diagnosis of chromosomal mosaicism. Methods：A total of 22 cases of potential chromosome mosaicism detected by the villus/aminotic cell G-band karyotype analysis were included in this study. The abnormities of chromosome karyotype and the ratio of chromosome mosaicism were further analyzed by chromosomal microarray analaysis (CMA) and FISH. Results：In those 22 cases, there were 13 cases of sex chromosome mosaicism, 6 cases of autosomal trisomy mosaicism and 3 cases of sex chromosome structure mosaicism. Almost 50% of chromosomal mosaicism were not found by CMA, which may be related to the fact that CMA can only detect the change of gene copy number and can not detect low ratio of chromosomal mosaicism. Because of great influence on the growth and development of fetus, cases of autosomal trisomy mosaicism were terminated except one case. Three cases of sex chromosome structure mosaicism were confirmed as the dicentric sex chromosome by the combined G-band, CMA and FISH. Conclusions：Multiple methods should be combined to verify the chromosomal mosaicism in those patients with the suspicious chromosomal mosaicism detected by the villus/aminotic cell G-band karyotype analysis in prenatal diagnosis. The combined application of CMA, FISH and G-band, as well as detailed ultrasound evaluation, is required. The accurate diagnosis of the chromosome mosaicism type and the ratio of abnormal mosaicism karyotype can provide a more reliable basis for genetic counseling. References | Related Articles | Metrics

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Examination of Early Spontaneous Abortion Villous Chromosome and Related Genetic Counseling GUO Li-na，LIAO Ying，LIU Pan，TIAN Yu，ZHAO Min-ying，SU Ya-qin 2020, 39 (2):  109-112.  Abstract ( 1377 )   PDF (596KB) ( 9038 )   Objective: To investigate the application value of high-throughput sequencing, fluorescence in situ hybridization (FISH) and karyotype analysis in the detection of villi chromosome abnormality in spontaneous abortion of early pregnancy. Methods：100 patients with spontaneous abortion of early pregnancy in The First Hospital of Shijiazhuang from January 2017 to January 2019 were selected as the research objects. In 100 villus samples, 17 samples were detected by karyotype analysis, 11 samples by FISH, and 72 samples by high-throughput sequencing. Those patients with the successful karyotype detection in villus samples were followed up and provided genetic counseling. The pregnancy outcomes were then analyzed. Results：Finally, 88 cases were successfully detected, and 45 cases with chromosomal abnormalities were detected. There were no significant differences in the success rate of detection and the positive rate of abnormal karyotypes among three detection technologies (P＞0.05). In all 88 cases of successful detection, the follow up visiting was finished in 51 cases, including 32 cases with abnormal villous chromosomes and 19 cases with normal villous chromosomes. The proportion of chromosomal abnormalities in the patients aged ≥35 years was higher than that in the patients aged ＜35 years (75.00% vs. 47.83%, χ2=3.898, P=0.044)， while the proportion of villous chromosomal abnormalities in the patients with the gestation of between 8 and 12 weeks was higher than that in patients with gestational week ＜8 weeks (74.19% vs. 45.00%, χ2=4.432, P=0.035). As for genetic counseling and re-pregnancy outcomes, 32 patients with villous chromosomal abnormalities were followed up, 22 had genetic counseling, 16 had normal re-pregnancy, 4 had miscarriages, and 2 were not pregnant. In 10 patients without genetic counseling, 2 patients had normal pregnancy, 7 were aborted again, and 1 was not pregnant. The outcome of re-pregnancy in the patients with genetic counseling was better than that in the patients without genetic counseling (P＜0.05). Conclusions：The three detection techniques have their own advantages in detecting the villous chromosomes of spontaneous abortion in early pregnancy, which can be selected according to the actual clinical situation. The combined use can improve the detection rate of abnormal karyotypes. Villous chromosome examination should be recommended for the patients aged over 35 years, or the patients with spontaneous abortion within the gestational weeks of 8 to 12. The genetic counseling should be provided for those patients with abnormal villous chromosomes before their re-pregnancy. References | Related Articles | Metrics

