目的应用子宫活性内膜评估宫腔粘连严重程度、预测术后妊娠结局,以验证新提出的宫腔粘连分类的临床适用性。方法回顾性分析2012年1月-2015年6月于海军总医院妇科住院行超声引导下宫腔粘连松解术（transcervical resection of adhesions,...目的应用子宫活性内膜评估宫腔粘连严重程度、预测术后妊娠结局,以验证新提出的宫腔粘连分类的临床适用性。方法回顾性分析2012年1月-2015年6月于海军总医院妇科住院行超声引导下宫腔粘连松解术（transcervical resection of adhesions,TCRA）并保留全程清晰手术视频的宫腔粘连（intrauterine adhesion,IUA）患者160例,术中手术医师按照欧洲妇科内镜协会（European Society of Gynecological Endoscopy,ESGE）宫腔粘连分类标准进行分级。该手术医师通过回顾手术视频按子宫活性内膜概念对IUA进行评估,根据子宫活性内膜面积将IUA分为A组（≥1/2,72例）、B组（1/4～1/2,34例）、C组（≤1/4,54例）,分别对应轻、中、重度IUA,3组平均年龄分别为31.81±4.802岁、34.06±3.931岁和33.28±5.402岁。2015年8月电话随访术后妊娠结局,比较子宫活性内膜分类与ESGE分类的相关性及一致性,以及各级宫腔粘连术后妊娠结局的差异。结果我们提出的子宫活性内膜分级结果与ESGE分类结果具有较强相关性（r=0.799,P〈0.001）,但一致性差（k=0.395,P〈0.001）。ESGE分类下的重度IUA按照子宫活性内膜分类标准也有粘连程度较重的趋势（χ2=64.332,P〈0.001）。144例IUA术后试孕,76例获得临床妊娠,其中6例妊娠2次,共计妊娠82次。A、B、C组术后妊娠率分别为69.7%（46/66）、51.6%（16/31）和29.8%（14/47）,差异有统计学意义（P=0.015）。A、B、C组术后抱婴率分别为65.4%（34/52）、50.0%（8/16）和42.9%（6/14）,差异无统计学意义（P=0.234）;A、B、C组妊娠丢失率分别为17.3%（9/52）、31.3%（5/11）和28.6%（4/14）,差异无统计学意义（P=0.403）。ESGE分类的轻、中、重度IUA与对应的A、B、C组比较,妊娠率、抱婴率及妊娠丢失率差异无统计学意义（P〉0.05）。结论子宫活性内膜面积单独评估IUA严重程度与ESGE分类结果具有良好相关性,但一致性较差,IUA术后妊�展开更多
In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of...In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of 94 infertile women who had undergone ART treatments with different outcomes (pregnant or nonpregnant) was done. Subendometrial blood flow was evaluated. The resistance index (RI), systolic/diastolic ratio (S/D) and pulsatility index (PI) were significantly lower in those who achieved pregnancy as compared with those who did not: 0.62±0.04 vs 0.68±0.04 (P<0.001), 2.66±0.33 vs 3.19±0.39 (P<0.01) and 1.15±0.17 vs 1.34±0.22 (P<0.05), respectively. Furthermore, when RI>0.72, PI>1.6, and S/D>3.6, no pregnancy occurred. These data suggest that the parameters of spiral artery blood flow could be used as a new assay in predicting endometrial receptivity before ET.展开更多
Background: Recent studies have revealed that noncoding RNAs play important regulatory roles in the formation of endometrial receptivity.Circular RNAs(circRNAs) are a universally expressed noncoding RNA species that h...Background: Recent studies have revealed that noncoding RNAs play important regulatory roles in the formation of endometrial receptivity.Circular RNAs(circRNAs) are a universally expressed noncoding RNA species that have been recently proposed to act as miRNA sponges that directly regulate expression of target genes or parental genes.Results: We used Illumina Solexa technology to analyze the expression profiles of circRNAs in the endometrium from three goats at gestational day 5(pre-receptive endometrium,PE) and three goats at gestational day 15(receptive endometrium,RE).Overall,21,813 circRNAs were identified,of which 5,925 circRNAs were specific to the RE and 9,078 were specific to the PE,which suggested high stage-specificity.Further analysis found 334 differentially expressed circRNAs in the RE