Journal of International Reproductive Health/Family Planning

Effect of Cesarean Section History on Cumulative Live Birth Rate Following IVF/ICSI-ET

YAO Ru-qiang, WANG Xin-yan, DIAO Jun-rong, ZHANG Xing-xing, ZHANG Yun-shan, LUO Hai-ning

2023, 42 (3): 177-183. doi: 10.12280/gjszjk.20220491

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Objective： To investigate whether a previous caesarean section affects the clinical outcomes of patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for the first oocyte retrieval cycle. Methods： This was a retrospective cohort study among women with one previous delivery history and undergoing IVF/ICSI-ET for the first-time treatment during January 2015 to December 2020 at the reproductive medicine center of Tianjin Central Hospital of Gynecology Obstetrics. All subjects were followed to the first delivery after ET, use-up of all embryos, drop-out or the end of the study period. We retrospectively analyzed the association between previous caesarean section and the cumulative live birth rate (CLBR). Results： A total of 1 216 women were included, including 605 with a history of caesarean section and 611 with a history of vaginal delivery. Women with a previous caesarean section went through 1 053 ET cycles, and women with a previous virginal delivery went through 947 ET cycles. No significant differences were observed in the baseline characteristics (except for prolactin and infertility time), clinical features of the treatment, number of oocytes retrieved and laboratory outcomes between the two groups (all P>0.05). Women with previous caesarean section history had higher proportions of single-embryo ET cycles and FET cycles (P<0.05). The CLBR among women with a previous caesarean section was 59.00% (95%CI: 55.08%-62.92%), and the CLBR among women with a previous vaginal delivery was 62.68% (95%CI: 58.84%-66.51%), the difference between the two groups was significant (χ²=13.665, P<0.001). For the women with a previous caesarean section compared to women with a previous vaginal delivery, the OR of CLBR after adjusting for age, number of oocytes retrieved, quality of embryos and the endometrium thickness was 0.825 (95%CI: 0.712-0.956, χ²=6.531, P=0.011). Conclusions： Compared to women with a previous vaginal delivery, women with a previous caesarean section had lower CLBR following IVF/ICSI-ET.

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Clinical Application of Growth Hormone Supplementation in Non-DOR Patients with Previous IVF/ICSI Failure

CHEN Qiu-yan, LU Nan, LIU Jia-yin

2023, 42 (3): 184-188. doi: 10.12280/gjszjk.20230027

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Objective： To investigate the effect of growth hormone(GH) supplementation on the clinical outcomes in non-diminished ovarian reserve(DOR) patients with previous in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) failure. Methods： It was a retrospective, self-controlled study. The clinical outcomes of the first and second IVF/ICSI cycle in 174 non-DOR patients undergoing the second IVF/ICSI cycle with GH supplement, from January 1st, 2018 to December 31st, 2021 in our center, were analyzed. Results： The gonadotropin(Gn) dosage per day, number of oocytes retrieved, 2PN cleavage rate, high-quality embryo rate, embryo implantation rate and clinical pregnancy rate were significantly increased, and Gn duration were significantly decreased in the GH group compared with control group(P<0.05). The clinical pregnancy rate was not affected by the ovarian stimulation protocol, while the differences of Gn dosage, endometrial thickness, fertilization rate and abortion rate were not statistically significant (all P>0.05). Subgroup analysis indicated that the antral follicle count (AFC), clinical pregnancy rate and live birth rate in the <35 years group were higher than those in the ≥35 years group (all P<0.05)，while there were no significant differences in body mass index (BMI), anti-mullerian hormone (AMH), basic follicle stimulating hormone(FSH), Gn duration and dosage, endometrial thickness on the day of embryo transfer, number of oocytes retrieved, fertilization rate, 2PN cleavage rate, high-quality embryo rate, embryo implantation rate and abortion rate between the two groups(all P>0.05). Conclusions： GH supplementation can improve the ovarian function and response, and clinical outcome for those non-DOR patients with previous IVF/ICSI failure, especially for young patients.

