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15 July 2026, Volume 45 Issue 4
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Career Development and Standardized Training for Clinical Embryologists in Reproductive Medicine Centers LIU Chuang, MENG Peng, WANG Hong-na, WEI Yan-ling, WANG Jing, XIANGLI Qian-qian, ZHANG Jian-fang 2026, 45 (4):  265-269.  doi: 10.12280/gjszjk.20260262 Abstract ( 84 )   HTML ( 22 )   PDF (849KB) ( 55 )   There are some issues in the current career development of clinical embryologists, mainly manifested in the mismatch between the actual medical job characteristics of clinical embryologists and the current occupational classifications (such as laboratory technology and researcher categories), as well as the poor alignment between the assessment content of the professional title promotion system and the actual job requirements of clinical embryologists; there is a lack of a registration, training, and assessment platform for clinical embryologists, while the quality of existing training models (national training bases, internal mentorship) varies. Against the backdrop of the combined application of artificial intelligence and the internet of things, the standardized training and assessment model for clinical embryologists still requires continuous exploration. This article, based on the current domestic and international situation and the National Health Commission's management regulations on assisted reproduction technology, proposes some recommendations for the standardized training model. Through policy support, the establishment of a "Clinical Embryology Technology" major, with the qualification certificate issued by the training base serving as the basis for participating in the "National Vocational Qualification Examination", will open the pathway of professional title evaluation from junior to senior. The construction of a national public platform will provide a foundation for the professional registration and systematic learning of clinical embryologists, enabling continuous updates to the knowledge system and ultimately achieving rapid development of clinical embryology technology, which will benefit infertile patients. References | Related Articles | Metrics

Original Article

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Analysis of Influencing Factors of Adverse Psychological State of Primipara in Late Pregnancy and Its Impact on Maternal and Infant Outcome CHEN Yan, WANG Shan-lin, MA Zhen-hua, GAO Hui, ZHOU Rong, DING Ming-ming, XIANG Min 2026, 45 (4):  270-275.  doi: 10.12280/gjszjk.20260007 Abstract ( 55 )   HTML ( 17 )   PDF (871KB) ( 45 )   Objective: To explore the influencing factors of adverse psychological state in primiparas during late pregnancy and its impact on maternal and infant outcome. Methods: A total of 264 primiparas were enrolled as the research objects. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate their psychological state in late pregnancy. The incidence and influencing factors of anxiety and depression symptoms were analyzed, and maternal and infant outcomes were compared between the groups with different psychological state. Results: Among the 264 primiparas, the incidence of anxiety symptoms was 23.11% (61/264), and the incidence of depression symptoms was 17.80% (47/264) in late pregnancy. Multivariate Logistic regression analysis showed that low education level, low monthly family income, poor social support and poor sleep status were risk factors for anxiety symptoms (all P<0.05); and that low education level, living with elders, low monthly family income, poor social support and poor sleep status were risk factors for depression symptoms (all P<0.05). Significant differences were found in cesarean section rate and the incidence of premature rupture of membranes, prolonged labor, postpartum hemorrhage, postpartum depression, postpartum infection, fetal intrauterine distress and premature delivery between the anxiety group and the non-anxiety group, as well as between the depression group and the non-depression group (all P<0.05). No significant differences were observed in the incidence of growth retardation and low body weight in infants at 1, 3 and 6 months of age (all P>0.05). Conclusions: The incidence of anxiety and depression symptoms is relatively high in primiparas during late pregnancy, which is affected by educational level, monthly family income, social support and sleep status, and is closely related to adverse maternal and infant outcomes. Figures and Tables | References | Related Articles | Metrics