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Screening of Common Deafness Gene Mutations in 129 Children Conceived through Assisted Reproductive Technology MENG Ye，TAO Yuan-yuan，HU Xin，SANG Mei-ying，TONG Xian-hong 2020, 39 (2):  113-116.  Abstract ( 1320 )   PDF (796KB) ( 8969 )   Objective: To investigate the mutative rate of common hereditary deafness genes in children conceived through assisted reproductive technology (ART offspring). Methods：A total of 129 cases of ART offspring in our center from January 2010 to December 2014 were included, and the average age of the subjects was (4.37±0.92) years old. Blood samples of 161 offspring conceived through natural pregnancy (as the control group) were collected. High-throughput sequencing was used to screen the deafness gene mutation sites. Results：A total of 11 ART offspring were found to have deafness gene mutations, including 12 mutations in the gene locus. A total of 9 cases in the control group were found to carry deafness gene mutations, including 9 mutations in the gene locus. There was no statistically significance of the mutation incidence in the two groups ( χ2=0.962, P=0.327). In ART offspring, there were 2 cases of GJB2 mutation carrier (1.55%, male to female was 1∶1), 3 cases of GJB3 mutation carrier (2.33%, male to female was 1∶2), 7 cases of SLC26A4 mutation carrier (5.43%, male to female was 5∶2) and one case of GJB2 gene 235delC site and a SLC26A4 gene IVS7-2A>G site double heterozygous mutation. There was no mitochondrial 12S rRNA gene mutation carrier in those ART offspring. The mutation rate of gene locus was 11.83% (11/93) in the IVF group, and 2.78% (1/36) in the ICSI group, with no significant difference between the IVF group and the ICSI group ( χ2=2.520, P=0.112). The mutation rate of gene locus was 11.39% (9/79) in the fresh embryo transfer group, and 6.00% (3/50) in the frozen embryo transfer group, with no significant difference between the two groups ( χ2=1.055, P=0.304). Conclusions：The incidence of hereditary deafness gene mutations in ART offspring is similar with the offspring conceived through natural pregnancy. In ART offspring, the positive rate of SLC26A4 gene IVS7-2A＞G site mutation is the highest. There is no significant effect of the fertilization method and the fresh or frozen-thawed embryo transfer on the mutation rate of hereditary deafness in ART offspring. References | Related Articles | Metrics

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Logistic Regression Analysis of Risk Factors Related to Insulin Resistance in Patients with Polycystic Ovary Syndrome and Normal Body Mass Index YU Jing-lu，HOU Li-hui，SUN Miao，WANG Ying 2020, 39 (2):  117-120.  Abstract ( 1283 )   PDF (592KB) ( 9076 )   Objective: To study the clinical risk factors of insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS) and normal body mass index (BMI). Methods：A total of 203 PCOS patients with normal BMI from our hospital, from March 2018 to May 2019, were included in this study. According to the homeostasis model assessment-insulin resistance index (HOMA-IR), the patients were divided into two groups: the observation group (PCOS with normal BMI and HOMA-IR≥2.69, n=50); the control group (PCOS with normal BMI and HOMA-IR＜2.69, n=153 cases). The clinical characteristics, sexual hormone levels and glycolipid metabolism of the two groups were compared. The correlation between clinical characteristics, sex hormone levels, lipid metabolism and HOMA-IR was analyzed. The clinical risk factors related to IR were analyzed by multivariate Logistic regression. Results：The levels of WC, HC, WHR, TG, LDL-C, and UA in the observation group were significantly higher than those in the control group, and the levels of FSH, SHBG and HDL-C were significantly lower (all P＜0.05). The levels of WC, HC and TG were positively correlated with HOMA-IR (all P＜0.05), and the levels of WHR and LDL-C were weakly positively correlated (both P＜0.05), while the levels of SHBG and HDL-C were negatively correlated with HOMA-IR (both P＜0.05). WC is the risk factor of inducing IR in PCOS patients with normal BMI, and HDL-C is the protective factor of preventing IR in PCOS patients with normal BMI (both P＜0.05). Conclusions：WC as a risk factor can induce IR in those PCOS patients with normal BMI, and HDL-C acts as a protective factor. References | Related Articles | Metrics