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Clinical Outcomes of Preimplantation Genetic Testing in Patients with Autosomal Dominant Polycystic Kidney Disease Associated with Male Infertility

WANG Jia-xiong, NI Meng-xia, WANG Wei-zhuo, TANG Zheng, SHEN Li-yan, FU Xu, YANG Shen-min, OU Jian

2023, 42 (3): 189-192. doi: 10.12280/gjszjk.20230048

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Objective： To investigate the clinical outcomes of preimplantation genetic testing (PGT) in patients with autosomal dominant polycystic kidney disease (ADPKD) associated with male infertility. Methods： From March 2020 to December 2021, 7 patients with ADPKD associated with male infertility were conducted PGT treatment in the center for reproduction and genetics of the Affiliated Suzhou Hospital of Nanjing Medical University. Data on imaging, sperm quality, sperm ultrastructure, genetic etiology, and preimplantation genetic analysis were retrospectively analyzed. Results： All 7 patients showed different degrees of oligozoospermia, and the PKD1 gene heterozygous mutation. The majority of patients showed dilatation or cystic lesions of the reproductive tract, and the disturbed partially ultrastructure of sperm flagellum. Five clinical pregnancies and successful births were achieved after assisted reproduction in 7 patients. Conclusions： The results of genetic testing can guide the treatment in patients with ADPKD associated with male infertility, and PGT can improve pregnancy outcomes.

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Analysis of Influencing Factors on Potential Categories of Post-Traumatic Stress Disorder Symptoms among Patients with Gynecologic Malignant Tumor

LI Yao, YAN Xue, LIU Qian-qian, WEI Si-qi

2023, 42 (3): 193-198. doi: 10.12280/gjszjk.20220595

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Objective： To explore the potential categories of post-traumatic stress disorder symptoms (PTSS) in patients with gynecologic malignant tumor, and to analyze the influencing factors of different categories of PTSS. Methods： A total of 231 patients with gynecologic malignant tumors were selected from three hospitals in Lanzhou City, from April 2022 to September 2022. The questionnaires of general information, the Posttraumatic Stress Disorder Checklist for DSM-5, Hardiness Scale, Generalized Anxiety Disorder 7-Item Scale and Perceived Social Support Scale were used in this study. The results of various models of PTSS patient were comprehensively judged by the latent profile analysis. The best model was determined through the "best interpretation model". The effects of various factors on the different PTSS categories were evaluated by the unordered multi-classification logistic regression. Results： PTSS in 231 patients with gynecologic malignant tumor was divided into three categories: 97 cases (42.0%) with moderate symptoms and high arousal; 98 cases (42.4%) were low symptom type; 36 cases (15.6%) with high symptoms and high avoidance. The results of logistic regression analysis showed that the number of children, tenacity personality, anxiety and social support affected the potential classification of PTSS in patients with gynecological malignancies (P<0.05). Conclusions： The PTSS of patients with gynecological malignant tumor has the significant classification characteristics. Medical staff can implement psychological intervention for the different types of patients according to the influencing factors of different types of PTSS, so as to alleviate the symptoms of patients.

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The Prevalence and Epidemiological Investigation of Birth Defects in Hebei Province from 2017 to 2021

TIAN Mei-ling, DU Li-yan, MA Guo-juan, MENG Fan-xue, XIAO Yuan-ge

2023, 42 (3): 199-202. doi: 10.12280/gjszjk.20220480

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Objective： To understand the prevalence and epidemiological characteristics of perinatal birth defects in Hebei Province from 2017 to 2021. Methods： The data were from the birth defect information monitoring system of Hebei Center for Women and Children′s Health from 2017 to 2021. The system includes 22 monitoring points (hospitals) distributed in various cities of Hebei Province. Results： There were 200 146 hospitalized deliveries in Hebei province, of which 8 908 were birth defects, and the incidence of birth defects was 445.08/10 000. The perinatal survival rate of birth defects was showed an upward trend. The top 10 reported cases were congenital heart disease, cleft palate/lip palate, polydactyls and syndactyls, other abnormalities of the outer ear, fetal chromosomal abnormalities, polydactyls and syndactyls, hydrocephalus, hypospadias, congenital malformations of the digestive system and clubfoot. The incidence of perinatal birth defects is different in different regions. The incidence of birth defects in urban areas was higher than that in rural areas; the incidences of birth defects in women aged <18 years and ≥35 years were higher than that in women aged 18-35 years; and the incidence of perinatal birth defects in menpara women was higher than that in primipara women. The incidence of perinatal birth defects in males was higher than that in females (P<0.001). Conclusions： There were the regional, urban and age differences in the incidence of birth defects in Hebei province. It is necessary to carry out eugenics′ education for pregnant women with high risk factors, and publicize the importance of health care before and during pregnancy.

