目的分析高龄不孕患者接受辅助生殖技术(ART)行冻融胚胎移植(FET)周期的胚胎数目和质量与早期妊娠丢失率的关系。方法选择2015年1月~2018年12月于南方医科大学南方医院接受ART并行FET的≥36岁的不孕症患者共2622例,对妊娠的976例患者根...目的分析高龄不孕患者接受辅助生殖技术(ART)行冻融胚胎移植(FET)周期的胚胎数目和质量与早期妊娠丢失率的关系。方法选择2015年1月~2018年12月于南方医科大学南方医院接受ART并行FET的≥36岁的不孕症患者共2622例,对妊娠的976例患者根据后续妊娠情况分为早期妊娠丢失组和持续妊娠组,分析早期妊娠丢失率与年龄、移植胚胎数、胚胎质量等的关系;根据患者年龄分为:36~37岁组、38~39岁组、40岁组、41岁组、42岁组、43岁组、44岁组和45~48岁组,进一步分析不同年龄段早期妊娠丢失率与胚胎移植数及胚胎质量的关系。结果本研究共纳入2622例FET周期,其中临床妊娠976例,临床妊娠率37.2%(976/2622),活产663例,活产率25.3%。临床妊娠患者中早期妊娠丢失241例,继续妊娠735例,早期妊娠丢失率24.7%(241/976)。各组患者临床妊娠率及活产率随年龄增长而降低,早期妊娠丢失率随年龄增长而显著升高(P<0.001);早期妊娠丢失组患者FET年龄及取卵年龄均高于持续妊娠组,移植D3胚胎数高于持续妊娠组(0.97 vs 0.81,P=0.030),着床胚胎数低于持续妊娠组(1.09 vs 1.25,P<0.001);各年龄组早期妊娠丢失率与移植胚胎数和胚胎质量没有显著关系(P>0.05)。结论高龄不孕女性患者冻融移植胚胎周期的早期妊娠丢失率随年龄增长而升高,年龄是导致早期妊娠丢失的无法补救的危险因素,故应对高龄不孕女性尽早实施ART助孕治疗。为降低早期胚胎丢失率,同时权衡多胎妊娠的风险,根据胚胎质量谨慎决定胚胎移植数。展开更多
Background： Early pregnancy failure has a profound impact on both human reproductive health and animal production. 2/3 pregnancy failures occur during the peri-implantation period; however, the underlying mechanism（...Background： Early pregnancy failure has a profound impact on both human reproductive health and animal production. 2/3 pregnancy failures occur during the peri-implantation period; however, the underlying mechanism（s） remains unclear. Well-organized modification of the endometrium to a receptive state is critical to establish pregnancy Aberrant endometrial modification during implantation is thought to be largely responsible for early pregnancy loss. Result： In this study, using well-managed recipient ewes that received embryo transfer as model, we compared the endometrial proteome between pregnant and non-pregnant ewes during implantation period. After embryo transfer, recipients were assigned as pregnant or non-pregnant ewes according to the presence or absence of an elongated conceptus at Day 17 of pregnancy. By comparing the endometrial proteomic profiles between pregnant and non-pregnant ewes, we identified 94 and 257 differentially expressed proteins （DEPs） in the endometrial caruncular and intercaruncular areas, respectively. Functional analysis showed that the DEPs were mainly associated with immune response, nutrient transport and utilization, as well as proteasome-mediated proteolysis. Conclusion： These analysis imply that dysfunction of these biological processes or pathways of DEP in the endometrium is highly associated with early pregnancy loss. In addition, many proteins that are essential for the establishment of pregnancy showed dysregulation in the endometrium of non-pregnant ewes. These proteins, as potential candidates, may contribute to early pregnancy loss.展开更多
目的:探讨绒毛组织中轴突导向因子(Netrin-1)及其受体结直肠癌缺失基因(deleted in colorectal cancer,DCC)和非协调性分子5同源蛋白B(uncoordinated-5-homolog B,UNC5B)的表达及其与胚胎停止发育的关系。方法:采用免疫组织化学PV法检...目的:探讨绒毛组织中轴突导向因子(Netrin-1)及其受体结直肠癌缺失基因(deleted in colorectal cancer,DCC)和非协调性分子5同源蛋白B(uncoordinated-5-homolog B,UNC5B)的表达及其与胚胎停止发育的关系。方法:采用免疫组织化学PV法检测20例正常早期妊娠绒毛(对照组)、25例早期胚胎停止发育绒毛(实验组)组织中Netrin-1及其受体DCC、UNC5B的表达情况。结果:Netrin-1在对照组的阳性表达率为95.00%,实验组的阳性表达率为76.00%,组间差异有统计学意义(P<0.01)。DCC在对照组阳性表达率为95.00%,实验组阳性表达率为32.00%,组间差异有统计学意义(P<0.01)。UNC5B在对照组阳性表达率为55.00%,实验组阳性表达率为96.00%,组间差异有统计学意义(P<0.01)。对照组Netrin-1、DCC和UNC5B三者两两间的表达无显著相关性。实验组DCC和Netrin-1的表达间呈显著负相关(r=-0.227,P<0.01),DCC和UNC5B的表达间呈显著正相关(r=0.151,P<0.05)。Netrin-1和UNC5B的表达间无显著相关性(r=-0.065,P=0.303)。结论:Netrin-1及其受体DCC、UNC5B的异常表达可能与早期胚胎停止发育发生有关;三者可能通过协同作用影响早期胚胎发育过程中胎盘血管的形成,导致胚胎停止发育。展开更多