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Characteristics of Genital Tract Infection in Late-Puberty Women Aged 14 to 18 Years XU Ling，LIN Xiao-neng，HU Zheng-qiang 2020, 39 (2):  121-125.  Abstract ( 1362 )   PDF (747KB) ( 9145 )   Objective: To discover the characteristics of genital tract infection in those late-puberty women aged 14 to 18 years, by analyzing retrospectively the genital tract infection condition and the differences in infection rates of different age groups. Methods：The genital tract infection conditions of 487 female patients of 14 to 18 years from July 2016 to June 2019 were analyzed retrospectively. The patients were divided into 5 age groups, including the groups of 14, 15, 16, 17 and 18 years old. The bacterial vaginosis (BV) infection rate, BV intermediate type detection rate, vulvovaginal candidiasis (VVC) total infection rate, trichomonas vaginalis (TV) infection rate, inflammatory response rate were analyzed. The differences in above rates were analyzed in the different age groups. Results：The BV infection rate, BV intermediate type detection rate, VVC total infection rate, TV infection rate, and inflammatory response rate were 25.67%, 19.30%, 29.36%, 2.46%, and 25.05%, respectively. For VVC infection, the infection rates of candida albicans and non-albicans candida were 16.84% and 12.53%, respectively. The VVC total infection rate and BV infection rate were roughly same, and both of them were significantly higher than the TV infection rate. There were no significant differences in the BV intermediate type detection rate, TV infection rate and inflammatory response rate in the five age groups(P＞0.05). The BV infection rate of the age group of 17 years was significantly higher than that of other groups(P＜0.05). The VVC total infection rate and non-albicans candida positive rate of the two groups of 17 and 18 years were significantly higher than those of the age group of 14 years(P＜0.05). Conclusions：BV and VVC were more susceptible than TV for female in late puberty. Although the BV detection rate, TV infection rate and inflammatory response rate did not significantly change with the increase of age, the BV infection rate of the group of 17 years was significantly higher than that of other groups while the VVC total infection rate and non-albicans candida positive rate of the two groups of 17 and 18 years were significantly higher than those of the age group of 14 years. Therefore, attentions should be paid to the effects of menstrual hygiene, vaginal internal environment and hygiene manner on genital tract infection at this stage. It is recommended to strengthen the education of reproductive health in adolescent women. References | Related Articles | Metrics

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A Bibliometric Analysis of Relevant Research Hotspots about Premature Birth Causality REN Li-jie，LIU Qian，XIA Chun-ling，YANG Yan 2020, 39 (2):  126-130.  Abstract ( 1205 )   PDF (1416KB) ( 9092 )   Objective: To search the hotspots and research trend of premature birth by bibliometric analysis, so as to propose the new directions for further research. Methods：Studies about Premature Birth in PubMed were searched from the establishment to April 2019. Bibliographic Items Co-Occurrence Matrix Builder (BICOMB) was used to extract the retrieved documents. High-frequency MeSH terms were identified to form article Matrix and co-occurrence Matrix. Hierarchical cluster analysis was conducted by SPSS 20.0 to form the hotspots. The strategic diagram was then created. Results：A total of 2 965 papers were retrieved, and 3 183 main MeSH terms were extracted by BICOMB software. Sixty four high-frequency keywords were determined and divided into six relevant research hotspots. Finally, a strategic diagram reflecting the development trend of each research hotspot was formed. Conclusions：The pregnant complications and comorbidities, adverse outcomes of maternal and child caused by premature birth, maternal body mass index, gestational age and parity were well developed as the relevant research hotspots. On the contrary, the factors of society, psychologyand genetics, and the adverse exposure during pregnancy, were not adequately documented, suggesting that these factors could be studied in future. In addition, the researches on the diagnosis and prevention of preterm birth are relatively mature, but the connection with other studies is not close enough and further development is needed. References | Related Articles | Metrics

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Prenatal Diagnosis of a Pallister-Killian Syndrome Case Through Copy Number Variation Sequencing Technique FENG Xuan，ZHANG Qing-hua，ZHANG Chuan，HAO Sheng-ju，ZHENG Lei，WANG Xing 2020, 39 (2):  131-134.  Abstract ( 1621 )   PDF (1235KB) ( 9230 )   The copy number variation sequencing (CNV-Seq) technique can be used to explore the fetal marker chromosome and its possible source in the prenatal diagnosis. With this technique, we found a case of Pallister-Killian syndrome (PKS). We discuss the clinical and genetic characteristics of PKS. High-throughput sequencing of free DNA in the peripheral blood of pregnant woman, followed by amniocentesis, whole-genome copy number variation analysis of fetal DNA, and karyotype analysis of amniotic fluid cells to confirm PKS syndrome. A duplication of the most whole short arm of chromosome 12 was detected by CNV-seq in the fetal. The amniotic fluid karyotype was 47,XY,+i(12)(p10)[58]/46,XX[42]. CNV-seq as a first-line prenatal diagnostic technique can effectively find PKS, when combined with clinical features, karyotyping and other techniques. References | Related Articles | Metrics