compared with PE(P < 0.05).The analysis of the circRNA-miRNA interaction network further supported the idea that circRNAs act as miRNA sponges to regulate gene expression.Moreover,some circRNAs were regulated by estrogen(E2)/progesterone(P4) in endometrial epithelium cell lines(EECs) and endometrial stromal cell line(ESCs),and each circRNA molecule exhibited unique regulation characteristics with respect to E2 and P4.Conclusions: These data provide an endometrium circRNA expression atlas corresponding to the biology of the goat receptive endometrium during embryo implantation.展开更多
Objective: To study oocyte donation in treatment of premature ovarian failure.Methods:Thirty premature ovarian failure patients receiving hormone replacement therapy had un-dergone 54 treatment cycles of in vitro fert...Objective: To study oocyte donation in treatment of premature ovarian failure.Methods:Thirty premature ovarian failure patients receiving hormone replacement therapy had un-dergone 54 treatment cycles of in vitro fertilization with their husbands’ sperm and donors’ oocytes.Ovulation induction was achieved by GnRH-α/HMG/hCG regimen in donors. Embryos transfers were performed in recipients from 15th to 20th day of hormone replacement therapy cycle. Preclinical preg-nancies were defined when serum β-hCG performed on day 14 post embryo transfer >3. 1ng/ml. Clini-cal pregnancies was diagnosed by the presence of a gestation sac with transvaginal ultrasound at six weeks of gestation.Results:Clinical pregnancy rate per embryo transfer cycle was 35- 2% (19/54). The first baby was deliveried on Jan 14, 1994 in premature ovarian failure patient with hormone replacement therapy and oocyte donation in China. Comharison of the results showed a singnificant increase in number of em-bryos transfer, embryo scoring and clinical pregnancy rate (54. 2 % ) in the whole cohort where oocytes were used. The P value was <0.05, <0. 001, <0.05 respectively. However the spontaneous abortion rate(15. 4% ) significantly decreased (P<0.001 ). No difference was found in the embryos scoring and the number of embryos transfer between groups with age less than 3O years or more than 30 years. But clinical pregnancy rate in the younger group (42. 9% ) was significantly higher than in the older group (30. 3%). The endometrium receptivity window of a 2-days embryo was from 15th to 19th day of a 28 days cycle. The highest pregnancy rate was in day 16 to 18 in the 28 days cycle.Conclusion: Hormone replacement therapy and oocyte donation is a effective method of obtaining successful pregnancy for those with premature ovarian failure. The quality of oocyte is an important factor that affects the pregnancy rate and spontaneous abortion rate. The endometrium receptivity ia al-so a major factor affecting the pregnancy rate, which declined with increasi展开更多