文摘目的分析高龄不孕患者接受辅助生殖技术(ART)行冻融胚胎移植(FET)周期的胚胎数目和质量与早期妊娠丢失率的关系。方法选择2015年1月~2018年12月于南方医科大学南方医院接受ART并行FET的≥36岁的不孕症患者共2622例,对妊娠的976例患者根据后续妊娠情况分为早期妊娠丢失组和持续妊娠组,分析早期妊娠丢失率与年龄、移植胚胎数、胚胎质量等的关系;根据患者年龄分为:36~37岁组、38~39岁组、40岁组、41岁组、42岁组、43岁组、44岁组和45~48岁组,进一步分析不同年龄段早期妊娠丢失率与胚胎移植数及胚胎质量的关系。结果本研究共纳入2622例FET周期,其中临床妊娠976例,临床妊娠率37.2%(976/2622),活产663例,活产率25.3%。临床妊娠患者中早期妊娠丢失241例,继续妊娠735例,早期妊娠丢失率24.7%(241/976)。各组患者临床妊娠率及活产率随年龄增长而降低,早期妊娠丢失率随年龄增长而显著升高(P<0.001);早期妊娠丢失组患者FET年龄及取卵年龄均高于持续妊娠组,移植D3胚胎数高于持续妊娠组(0.97 vs 0.81,P=0.030),着床胚胎数低于持续妊娠组(1.09 vs 1.25,P<0.001);各年龄组早期妊娠丢失率与移植胚胎数和胚胎质量没有显著关系(P>0.05)。结论高龄不孕女性患者冻融移植胚胎周期的早期妊娠丢失率随年龄增长而升高,年龄是导致早期妊娠丢失的无法补救的危险因素,故应对高龄不孕女性尽早实施ART助孕治疗。为降低早期胚胎丢失率,同时权衡多胎妊娠的风险,根据胚胎质量谨慎决定胚胎移植数。
基金supported by grants from the National High-Tech R&D Program (Nos.2011AA100303,2013AA102506)the National Key Technology R&D Program(Nos.2011BAD19B01,2011BAD19B03,2011BAD19B04)
文摘Background： Early pregnancy failure has a profound impact on both human reproductive health and animal production. 2/3 pregnancy failures occur during the peri-implantation period; however, the underlying mechanism（s） remains unclear. Well-organized modification of the endometrium to a receptive state is critical to establish pregnancy Aberrant endometrial modification during implantation is thought to be largely responsible for early pregnancy loss. Result： In this study, using well-managed recipient ewes that received embryo transfer as model, we compared the endometrial proteome between pregnant and non-pregnant ewes during implantation period. After embryo transfer, recipients were assigned as pregnant or non-pregnant ewes according to the presence or absence of an elongated conceptus at Day 17 of pregnancy. By comparing the endometrial proteomic profiles between pregnant and non-pregnant ewes, we identified 94 and 257 differentially expressed proteins （DEPs） in the endometrial caruncular and intercaruncular areas, respectively. Functional analysis showed that the DEPs were mainly associated with immune response, nutrient transport and utilization, as well as proteasome-mediated proteolysis. Conclusion： These analysis imply that dysfunction of these biological processes or pathways of DEP in the endometrium is highly associated with early pregnancy loss. In addition, many proteins that are essential for the establishment of pregnancy showed dysregulation in the endometrium of non-pregnant ewes. These proteins, as potential candidates, may contribute to early pregnancy loss.
文摘目的:探讨绒毛组织中轴突导向因子(Netrin-1)及其受体结直肠癌缺失基因(deleted in colorectal cancer,DCC)和非协调性分子5同源蛋白B(uncoordinated-5-homolog B,UNC5B)的表达及其与胚胎停止发育的关系。方法:采用免疫组织化学PV法检测20例正常早期妊娠绒毛(对照组)、25例早期胚胎停止发育绒毛(实验组)组织中Netrin-1及其受体DCC、UNC5B的表达情况。结果:Netrin-1在对照组的阳性表达率为95.00%,实验组的阳性表达率为76.00%,组间差异有统计学意义(P<0.01)。DCC在对照组阳性表达率为95.00%,实验组阳性表达率为32.00%,组间差异有统计学意义(P<0.01)。UNC5B在对照组阳性表达率为55.00%,实验组阳性表达率为96.00%,组间差异有统计学意义(P<0.01)。对照组Netrin-1、DCC和UNC5B三者两两间的表达无显著相关性。实验组DCC和Netrin-1的表达间呈显著负相关(r=-0.227,P<0.01),DCC和UNC5B的表达间呈显著正相关(r=0.151,P<0.05)。Netrin-1和UNC5B的表达间无显著相关性(r=-0.065,P=0.303)。结论:Netrin-1及其受体DCC、UNC5B的异常表达可能与早期胚胎停止发育发生有关;三者可能通过协同作用影响早期胚胎发育过程中胎盘血管的形成,导致胚胎停止发育。