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Tandem Mass Spectrometry Screening and BCKDHA, BCKDHB, and DBT Genetic Mutation Analysis in Children with Maple Syrup Urine Disease in Shijiazhuang Area, China

JIA Li-yun, GONG Miao, YANG Hui-xin, WANG Xi, FENG Ji-zhen

2023, 42 (3): 203-205. doi: 10.12280/gjszjk.20230033

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Objective： To explore the prevalence rate of maple syrup urine disease (MSUD) in newborns, and to analyze the mutation characteristics of related genes in Shijiazhuang area, China. Methods： A total of 185 683 newborns born from January 2014 to December 2021 in Shijiazhuang area were screened for MSUD by tandem mass spectrometry, and BCKDHA, BCKDHB and DBT mutations were detected in newborns with positive screening. Results： Two children with MSUD were confirmed, with a prevalence rate of 1∶92 842. In two confirmed cases, the levels of blood leucine (Leu) and valine (Val) were elevated during initial screening. The levels of case 2 were also elevated in the review of tandem mass spectrometry, while case 1 died prematurely before being recalled for review and was not performed the review of tandem mass spectrometry. Two children with MSUD were all classic with gene complex heterozygous mutations of BCKDHB and DBT, and four mutations were found including c.331C>T, c.289G>T, c.75_76delAT and c.1359_1360delAG. Two unreported gene mutations were found, c.289G>T and c.1359_1360delAG. No mutations in the BCKDHA gene were detected. Case 1 died prematurely 10 days after birth. Case 2 began to develop symptoms 8 days after birth, and improved after timely intervention and treatment. Conclusions： Tandem mass spectrometry technology can be applied in newborn disease screening to detect early newborns with MSUD. The genetic testing can identify genetic causes and provide a basis for genetic counseling. The prevalence rate of MSUD in Shijiazhuang area was 1∶92 842. Four gene mutations, two of which were unreported gene mutations, were found in this study, enriching the gene mutation spectrum of MSUD.

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Two Lesions of Uterine Arteriovenous Fistula Combined with Retained Products of Conception: A Case Report

XU Qian, PENG Yan-zhen, LIU Xin, CHEN Xi

2023, 42 (3): 206-210. doi: 10.12280/gjszjk.20220526

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A case of the two lesions of uterine arteriovenous fistula combined with retained products of conception was reported. The patient was admitted to hospital with vaginal dripping bleeding with paroxysmal massive bleeding after the curettage of missed miscarriage. Uterine artery embolization was performed after admission. Uterine arteriovenous fistula was definitely diagnosed during the operation. On the second day, hysteroscopy combined with laparoscopy was performed. Hysteroscopy revealed that the embryo residues in the uterine cavity. Laparoscopy revealed that the right cornu uteri protrusion, while the left fundus near the left cornu uteri was locally purple blue lesions. The surface was covered with a large number of malformed blood vessels. During laparoscopic resection of the right cornu uteri and the left fundus lesions, tubular dilated blood vessels between the muscular layers was observed. Uterine arteriovenous fistula appeared a fatal hemorrhage, when combined with embryo residue, the risk of bleeding was higher. Clinical awareness of uterine arteriovenous fistula combined with retained products of conception needs to be improved. Ultrasound is the preferred imaging, and when the peak systolic velocity(PSV) of the uterine artery is greater than 60-70 cm/s, immediate intervention is required. Digital subtraction angiography(DSA) is the gold standard for diagnosing uterine arteriovenous fistula, which can be performed concurrently with uterine artery embolization to reduce bleeding. During surgery, intermural lesions should be carefully explored to prevent the formation of multiple arteriovenous fistulas between the muscles and the missed diagnosis. If uterine arteriovenous fistula is combined with retained products of conception, the combined hysteroscopy and laparoscopy may be the recommended treatment.

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A Case of Female Sexual Reversal Syndrome Combined with Gonadoblastoma and Dysgerminoma

WANG Min, MA Shuai, LI Dan, ZHENG Lian-wen, LIU Wei

2023, 42 (3): 211-212. doi: 10.12280/gjszjk.20220423

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Sexual reversal syndrome is a kind of hereditary disease whose chromosome sex is not consistent with gonad sex. The incidence is very low, and pathogenesis is unknown. The related clinical manifestations are different. This paper report a patient with 46, XY chromosome karyotype, but her gender, internal and external genitalia are female, and the right ovary is accompanied by gonadoblastoma and dysgerminoma, in order to provide some new clinical ideas for the diagnosis, treatment and research of sex reversal syndrome.