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Analysis of the Potential Changes in Psychological Resilience and Influencing Factors in Advanced Age Patients Undergoing Abortion LIU Wei-wei, LUO Shao-lian, KONG Yan-qing, LIU Ke-xuan 2026, 45 (4):  276-281.  doi: 10.12280/gjszjk.20260108 Abstract ( 67 )   HTML ( 12 )   PDF (988KB) ( 39 )   Objective: To investigate the changes in the categories of psychological resilience in the advanced age patients with abortion over time, and to analyze the factors influencing the category transitions. Methods: A purposive sampling method was used to select 210 advanced age patients with abortion who were treated in the gynecology outpatient department of The First People's Hospital of Foshan from February 2024 to February 2025. The Connor-Davidson Resilience Scale, Social Support Rating Scale, Emotion Regulation Questionnaire and Family APGAR Index were used to conduct follow-up investigation at one week (T1) and six months (T2) after induced abortion. Latent profile analysis and latent transition analysis was employed to explore the latent categories of psychological resilience and the transition probabilities. Multivariate logistic regression was used to investigate the effects of social support, family care, and emotional regulation strategies on the category transitions of psychological resilience. Results: The psychological resilience of the advanced age patients with abortion can be classified into three potential profile categories: the low resilience group, the medium resilience group, and the high resilience group. The proportions of each group at the time points of T1 and T2 were 80.5% and 13.4%, 10.7% and 35.6%, and 8.8% and 51.0% respectively. The results of the latent transition analysis showed that the high resilience group had a 100% probability of remaining in the original group at the time point of T2, indicating the strongest stability; the medium resilience group had the poorest stability, with a 100% probability of transforming to the high resilience group at the time point of T2; the low resilience group had poorer stability, with a 26.3% probability of remaining in the original group and a 73.7% probability of transforming to the medium resilience group at the time point of T2. Multivariate logistic regression showed that social support, family care, and cognitive reappraisal would promote the transformations from low resilience to medium resilience (ORs of 1.306, 2.165, and 1.171, respectively, all P<0.05), and from medium resilience to high resilience (ORs of 1.169, 2.195, and 1.426, respectively, all P<0.05); and that expression inhibition would inhibit the transformations from low resilience to medium resilience, and from medium resilience to high resilience (ORs of 0.862 and 0.889, respectively, both P<0.05). Conclusions: The psychological resilience of advanced age patients who have undergone abortion is poorer in the early postoperative period. Most patients can develop to a higher level of resilience, but there are still some patients with low resilience who have not shown any improvement trend. Clinically, attention should be paid to their psychological state in the early postoperative period. By changing social support, family care, and emotional regulation strategies, the levels of individual psychological resilience can be improved. Figures and Tables | References | Related Articles | Metrics

Case Report

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A Case of Misdiagnosed Chromosomal Insertion Translocation as A Balanced Translocation YI Jia-xin, ZHANG Na, CHEN Yu-hua, YE Wei, CHEN He-lian, XIE Si-ying, WANG Ming-rui 2026, 45 (4):  282-284.  doi: 10.12280/gjszjk.20260027 Abstract ( 58 )   HTML ( 4 )   PDF (997KB) ( 43 )   We report a case of theoretically inconsistent results between the prenatal diagnosis and previous chromosomal karyotype analysis at Affiliated Hospital of Guangdong Medical University (our hospital). The previous previous karyotype analysis of peripheral blood from an outside hospital suggested 46,XX,t(1;5)(p36;q22) in the pregnant woman, and 46,XY,inv(Y)(p11q11) in her spouse. However, the amniotic fluid karyotype at our hospital was 46,XN,ins(1;5)(p33;q34q21). According to the theory of gamete segregation of reciprocal translocation carriers, if the previous diagnosis is translocation, it is theoretically difficult to explain the current fetal karyotype, considering that the results of previous chromosomal karyotype analysis in the pregnant woman could be biased. For further verification, the pregnant woman was suggested to higher-level hospital for high-resolution G-banding review, and the peripheral blood karyotype of the pregnant women was confirmed to be 46,XX,ins(1;5)(p32.2;q33.2q22), which was consistent with the results of amniotic fluid karyotype from our hospital. This case suggests that the conventional G-banding has limited resolution for complex or atypical chromosomal structural abnormalities, especially when complex rearrangements are involved. It is necessary to further conduct high-resolution banding to accurately locate break points and rearrangement types, in combination with theoretical knowledge, so as to avoid affecting genetic counseling based on wrong diagnosis. Figures and Tables | References | Related Articles | Metrics