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Case Report of 45, X/46, XY Mosaic and Literature Review ZHAO Hai-jun，LU Jing，ZHANG Xi-hui，XING Xiao-yuan 2020, 39 (2):  135-137.  Abstract ( 2083 )   PDF (977KB) ( 9212 )   45, X/46, XY mosaic, a kind of mixed gonadal dysplasia, is a rare abnormality of sex chromosomes. This mosaic can lead to the developmental disorders of gonad and externalia, short stature, even the malignant degeneration of gonad, which is related to Y chromosome and sex-determining genes. In this paper, we report the clinical data of a 45, X/46, XY mosaic case with female phenotype, including the pathogenesis, clinical manifestations and reproductive problems of the disease. We also review the related literatures in order to increase the understanding, and to treat those patients better. References | Related Articles | Metrics

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Diagnosis and Treatment of Propionic Academia: A Case Report of A Pair of Twin Siblings ZHANG Ying，ZHANG Fang，YANG Yang 2020, 39 (2):  138-140.  Abstract ( 1386 )   PDF (595KB) ( 9093 )   Propionic acidemia is a common organic acid-metabolic disease in neonatal period. Because the clinical manifestations are lack of specificity, and the onset in neonatal period is often acute and critical, timely treatment is of a huge challenge. Two cases of propionic acid, twin brother and sister, from our department in June 2019 were reported, including our experience in diagnosis and treatment. The detailed medical history collection and routine laboratory examination can provide a strong guidance for early diagnosis and initial emergency treatment of the disease, and for the second-line laboratory examination to confirm the diagnosis. Blood tandem mass spectrometry and urine organic acid analysis can find the specific biochemical changes of various inherited metabolic diseases, including organic acid metabolism disorder, which play an important role in the early diagnosis. The definite diagnosis needs to test the activity of specific enzyme or the pathogenic genes. The next generation sequencing (NGS) is not only helpful for the definite diagnosis, but also helpful for the prenatal screening and the guidance of eugenics. References | Related Articles | Metrics

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Clinical Characteristics and Management of 2 Cases of Complete Androgen Insensitivity Syndrome TAO Hong-jiang，CHEN Jie，CHEN Xiao-yan 2020, 39 (2):  141-143.  Abstract ( 1654 )   PDF (2559KB) ( 9227 )   Androgen insensitivity syndrome (AIS), also known as testicular feminization syndrome, is an X-linked genetic disease. AIS is a common type of male pseudohermaphroditism. It can be divided into complete AIS and incomplete AIS. The main reason is that the mutations of androgen receptor gene lead to androgen resistance and non-response. The clinical data, diagnosis and treatment of two patients with CAIS in our hospital are reviewed in order to further improve the cognition, diagnosis and treatment of the disease. References | Related Articles | Metrics

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A Case Report of Giant Endometrial Polyps Shedding Spontaneously and Literature Review XIAO Xiao，ZHAO Wei，LIU Dan，ZHU Mei，TENG Xiu-xiang 2020, 39 (2):  144-146.  Abstract ( 1900 )   PDF (3044KB) ( 9430 )   The clinical data of 1 case of giant endometrial polyp (4 cm×2 cm×1 cm) shedding spontaneously in luteal stage were retrospectively analyzed, and the relevant literatures of endometrial polyp were reviewed. The incidence of endometrial polyps is high, however the endometrial polyps larger than 4 cm are rare in clinic. Most patients have no clinical symptoms. Those endometrial polyps smaller than 1 cm are mostly functional polyps, which may be stripped by themselves during menstruation. The etiology and pathogenesis of endometrial polyps are unclear, which is related to the imbalance of estrogen receptor and progesterone receptor, infection and inflammation, oxidative stress, abnormal expression of cytokines, and the imbalance of cell proliferation and apoptosis. Hysteroscopy and hysteroscopic polypectomy are the most simple and effective methods to treat endometrial polyps. Clinically, endometrial polyps smaller than 0.7 cm can be observed. Drug therapy (estrogen-progesterone or progesterone) and LNG-IUS are mostly used to prevent the recurrence of endometrial polyps after hysteroscopic surgery. References | Related Articles | Metrics