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Ovarian Hyperstimulation Syndrome Complicated with Superior Mesenteric Venous Thrombosis and Portal Vein Thrombosis: A Case Report

QIU Meng-zhen, SHANG Jin, TU Xiao-jun, LI Jie

2023, 42 (3): 213-217. doi: 10.12280/gjszjk.20220552

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The ovarian hyperstimulation syndrome (OHSS) complicated with superior mesenteric venous thrombosis (SMVT) and portal vein thrombosis (PVT) is a rare thrombotic disease, with the continuous increase of human chorionic gonadotropin in pregnant women and the further aggravated condition. In severe cases, intestinal ischemic hemorrhage, septic shock, abortion, premature delivery and death may occur. Therefore, it is one of the serious complications in the process of in vitro fertilization-embryo transfer (IVF-ET). The early clinical manifestations and auxiliary examinations of the disease are lack of specificity, and it is easy to be misdiagnosed or missed, and to delay treatment. A case of OHSS found 10 days after IVF-ET and diagnosed with SMVT and PVT complicated with intestinal obstruction 61 days after transplantation was reported. After multidisciplinary consultation, the comprehensive treatment of oxygen inhalation, expansion of blood volume, anticoagulation, infection prevention, correction of electrolyte disorders and others was given. The effect was poor and the condition deteriorated sharply. After transferred to our hospital, the emergency resection of necrotic small intestine plus end-to-end anastomosis of residual small intestine plus thrombectomy of superior mesenteric vein and portal vein was performed. At more than 5 months of pregnancy, induction of labor was performed due to fetal death.

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A Case Report of Pregnancy Complicated with Uterine Adhesion "Wall"

LIAO Dai-ya, LI Xue, QIAO Zhi-li, LIAO Xiang-yu, ZHANG Ke-rong

2023, 42 (3): 218-220. doi: 10.12280/gjszjk.20220481

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In recent years, the incidence of uterine adhesion is on the rise. A case of full-term pregnancy with uterine cavity adhesion "wall" (about 2.5 cm thick) was reported. The patient was admitted to hospital for 36⁺² weeks of gestation and irregular abdominal pain for more than 3 hours. The patient had a history of 2 cesarean sections and 1 uterine curettage. Multiple ultrasound during pregnancy revealed heterogeneous echoes in the lower segment of the uterus, which had been diagnosed as placenta previa. After admission, cesarean section was performed due to scar uterus. During the operation, a cavity was found in the lower segment of the uterus, which was about 12 cm × 6 cm×4 cm. The top of the cavity was curved from right to left, which was muscular tissue, and no pregnancy was found in the cavity. After switching to the "inverted T" incision of the uterus and thoroughly cutting open the muscular tissue at the top of the lacuna, the amniotic sac of pregnancy was seen. After the fetus was removed, the placenta was found in the posterior wall of the uterus, covering the muscular tissue (adhesion "wall") down to the anterior wall. After artificial exfoliation of the placenta, the muscular adhesion "wall" was removed and the uterine anatomy was restored. The patient recovered well after operation. Through reviewing this case and summing up the experience, the understanding of uterine cavity adhesion will be strengthen for clinical and ultrasonic doctors.

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Research Progress of In Vitro Three-Dimensional Culture System of Preantral Follicles

LI Yan, HU Fang-fang, CHEN Huan-huan, ZHANG Lei, ZHANG Cui-lian, LIANG Lin-lin

2023, 42 (3): 221-225. doi: 10.12280/gjszjk.20220455

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In vitro follicle culture has important implications for preserving fertility in patients with the decreased ovarian function caused by cancer treatment. It is also an effective method for studying follicle development and oocyte maturation. In order to establish an in vitro culture system that can better simulate the in vivo growth environment, current in vitro follicle culture systems are roughly divided into two-dimensional and three-dimensional cultures. Two-dimensional follicle culture systems have been successfully established in rodent models. However, since three-dimensional culture can provide the spatial structure for follicular growth, the effect of three-dimensional culture is superior to that of two-dimensional culture. Therefore, three-dimensional culture has been widely used for the culture of follicles in various animal models. Three-dimensional culture systems can be divided into scaffold-based and scaffold-free culture systems, and the choice of scaffold material has a direct impact on in vitro follicle development. Scaffold materials can be classified into natural and synthetic materials according to their source. Natural materials, such as alginate, collagen and fibronectin, have better biocompatibility than synthetic materials, but the adjustability of synthetic materials makes them promising. This review summarizes the effects of choosing a three-dimensional culture system on in vitro follicle development.