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Compound Heterozygous Mutations in SUN5 Cause Acephalic Spermatozoa: A Case Report CHEN Hai-xia, YANG Lin, MU Xiao-huan, SONG Xue-ru, TIAN Wen-yan, BAI Xiao-hong 2026, 45 (4):  285-289.  doi: 10.12280/gjszjk.20260048 Abstract ( 70 )   HTML ( 7 )   PDF (2915KB) ( 29 )   Acephalic spermatozoa is a severe sperm malformation characterized by the presence of sperm without heads and detached sperm heads, and abnormal head-neck connections in the semen. Here we report a case of male infertility due to acephalic spermatozoa. Through family-based whole exome sequencing and Sanger sequencing verification, it was found that the patient has compound heterozygous mutations c.7C>T(p.Arg3Trp) and c.1043A>T(p.Asn348Ile) in the SUN5 gene. Both parents were the heterozygous carriers of these mutations. Further protein functional assays predicted that the compound heterozygous mutations in SUN5 are disruptive to protein function. These findings suggest that SUN5 mutation may be a causative factor for acephalic spermatozoa in this patient. The spouse of the patient achieved clinical pregnancy and live birth through intracytoplasmic sperm injection (ICSI) technology, indicating that ICSI is currently the most direct assisted reproductive method for such patients. Figures and Tables | References | Related Articles | Metrics

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Laser-Assisted Hatching Improves Blastocyst Formation from Low-Grade Cleavage Embryos in Patients with Cryptozoospermia and Achieves Pregnancy: A Case Report TANG Xue-qiong, WU Xiao-dan, LI Deng-kun, ZHANG Jing, SU Guo 2026, 45 (4):  290-293.  doi: 10.12280/gjszjk.20260051 Abstract ( 65 )   HTML ( 8 )   PDF (874KB) ( 40 )   In assisted reproductive technology, the low-grade cleavage embryo (LGCE) is associated with a lower probability of developing into viable blastocysts, making it difficult to achieve satisfactory outcomes. We report a case of a 35-year-old male patient with cryptozoospermia who sought medical attention after more than two years of unprotected intercourse without conception while attempting to have a second child. He was diagnosed with secondary male infertility. His 31-year-old spouse underwent assisted reproductive technology with him. In the first oocyte retrieval cycle, 16 oocytes were retrieved, and 10 underwent intracytoplasmic sperm injection (ICSI). On Day 3, all embryos were LGCE (Grade Ⅲ-Ⅳ), and no viable blastocysts were formed following blastocyst culture. In the second oocyte retrieval cycle, 18 oocytes were retrieved, and 11 underwent ICSI. On Day 3, the embryos remained LGCE. Two fresh embryos were transferred, but did not result in pregnancy. The remaining embryos underwent blastocyst culture, and laser-assisted hatching (LAH) was employed to improve LGCE blastocyst formation, ultimately resulting in one 3BC-grade blastocyst that was cryopreserved. A live birth was subsequently achieved following a frozen-thawed embryo transfer cycle. By summarizing the management of this patient's LGCE, we explore the laboratory strategy to improve the blastocyst formation of LGCE in patients with cryptozoospermia, and to enhance their chances of pregnancy. References | Related Articles | Metrics

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Intrauterine Contraceptive Device with Rectal Ectopia and Transanal Protrusion: A Case Report SI Zhong-hua, DING Yang, XU Ling-ling 2026, 45 (4):  294-296.  doi: 10.12280/gjszjk.20260170 Abstract ( 64 )   HTML ( 4 )   PDF (1822KB) ( 42 )   Ectopic of the intrauterine contraceptive device (IUD) is a rare but serious complication following IUD insertion. Ectopic of the IUD can lead to uterine perforation, formation of an intra-abdominal foreign body, and even erosion into adjacent organs. We report a rare case in which an IUD penetrated the uterus, eroded through the rectum, and was eventually protruded via the anus. The patient presented with anal protrusion for 5 days, and successfully underwent the laparoscopic exploration combined with transanal removal of the foreign body. The postoperative course was uneventful with no complications. By reviewing relevant literature, we discuss the pathogenesis, diagnostic strategies, and minimally invasive surgical management of rectal ectopia of the IUD. Clinicians should maintain a high index of suspicion for IUD ectopia in patients with a history of IUD placement who present with anal protrusion or symptoms of rectal irritation. Laparoscopic exploration combined with transanal removal of the foreign body represents a safe and effective therapeutic option for this condition. Figures and Tables | References | Related Articles | Metrics