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The Structure and Function of Ion Channels KSper and CatSper in Sperm Tail YAO Ye-jie，GAO Yi-ning，JIN Jun，YU Dai-er，HE Chen，LIU Qiang 2020, 39 (2):  147-152.  Abstract ( 1713 )   PDF (965KB) ( 9374 )   Sperm-specific potassium channel, KSper, and sperm-specific calcium channel, CatSper, are the most important specific ion channels on the spermatozoa, which play a key role in the sperm motility, hyperactivation and fertilization. They are regulated by physiological stimuli, such as pH, membrane potential and cyclic adenosine analogues. The KSper protein expressed on testicles and sperm is composed of the main subunit Slo3 and auxiliary subunit LRRC52. It mediates the pH-dependent K+ current (IKSper) produced by mature sperm and regulates the signal transduction process associated with membrane potential, thus influencing male fertility. The CatSper protein expressed exclusively on the principal piece of the sperm tail is composed of CatSper1-4 subunits and 5 auxiliary units, β, γ, δ, ε and ζ. It participates in the spatiotemporal regulation of protein tyrosine-phosphorylation, thus maintaining sperm hyperactivation. Three aspects of Ksper and CatSper, molecular structures, modes of expressions and physiological functions, are summarized in this review. References | Related Articles | Metrics

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Research Progress in the Prevention of Mitochondrial Genetic Diseases by Reproductive Genetic Technology JI Dong-mei，CAO Yun-xia 2020, 39 (2):  153-157.  Abstract ( 1767 )   PDF (820KB) ( 9204 )   Mutations in mitochondrial DNA (mtDNA) that occur in oocytes cause the maternal inherited disorders, known as mitochondrial genetic disease. Mitochondrial genetic diseases usually occur in infants, while most of inherited mtDNA-related diseases affect the function of multiple organs and systems. Therefore, mitochondrial genetic diseases are a series of disabling and fatal diseases that could endanger human health seriously, without effective medical treatment. Those female patients with mitochondrial genetic diseases are not recommended to give birth. Genetic characteristics of mtDNA make the prenatal and pre-pregnancy counseling more difficult for many women with pathogenic mtDNA mutations. The modern reproductive genetic interventions could be considered to reduce the risk of inherited mtDNA-related diseases transmitted to offspring. Preimplantation genetic testing (PGT) and prenatal diagnostic techniques may detect the level of mtDNA mutations, and select normal embryos for transplantation or prevent the birth of offspring with the high levels of mutations. However, these techniques may not be appropriate for all patients. The mitochondrial replacement technique has brought new hope for the prevention of serious inherited mtDNA-related diseases, which is expected to minimize the risk of mtDNA-related diseases in their offspring. The long-term safety and effectiveness should be further studied. References | Related Articles | Metrics

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Research Progress in Application of Reproductive Tract Microbiomes in Embryo Transfer REN Shu-qing，ZHANG Wei 2020, 39 (2):  158-162.  Abstract ( 1299 )   PDF (738KB) ( 9510 )   Embryo transfer (ET) technology is Embryo transfer (ET) is one of the core technologies of contemporary treatment of infertility. At present, the clinical pregnancy rate of ET is only 29.7%-43.4%. The success rate of embryo transfer is affected by many factors, and reproductive tract infection is one of those factors. The reproductive tract microbiome is one of the important micro-ecological systems of the human body. It forms a mutually-restricted and coordinated micro-ecological balance between the host and the environment, and plays a key role in maintaining female reproductive tract health. By evaluating the microecological status of the genital tract before ET, the risk factors of genital tract diseases can be found in time, and the success rate of ET can be improved. The mechanism by which the reproductive tract microbiome affects the success rate of embryo transfer may be related to the abnormal inflammation and immune response caused by changes in the colonic flora of the uterine cavity, which in turn affect endometrial receptivity. The research progress in the application of reproductive tract microbiology in embryo transfer was reviewed in order to provide a new direction for improving the success rate of embryo transfer. References | Related Articles | Metrics