Objective:To evaluate the effect of recombinant human growth hormone(rhGH)supplementation during hormone-replacement therapy and frozen-thawed embryo transfer(FET)in patients with thin endometrium.Methods:A retrospect...Objective:To evaluate the effect of recombinant human growth hormone(rhGH)supplementation during hormone-replacement therapy and frozen-thawed embryo transfer(FET)in patients with thin endometrium.Methods:A retrospective research was conducted on 225 patients,who underwent artificial cycle FET in Shanghai,China,between January 2016 and November 2017.Data from 245 FET cycles were analyzed,of which 184 cycles received rhGH(GH group)and 61 did not(control group).Results:Clinical pregnancy and implantation rates were significantly higher in the GH group than those in the control group(64.7%vs.49.2%,P=0.032;44.8%vs.32.8%,P=0.019,respectively).After logistic regression analysis,rhGH was considered the only significant variable that influenced clinical pregnancy rate,increasing it by 1.89-fold.On the other hand,the presence of rhGH did not seem to affect the early pregnancy loss.Conclusions:Our results indicated that simultaneous addition of rhGH could improve clinical outcomes of FET in patients with thin endometrium,particularly in patients between 30 and 34 years of age.展开更多
文摘目的应用子宫活性内膜评估宫腔粘连严重程度、预测术后妊娠结局,以验证新提出的宫腔粘连分类的临床适用性。方法回顾性分析2012年1月-2015年6月于海军总医院妇科住院行超声引导下宫腔粘连松解术（transcervical resection of adhesions,TCRA）并保留全程清晰手术视频的宫腔粘连（intrauterine adhesion,IUA）患者160例,术中手术医师按照欧洲妇科内镜协会（European Society of Gynecological Endoscopy,ESGE）宫腔粘连分类标准进行分级。该手术医师通过回顾手术视频按子宫活性内膜概念对IUA进行评估,根据子宫活性内膜面积将IUA分为A组（≥1/2,72例）、B组（1/4～1/2,34例）、C组（≤1/4,54例）,分别对应轻、中、重度IUA,3组平均年龄分别为31.81±4.802岁、34.06±3.931岁和33.28±5.402岁。2015年8月电话随访术后妊娠结局,比较子宫活性内膜分类与ESGE分类的相关性及一致性,以及各级宫腔粘连术后妊娠结局的差异。结果我们提出的子宫活性内膜分级结果与ESGE分类结果具有较强相关性（r=0.799,P〈0.001）,但一致性差（k=0.395,P〈0.001）。ESGE分类下的重度IUA按照子宫活性内膜分类标准也有粘连程度较重的趋势（χ2=64.332,P〈0.001）。144例IUA术后试孕,76例获得临床妊娠,其中6例妊娠2次,共计妊娠82次。A、B、C组术后妊娠率分别为69.7%（46/66）、51.6%（16/31）和29.8%（14/47）,差异有统计学意义（P=0.015）。A、B、C组术后抱婴率分别为65.4%（34/52）、50.0%（8/16）和42.9%（6/14）,差异无统计学意义（P=0.234）;A、B、C组妊娠丢失率分别为17.3%（9/52）、31.3%（5/11）和28.6%（4/14）,差异无统计学意义（P=0.403）。ESGE分类的轻、中、重度IUA与对应的A、B、C组比较,妊娠率、抱婴率及妊娠丢失率差异无统计学意义（P〉0.05）。结论子宫活性内膜面积单独评估IUA严重程度与ESGE分类结果具有良好相关性,但一致性较差,IUA术后妊�
文摘In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of 94 infertile women who had undergone ART treatments with different outcomes (pregnant or nonpregnant) was done. Subendometrial blood flow was evaluated. The resistance index (RI), systolic/diastolic ratio (S/D) and pulsatility index (PI) were significantly lower in those who achieved pregnancy as compared with those who did not: 0.62±0.04 vs 0.68±0.04 (P<0.001), 2.66±0.33 vs 3.19±0.39 (P<0.01) and 1.15±0.17 vs 1.34±0.22 (P<0.05), respectively. Furthermore, when RI>0.72, PI>1.6, and S/D>3.6, no pregnancy occurred. These data suggest that the parameters of spiral artery blood flow could be used as a new assay in predicting endometrial receptivity before ET.