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Selective Reduction for Cornual Heterotopic Pregnancy: A Case Report CHEN Meng-ting, LIU Jun-yan, BAO Hong-chu 2026, 45 (4):  297-301.  doi: 10.12280/gjszjk.20260064 Abstract ( 72 )   HTML ( 5 )   PDF (1626KB) ( 66 )   A 36-year-old woman, who conceived via assisted reproductive technology, was diagnosed with heterotopic pregnancy involving intrauterine and right cornual pregnancy (dichorionic diamniotic twins). Selective reduction of the right cornual pregnancy was performed under transvaginal ultrasound guidance at 10+4 weeks of gestation. The cornual fetus was successfully selectively reduced, while the intrauterine embryo continued to develop normally. The patient delivered a live infant by cesarean section at 35+2 weeks of gestation, with a favorable maternal and neonatal outcomes. Cornual heterotopic pregnancy after embryo transfer is clinically rare. Due to the thin myometrium at the cornual region, the risk of rupture and hemorrhage is high in the second and third trimesters, making management challenging. Early and accurate diagnosis is essential for such patients, with priority given to protecting the intrauterine pregnancy and avoiding blind curettage or excessive intervention. Meanwhile, this case indicates that single embryo transfer is strongly recommended in assisted reproductive technology to effectively reduce the risk of such high-risk heterotopic pregnancies. Figures and Tables | References | Related Articles | Metrics

Review

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Research Progress on the Growth Hormone/Insulin-Like Growth Factor-1 Axis in Regulating Male Reproductive Function CHEN Tian-ze, WANG Dan-dan, HONG Ju-sheng, YANG Guang-ping 2026, 45 (4):  301-305.  doi: 10.12280/gjszjk.20260109 Abstract ( 59 )   HTML ( 16 )   PDF (1056KB) ( 51 )   Growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis not only participates in body growth and development as well as energy homeostasis maintenance, but also plays a significant role in the regulation of male reproductive function. At the central level, IGF-1 can participate in the regulation of gonadotropin-releasing hormone and luteinizing hormone secretion through influencing the excitability of hypothalamic Kisspeptin/neurokinin B/dynorphin (KNDy) neurons. At the testicular level, the GH/IGF-1 axis can affect testosterone synthesis and spermatogenesis by regulating the functions of Leydig cells and Sertoli cells, enhancing the responsiveness of testis to gonadotropin, and improving the local microenvironment of spermatogenesis. At the peripheral effect level, GH/IGF-1 axis may participate in the regulation of erectile function by maintaining endothelial cell function, regulating the nitric oxide/cyclic guanosine monophosphate (NO/cGMP) signal pathway, supporting nerve repair and maintaining the stability of the smooth muscle of the corpus cavernosum. However, the existing evidence is mainly based on animal experiments, in vitro studies and small-sample clinical observations, and the impact of the GH/IGF-1 axis on male reproductive functions is not a one-way promotion. There is still a lack of high-quality clinical intervention studies to support its routine application. References | Related Articles | Metrics