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Assisted Pregnancy Strategy for Patients with Clomiphene-Resistant Polycystic Ovary Syndrome WANG Bao-juan，SONG Jia-yi，GONG Zheng，XIA Tian，MA Rui-hong 2020, 39 (2):  163-166.  Abstract ( 1377 )   PDF (645KB) ( 9150 )   Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease for women of childbearing age. Ovulation stimulation is the main treatment of PCOS, and clomiphene citrate (CC) is the first-line medicine of ovulation stimulant. However, some patients are not sensitive to CC, so-called clomiphene resistant PCOS (CCR-PCOS). Clinically, pre-treatments should be done in the early stage of ovulation induction in order to achieve a good therapeutic effect, including lifestyle management, improvement of insulin resistance, reduction of androgens and lipid levels, etc., the single or combined stimulation therapy was then selected among letrozole, gonadotropin and laparoscopic ovarian drilling. It is worth noting that IVF can be used to facilitate pregnancy in those CCR-PCOS patients with the first- and second-line ovulation induction failure or with other IVF indications (such as advanced age, fallopian tube factors or male factors leading to infertility). The pregnancy-promoting strategies of CCR-PCOS patients were reviewed in this paper. References | Related Articles | Metrics

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Factors Influencing Pregnancy after Hysteroscopic Submucosal Hysteromyoma Resection BAI Jian-ping，ZHOU Jian-zheng 2020, 39 (2):  167-171.  Abstract ( 1639 )   PDF (713KB) ( 9090 )   Uterine fibroids are the most common benign tumors in women of childbearing age, among which submucosal fibroids account for about 10% to 15%. Submucosal uterine fibroids deform the uterine cavity, which is one of the important causes of infertility, miscarriage, prolongation and postpartum hemorrhage. Hysteroscopic surgery is the preferred treatment of submucosal uterine fibroids with the benefits of simple operation, less bleeding and fewer complications. The submucosal uterine fibroids size, operating time, pressure of palace, palace medium, postoperative intrauterine adhesions, and other factors, will affect the postoperative pregnancy. The adverse effects of those factors on pregnancy can be reduced by the preoperative pretreatment to reduce the size of submucosal uterine fibroids, by reducing the risk of cervical and endometrial lesion during operation, reducing the incidence of the body fluid overload, and preventing intrauterine adhesions by comprehensive measures. The close follow-up and other methods are also helpful for the postoperative pregnancy. References | Related Articles | Metrics

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Research Progress in Osteopontin and Matrix Metalloproteinase-2 in Ovarian Cancer TIAN Xin-yu，YOU Qi，GONG Cheng-feng，CHENG Cong-cong，LI Yun-xiu，WU Jin-yu，YUAN Hai-tao 2020, 39 (2):  172-176.  Abstract ( 1320 )   PDF (693KB) ( 9133 )   Ovarian cancer is one of the common gynecological malignancies, and the mortality rate is the tope of three major gynecological malignancies. The hidden onset, rapid development and resistance to chemotherapy are of three characteristics, and most patients have a poor prognosis. Osteopontin (OPN) and matrix metalloproteinase 2 (MMP-2) are two kinds of novel tumor markers. In recent years, the high expressions of OPN and MMP-2 in ovarian cancer were found. OPN is a secreted phosphorylated glycoprotein, which can inhibit ovarian cancer cell apoptosis through NF-κB and other pathways, and activate the MAPK signal transduction pathway and change the cytoskeleton. OPN can induce ovarian cancer cell growth and proliferation, and promote cell adhesion and metastasis, by activating the PI3K/Akt pathway. MMP-2 is a type Ⅳ collagenase, which is mainly related to the occurrence, development, invasion and metastasis of ovarian cancer by degrading extracellular matrix proteins and participating in cell signal transduction. In addition, OPN can activate the MMP-2 expression through a variety of signal pathways, and accelerate the degradation of the extracellular matrix around ovarian cancer cells. The combined detection of the two markers can improve the sensitivity and specificity of ovarian cancer diagnosis. The combined detection is also helpful to predict the treatment prognosis. In this article, the effects of OPN and MMP-2 on the biological behaviors of ovarian cancer such as invasion and metastasis, and the molecular mechanism, were discussed. References | Related Articles | Metrics