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Assisted Reproductive Technology and Offspring Safety

WANG Chun-yan, WANG Jie-yu, CHENG Jing-xian, WANG Yin-shuang, LUO Gui-ying

2023, 42 (3): 226-230. doi: 10.12280/gjszjk.20220556

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Whether the artificial intervention of assisted reproductive technology（ART） in the early life will bring potential risks to the long-term health and safety of the offspring has always been a key issue of human health. This article reviews the key points of ART, such as artificial insemination, in vitro fertilization-embryo transfer and its derivative technology, and summarizes and analyzes the safety of offspring from the aspects of adverse pregnancy outcomes, birth defects, long-term health problems, and genetic imprinting abnormalities. Most studies support the safety of ART and believe that children born by ART do not increase the incidence of adverse events. However, since most research data focus on infants and young children, it is still necessary to conduct the long-term health follow-up of children born by ART to obtain health data in adolescents and adulthood, and to further demonstrate the safety of children born by ART.

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Effects of Novel Coronavirus Infection on Semen Indexes

ZHANG Li-hong, HU Rong, XIE Lei, XU Xiao-juan, HU Jun-ping

2023, 42 (3): 231-235. doi: 10.12280/gjszjk.20220600

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At present, the mechanism of novel coronavirus infection has been clarified, and the male reproductive system may also be the target of novel coronavirus infection. After a man is infected with the novel coronavirus, there may be temporary decrease in semen volume, sperm concentration, sperm count, sperm motility, percentage of normal morphologic sperm, and increased sperm DNA fragment rate, and other semen detection indicators, which affect the quality of male semen and reduce male fertility. The possible mechanisms causing these changes include testicular inflammation, over-immunity, cytokine storm, the impaired endocrine function, fever, etc. Whether novel coronavirus exist in male semen needs further research and testing. In this paper, the specific effects of novel coronavirus infection on male semen indexes and the potential mechanism were summarized, providing a reference for pregnant couples to choose the fertilization time of related treatment and assisted reproductive treatment after their infection with novel coronavirus.

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Association of Intestinal Flora with Male Infertility

HU Rong, XIE Lei, ZHANG Li-hong, HU Jun-ping

2023, 42 (3): 236-239. doi: 10.12280/gjszjk.20220579

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The intestinal flora, with a large number and a wide variety of categories, plays an irreplaceable role in human immunity, metabolism, and neuromodulation. Studies have shown an inextricable link between gut microbiota and male infertility. The intestinal flora of male infertility patients is related to the inflammatory response, metabolic regulation, neuromodulation and erectile dysfunction, and may affect male fertility through endotoxemia, energy metabolism, short-chain fatty acids, insulin resistance, etc. In addition, there have been a small number of studies on the clinical practice of dietary modification and supplementation of probiotics to regulate the intestinal flora in the treatment of some diseases. For example, the oral probiotics combined with L-carnitine can reduce the rate of sperm DNA fragmentation in obese men, which provides new ideas for the treatment of male infertility. In this paper, the association between intestinal flora and male infertility was summarized. The discussion of the role of intestinal flora in male infertility will be helpful for improving the clinical treatment options.

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Mitophagy and Ovarian Function

YANG Zhi-juan, YAO Ting, HOU Hai-yan

2023, 42 (3): 240-244. doi: 10.12280/gjszjk.20220558

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Mitochondria play a crucial role in determining oocyte development ability and ovarian function. Mitophagy is a process that selectively remove the excess or damaged mitochondria. It is associated with the maintenance of mitochondrial homeostasis and cell survival. However, inhibition or overactivation of mitophagy may affect cell function and cell survival. When exposed to adverse environment, oocyte is impaired in the mitochondrial function, inducing excessive mitophagy. Ultimately, the oocyte quality is declined. The mitochondria of the postovulatory aging oocytes are damaged to a certain extent, the application of antioxidants can induce mitophagy in oocytes to remove the damaged mitochondria and improve oocytes development ability. The relationship between oocytes mitophagy and ovarian function, as well as the effects of adverse environmental stimulation and antioxidants on oocyte mitophagy were reviewed in this paper, to provide a theoretical basis for the application of antioxidants to improve oocyte quality in patients with the decreased ovarian reserve.