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Research Progress on the Animal Models and Mechanisms of Psychological Stress-Induced Reproductive Dysfunction LIU Jin-yu, MA Rui-hong, ZHAO Zhi-mei 2026, 45 (4):  306-310.  doi: 10.12280/gjszjk.20260238 Abstract ( 80 )   HTML ( 7 )   PDF (1523KB) ( 82 )   Psychological stress disrupts reproductive function through a multi-system network, which is a research focus in reproductive medicine. Common methods for modeling chronic psychological stress include chronic restraint stress, chronic unpredictable mild stress, social defeat stress, social isolation stress, and early-life stress. Psychological stress activates the hypothalamic-pituitary-adrenal (HPA) axis while inhibiting the hypothalamic-pituitary-gonadal (HPG) axis, leading to abnormal sex hormone secretion. It also induces oxidative damage and chronic inflammatory responses in reproductive tissues. Gut microbiota dysbiosis further amplifies the stress effect through the gut-brain-gonad axis, and epigenetic modifications mediate the long-term persistence and transgenerational transmission of stress effects. Future efforts should integrate multi-omics technologies to construct the standardized animal models of chronic stress, and to explore early intervention targets and personalized treatment strategies for stress-related reproductive dysfunction, thereby providing a theoretical foundation for clinical prevention and treatment. Figures and Tables | References | Related Articles | Metrics

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Precise Application of Short-Term Insemination Combined with Early Rescue Intracytoplasmic Sperm Injection YUAN Xia, HAN Xiao-fang, LI Hong 2026, 45 (4):  311-317.  doi: 10.12280/gjszjk.20260080 Abstract ( 89 )   HTML ( 18 )   PDF (896KB) ( 40 )   Conventional in vitro fertilization (c-IVF) is one of the most widely used assisted reproductive technologies in clinical practice. However, 5% to 15% of total fertilization failure (TFF) rate remains a non-negligible clinical challenge, which can significantly reduce the cumulative live birth rate, directly lead to cycle cancellation and embryo resource depletion, and impose a heavy burden on patients. The short-term insemination combined with early rescue intracytoplasmic sperm injection (E-RICSI) is the core strategy for preventing TFF in c-IVF cycles. By the co-incubating sperm and oocytes for 3 to 6 hours combined with monitoring of second polar body extrusion, this technique enables a timely intervention for fertilization disorders, avoids the risk of oocyte aging in vitro, and simultaneously preserves the advantages of natural fertilization. Evidence-based studies have confirmed that this technique can reduce the TFF rate to below 1%, maintain favorable normal fertilization rate and high-quality blastocyst formation rate. Its clinical pregnancy outcomes, cumulative live birth outcomes and neonatal safety are comparable to those of conventional intracytoplasmic sperm injection (ICSI), with good health economic benefits. Nevertheless, this technique still faces some problems such as inconsistent indications, insufficient accuracy of risk stratification, and non-standard clinical application. This article reviews the evidence-based progress, risk stratification system, and clinical decision-making pathway of this technique, aiming to provide evidence-based references for its standardized and precise clinical application. Figures and Tables | References | Related Articles | Metrics

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Effects of Different Weight Loss Methods on Reproductive Health LI Xue, ZHAO Jing-hua, CUI Na, WANG Shu-hua, CHEN Li, TIAN Wen-yan 2026, 45 (4):  318-325.  doi: 10.12280/gjszjk.20260184 Abstract ( 80 )   HTML ( 9 )   PDF (915KB) ( 68 )   Obesity impairs female oocyte quality, induces polycystic ovary syndrome (PCOS), and reduces male sperm motility and DNA integrity, by disrupting the hypothalamic-pituitary-gonadal axis function, triggering insulin resistance, and exacerbating oxidative stress and inflammatory responses. Consequently, it significantly increases the risks of infertility, pregnancy complications, and sexual dysfunction. Weight loss can substantially enhance fertility by improving metabolic disorders and chronic inflammatory states, regulating hormone levels, and modulating gut microbiota. Novel anti-obesity agents, such as glucagon-like peptide 1 (GLP-1) receptor agonists, have been widely acknowledged in clinical practice due to their remarkable weight-reducing efficacy. Meanwhile, bariatric surgery, as a potent weight loss intervention, remains irreplaceable in clinical settings. Notably, different weight loss approaches exert distinct impacts on reproductive health. Pharmacological weight loss can improve ovulatory function and pregnancy rates in patients with PCOS; however, close attention should be paid to gestational safety and body weight rebound following drug withdrawal. For obese women, bariatric surgery can achieve more significant improvement in menstrual recovery, spontaneous ovulation, and assisted reproductive outcomes. Postoperatively, strict control of the conception timing and regular monitoring of nutritional status are imperative. While its effect on male semen quality remains controversial, its beneficial role in improving sexual function has been well established. In the future, further investigations are needed to explore the long-term effects of different weight loss modalities on offspring health, and individualized weight management strategies should be formulated to optimize reproductive health management. References | Related Articles | Metrics