基金supported by PhD research startup foundation of Northwest A&F University(00400/Z109021811)National Key Research and Development Program of China(2016YFD0500508)Shaanxi Science and Technology Innovation Project Plan(2015KTCQ03–08)
文摘Background: Recent studies have revealed that noncoding RNAs play important regulatory roles in the formation of endometrial receptivity.Circular RNAs(circRNAs) are a universally expressed noncoding RNA species that have been recently proposed to act as miRNA sponges that directly regulate expression of target genes or parental genes.Results: We used Illumina Solexa technology to analyze the expression profiles of circRNAs in the endometrium from three goats at gestational day 5(pre-receptive endometrium,PE) and three goats at gestational day 15(receptive endometrium,RE).Overall,21,813 circRNAs were identified,of which 5,925 circRNAs were specific to the RE and 9,078 were specific to the PE,which suggested high stage-specificity.Further analysis found 334 differentially expressed circRNAs in the RE compared with PE(P < 0.05).The analysis of the circRNA-miRNA interaction network further supported the idea that circRNAs act as miRNA sponges to regulate gene expression.Moreover,some circRNAs were regulated by estrogen(E2)/progesterone(P4) in endometrial epithelium cell lines(EECs) and endometrial stromal cell line(ESCs),and each circRNA molecule exhibited unique regulation characteristics with respect to E2 and P4.Conclusions: These data provide an endometrium circRNA expression atlas corresponding to the biology of the goat receptive endometrium during embryo implantation.
文摘Objective: To study oocyte donation in treatment of premature ovarian failure.Methods:Thirty premature ovarian failure patients receiving hormone replacement therapy had un-dergone 54 treatment cycles of in vitro fertilization with their husbands’ sperm and donors’ oocytes.Ovulation induction was achieved by GnRH-α/HMG/hCG regimen in donors. Embryos transfers were performed in recipients from 15th to 20th day of hormone replacement therapy cycle. Preclinical preg-nancies were defined when serum β-hCG performed on day 14 post embryo transfer >3. 1ng/ml. Clini-cal pregnancies was diagnosed by the presence of a gestation sac with transvaginal ultrasound at six weeks of gestation.Results:Clinical pregnancy rate per embryo transfer cycle was 35- 2% (19/54). The first baby was deliveried on Jan 14, 1994 in premature ovarian failure patient with hormone replacement therapy and oocyte donation in China. Comharison of the results showed a singnificant increase in number of em-bryos transfer, embryo scoring and clinical pregnancy rate (54. 2 % ) in the whole cohort where oocytes were used. The P value was <0.05, <0. 001, <0.05 respectively. However the spontaneous abortion rate(15. 4% ) significantly decreased (P<0.001 ). No difference was found in the embryos scoring and the number of embryos transfer between groups with age less than 3O years or more than 30 years. But clinical pregnancy rate in the younger group (42. 9% ) was significantly higher than in the older group (30. 3%). The endometrium receptivity window of a 2-days embryo was from 15th to 19th day of a 28 days cycle. The highest pregnancy rate was in day 16 to 18 in the 28 days cycle.Conclusion: Hormone replacement therapy and oocyte donation is a effective method of obtaining successful pregnancy for those with premature ovarian failure. The quality of oocyte is an important factor that affects the pregnancy rate and spontaneous abortion rate. The endometrium receptivity ia al-so a major factor affecting the pregnancy rate, which declined with increasi
文摘Objective:To evaluate the effect of recombinant human growth hormone(rhGH)supplementation during hormone-replacement therapy and frozen-thawed embryo transfer(FET)in patients with thin endometrium.Methods:A retrospective research was conducted on 225 patients,who underwent artificial cycle FET in Shanghai,China,between January 2016 and November 2017.Data from 245 FET cycles were analyzed,of which 184 cycles received rhGH(GH group)and 61 did not(control group).Results:Clinical pregnancy and implantation rates were significantly higher in the GH group than those in the control group(64.7%vs.49.2%,P=0.032;44.8%vs.32.8%,P=0.019,respectively).After logistic regression analysis,rhGH was considered the only significant variable that influenced clinical pregnancy rate,increasing it by 1.89-fold.On the other hand,the presence of rhGH did not seem to affect the early pregnancy loss.Conclusions:Our results indicated that simultaneous addition of rhGH could improve clinical outcomes of FET in patients with thin endometrium,particularly in patients between 30 and 34 years of age.