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Effects of Continuous Light and Staying Up Late on Female Reproductive Function

DU Wen-hao, GAO Fu-min, LI Xiao-long, OU Xiang-hong

2023, 42 (3): 245-249. doi: 10.12280/gjszjk.20230010

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In recent years, the shift system, overtime and staying up late have gradually become the life norm. More and more people have been exposed to artificial light sources for a long time, and light pollution has been identified as one of the major threats to human health, particularly among the urban population. Continuous lighting and staying up late have been linked to female menstrual disorders, infertility, recurrent spontaneous abortion, and other issues. The relevant mechanisms may include the endocrine disorder, abnormal follicular development, luteal dysfunction and metabolic disorders by inhibiting the hypothalamus-pituitary-gonad axis. However, the exact mechanisms are still unknown. We review the impact of continuous light on female reproductive function and the relationship between continuous light and infertility and recurrent spontaneous abortion, and possible mechanisms of action in this paper.

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Effect of Different Dietary Patterns on Female Fertility

ZENG Zhong-hong, LIANG Ting

2023, 42 (3): 250-253. doi: 10.12280/gjszjk.20230011

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With the postponement of the childbearing age and the change of their living environment, more and more women of childbearing age are facing infertility. There are many factors that affect female fertility, and the preparation of diet is concerned. Specific nutrients in the dietary pattern can provide the nutrients needed by the body, which also improve female fertility by improving egg quality, regulating sex hormone levels, reducing oxidative stress, managing body mass and other ways. The four common dietary patterns, including the Mediterranean diet, dietary approaches to stop hypertension, anti-inflammatory diet and ketogenic diet, are closely related to female fertility. They have a considerable degree of overlap, with obvious differences in terms of dietary composition, characteristics and applicable population. At present, dietotherapy has been widely used and achieved relatively optimistic results. However, dietotherapy has not been applied to improve female fertility in clinical practice in China. The research progress of the effect of different dietary patterns on female fertility is summarized, with a view to providing reference for clinical treatment and scientific research.

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Research Progress of Recurrent Spontaneous Abortion Caused by Abnormal Immune Microenvironment at the Maternal-Fetal Interface

SU Dan-na, DIAO Rui-ying, SHE Jia-jie, SHUAI Ling, GUO Yan, LI Dong-dong, YE Xiao-feng, WANG Li-ping

2023, 42 (3): 254-260. doi: 10.12280/gjszjk.20220509

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Maternal recognition of embryos and the establishment of immune tolerance are necessary conditions for pregnancy. The essence of immune tolerance at the maternal-fetal interface is that embryonic trophoblast cells, decidual stromal cells and decidual immune cells jointly participate in the process of maternal-fetal dialogue, promoting the transformation of the immune microenvironment and the establishment of adaptive immunity at the maternal-fetal interface, such as trophoblast cell infiltration, spiral artery remodeling, maternal-fetal immune tolerance establishment and so on. The imbalanced immune homeostasis caused by abnormal maternal-fetal immune microenvironment is an important cause of recurrent spontaneous abortion (RSA). Abnormal maternal-fetal immune microenvironment includes excessive immune inflammatory response, the impaired immune tolerance, and the oscillation of maternal-fetal immune microenvironment. Therefore, immunomodulation should be one of the core strategies for the treatment of RSA, including the application of immunosuppressants, immunomodulatory drugs, and active lymphocyte immunotherapy. However, the efficacy of immunomodulation needs to be verified by more high-quality evidence from evidence-based medicine.

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Effect of Iron Overload and Ferroptosis on the Reproductive Function of Endometriosis Patients

CHEN Lu, YANG Chun-xia, SUN Yan, LI Feng, XUE Tong-min, LU Dan

2023, 42 (3): 261-264. doi: 10.12280/gjszjk.20230017

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Endometriosis as an estrogen-dependent chronic inflammatory disease may increase the rate of infertility in women of childbearing age by the decreased fertilization, poor oocyte quality and low quality of embryos. Although it is generally believed that endometriosis is related to hormonal, inflammatory, oxidative stress, genetic and other factors, the relevant mechanisms of endometriosis have not been fully clarified. Recently, iron overload and ferroptosis have been widely studied in endometriosis. Iron is a basic element for survival of most organisms including human beings, and iron deficiency may cause the disorder of reproduction. Adequate level of iron can promote embryonic development. However, the epidemiological studies have shown that excessive iron intake or high iron status may be harmful to female reproduction. Here, we focus on the impact of iron overload and ferroptosis in endometriosis on the different aspects of the female reproductive system.

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