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Roles and Mechanisms of Lysophosphatidic Acid in Follicular Development HUANG Jun, MAO Fei, FENG Rui-zhi, QIAN Yun 2026, 45 (4):  326-330.  doi: 10.12280/gjszjk.20260270 Abstract ( 69 )   HTML ( 11 )   PDF (865KB) ( 32 )   Follicular development is an essential component of ovarian function, which is jointly regulated by the follicular fluid microenvironment, local cell-cell communication, and endocrine signals. Recent studies have shown that the level of lysophosphatidic acid (LPA) in follicular fluid, and the changes of related metabolic enzymes and receptors in the follicular microenvironment, are closely associated with follicular development. LPA mediates signaling pathways such as phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) and extracellular signal-regulated kinase 1/2 (ERK1/2) through its receptors, regulating the proliferation, autophagy and apoptosis of granulosa cells, promoting cumulus expansion and oocyte maturation, and potentially participating in the production and regulation of ovarian steroid hormones. Current studies indicate that LPA exerts certain protective and promotive effects in assisted reproductive related processes including in vitro oocyte maturation, chemotherapy-induced ovarian damage, and ovarian tissue cryopreservation and transplantation. However, its safety and clinical translational value remain to be further validated. Future research should further elucidate the roles and key mechanisms of LPA at the different stage of follicular development, thereby providing a basis for interventions in those diseases related to follicular development disorder. References | Related Articles | Metrics

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Research Progress on Mesenchymal Stem Cells in the Treatment of Premature Ovarian Failure LI Huan, YANG Li-juan, HU Shuo-nan, LI Lin, XIONG Qing 2026, 45 (4):  331-335.  doi: 10.12280/gjszjk.20260115 Abstract ( 77 )   HTML ( 10 )   PDF (869KB) ( 33 )   Premature ovarian failure (POF) is a major endocrine disorder leading to female infertility and long?term health risks, with limited efficacy of conventional therapies. Mesenchymal stem cells (MSCs) offer new therapeutic avenues for POF due to the multidirectional differentiation, paracrine activity, immunomodulation, and homing capacity. MSCs from various tissue sources (umbilical cord, bone marrow, menstrual blood, adipose tissue, amnion, urine, etc.) have distinct advantages in efficacy and accessibility. Strategies including genetic engineering modification, preconditioning, extracellular vesicles, and biomaterial-based scaffolds further enhance the reparative potential of MSCs. Preliminary clinical studies have demonstrated the safety and feasibility of MSCs, yet challenges remain, such as standardization, heterogeneous efficacy, and long-term safety. Future directions, such as precision therapy, cell-free approaches, ovarian organoid construction and interdisciplinary integration, will promote the clinical translation. References | Related Articles | Metrics

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Advances in the Relationship between Low Energy Availability and Functional Hypothalamic Amenorrhea ZHANG Yu, DING Xue-song, GUO Ying-ying, XUE Wei, WANG Yang, SUN Ai-jun 2026, 45 (4):  336-341.  doi: 10.12280/gjszjk.20260145 Abstract ( 67 )   HTML ( 8 )   PDF (930KB) ( 47 )   Functional hypothalamic amenorrhea (FHA) is a central, non-organic, and reversible form of amenorrhea, resulting from the suppression of hypothalamic-pituitary-ovarian (HPO) axis induced by various intrinsic and extrinsic factors, such as insufficient energy intake, excessive physical activity, psychological stress, and genetic susceptibility. In recent years, low energy availability (LEA) has provided a unifying theoretical framework for understanding the pathophysiology of FHA. Under LEA, the body initiates adaptive responses that prioritize vital physiological functions while suppressing energy-demanding reproductive processes. These adaptations are characterized by the alterations in peripheral metabolic signals and impaired function of hypothalamic Kisspeptin/neurokinin B/dynorphin (KNDy) neurons, ultimately leading to the disrupted gonadotropin-releasing hormone (GnRH) pulsatility and the attenuation of HPO axis function. Based on improving LEA, strategies for treating the FHA primarily focus on restoring energy availability. First-line management mainly involves lifestyle interventions, including nutritional support, appropriate exercise modification, and psychological intervention. In addition, the targeted therapies involving Kisspeptin and its receptor have also shown a potential therapeutic prospect. References | Related Articles | Metrics

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Research Progress of Circular RNAs in Pregnancy and Pregnancy-Related Diseases PAN Peng, ZHANG Yu, YANG Xiao-qing 2026, 45 (4):  342-346.  doi: 10.12280/gjszjk.20260089 Abstract ( 49 )   HTML ( 9 )   PDF (869KB) ( 19 )   Circular RNAs (circRNAs), as a group of crucial regulatory molecules, are capable of modulating gene expression and mediating signaling pathways, and exert vital functions in the sophisticated physiological process of pregnancy. Studies have demonstrated that circRNAs participate in the core physiological processes including embryonic development, placental formation and maternal-fetal interface signal transduction via multiple mechanisms such as competing endogenous RNA network, epigenetic regulation and protein-protein interaction. Specifically, circRNAs are involved in regulating trophoblast function, angiogenesis, glycolipid metabolism, immune homeostasis and decidualization. Dysregulated expressions of circRNAs are closely associated with the pathogenesis of multiple pregnancy-related diseases, including preeclampsia, gestational diabetes mellitus, recurrent spontaneous abortion, fetal growth restriction and intrahepatic cholestasis of pregnancy. It is necessary to explore the intervention strategies of circRNAs and identify specific circRNAs as early screening biomarkers for pregnancy-related diseases, which is helpful to facilitate the auxiliary diagnosis and treatment of pregnancy-related diseases. References | Related Articles | Metrics

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Clinical Application of Immunosuppressive Therapy in Recurrent Spontaneous Abortion ZHUANG Guo-li, WANG Bin, ZENG Jian, TIAN Yun, QIN Zhe 2026, 45 (4):  347-352.  doi: 10.12280/gjszjk.20260063 Abstract ( 95 )   HTML ( 13 )   PDF (928KB) ( 79 )   The etiology of recurrent spontaneous abortion (RSA) is complex, and immune is an important factor of the occurrence and development of RSA. The pathological mechanisms of RSA caused by immune abnormalities include: autoimmune diseases represented by antiphospholipid syndrome and systemic lupus erythematosus; alloimmune abnormalities centered on maternal-fetal immune rejection; and pathological inflammatory responses that run through multiple etiologies. These factors lead to pregnancy loss by affecting embryo implantation, placentation, and inducing thrombosis. The current clinical application status and evidence of various immunosuppressive therapies are as follows: ①Classic immunosuppressants such as glucocorticoids, hydroxychloroquine, and calcineurin inhibitors remain the mainstay for the treatment of RSA associated with autoimmune abnormalities. However, the indication and safety must be strictly controlled. ②Biologic targeted drugs, including tumor necrosis factor-α inhibitors and interleukin inhibitors, provide a new "precision" intervention direction for the refractory cases that fail conventional treatment, although they are still in the exploratory stage. ③Immunoglobulin and peripheral blood mononuclear cell therapy have shown the potential in patients with specific immune abnormalities, but the efficacy requires to be validated by higher-level evidence. Although immunosuppressive therapy has moved from empirical use to a more targeted stage, the overall treatment system remains incomplete. In the future, multi-omics technologies should be employed to deepen the study of mechanism, to discover more biomarkers that accurately predict therapeutic efficacy, and to advance the prospective randomized controlled trials, in order to establish a patient-centered, evidence-based new paradigm of precision immunosuppressive therapy and effectively improve the reproductive outcomes of patients with RSA. References | Related Articles | Metrics