Reproductive Outcome of Transcervical Uterine Incision in Unicornuate Uterus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The pregnancy outcome of the unicornuate uterus is associated with an increased risk of miscarriage, cervical incompetence, and a number of obstetric complications. However, at present, there is no accepted treatment method for women with unicornuate uterus, other than expectant measures. The aim of this study was to evaluate the reproductive outcome of transcervical uterine incision (TCUI) in patients with unicornuate uterus.</p><p><b>METHODS</b>Thirty-three patients with unicornuate uterus presented to our tertiary center for infertility or miscarriage. All 33 patients underwent TCUI and were followed up for 10-52 months. The pregnancy outcomes ( first-trimester miscarriage, second-trimester miscarriage, preterm, term, intrauterine death, ongoing pregnancy, and live birth) before and after TCUI were compared by t- test.</p><p><b>RESULTS</b>Among 31 patients who attempted to conceive after TCUI, twenty conceived including one termination of pregnancy, one second-trimester miscarriage, one ectopic pregnancy, five preterm deliveries, 11 term delivery, and one ongoing pregnancy. There were 16 live births in total. There was significant reduction in the first-trimester miscarriage rate (t = 4.890; P< 0.001), increase in term delivery (t = -3.288; P = 0.002), and live birth rates (t = -4.073; P< 0.001) after TCUI.</p><p><b>CONCLUSION</b>TCUI appeared to improve the pregnancy outcome in women with unicornuate uterus presenting with infertility or miscarriage.</p>

Effect of interval after surgery on in vitro fertilization/ intracytoplasmic sperm injection outcomes in patients with stage III/IV endometriosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy. Surgery is one of the treatment options; however, if patients failed to conceive after surgery, in vitro fertilization (IVF) is effective. The objective of this retrospective study was to determine the clinical characteristics of IVF/intracytoplasmic sperm injection (ICSI) in patients with stage III/IV endometriosis, and to determine the impact of the interval from surgery to IVF/ICSI on outcome.</p><p><b>METHODS</b>One hundred and sixty patients who were diagnosed with stage III/IV endometriosis underwent IVF/ICSI cycles between February 2004 and June 2009 were enrolled. The mean interval from surgery to IVF, number of oocytes retrieved, fertilization rate, implantation rate, embryos transferred, and good embryos transferred were compared between two age groups (<or=35 years and >35 years).</p><p><b>RESULTS</b>The mean interval from surgery to IVF was (37.9+/-28.9) months for the group<or=35 years of age and (57.6+/-39.7) months for the group>35 years of age. Twenty-five IVF/ICSI cycles (12.8%) were performed during the first year after surgery, and 34.9% IVF/ICSI cycles were performed 2 years after surgery. No significant differences existed between the two groups with respect to the fertilization rate, implantation rate, number of embryos transferred, number of good embryos, clinical pregnancy rates, live birth rates, and cumulative clinical pregnancy rates (P>0.05). The probability of cumulative clinical pregnancies was 75%, 50%, and 25% ((29.0+/-4.8), (61.0+/-7.6), and (120.0+/-16.9) months after surgery, respectively).</p><p><b>CONCLUSIONS</b>For infertile patients with stage III/IV endometriosis, the optimal time to conceive by IVF/ICSI is <2 years after surgery; nevertheless, most of the patients took a longer time to conceive.</p>

The study on the relationship between Rsa I, Alu I polymorphism of the estrogen receptor beta gene and unknown aetiology hypomenorrhea / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the relationship between estrogen receptor beta gene (ER beta) polymorphism and unknown aetiology hypomenorrhea in Southwestern China .</p><p><b>METHODS</b>One hundred eumenorrhea women were chosen as control group and another 100 hypomenorrhea patients as case group from Southwestern China. Restriction fragment length polymorphism (RFLP) of the Rsa I and Alu I in ER beta gene was analysed. The ER beta gene polymorphism genotype distribution in case group and control group was compared.</p><p><b>RESULTS</b>R allele frequency in case and control groups was 37.5% and 48.5% respectively, the OR was 0.64 (95%CI: 0.42-0.97), P= 0.026. A allele frequency in case and control groups was 18.0% and 11.5% respectively, the OR was 1.69 (95%CI: 0.93-3.09), P= 0.07. RFLP of Rsa I and Alu I in both groups were distributed with polymorphism.</p><p><b>CONCLUSION</b>ERbeta gene polymorphism has a relation with unknown aetiological hypomenorrhea. R allele may be the guard factor, and A allele may be its risk factor.</p>

Study on the peritoneal dissemination of endometrial cells during hysteroscopy / 中华妇产科杂志

Objective To study prospectively the likelihood and the affecting factors of endometrial cell dissemination into the peritoneal cavity during hysteroseopie procedures.Methods A total of 121 patients with benign endometrial pathology underwent hysteroscopy combined with laparoseopy.All the patients had pelvic washings performed just before and after the procedure of hysteroscopy.We collected the peritoneal washings and analyzed the peritoneal cytology changes in both groups pre-and post-hysteroscopy, as well as the dissemination rate related to the time of hysteroscopy,the intrauterine distention pressure,the volume of distention media,and the feature of endometrial conditions.Results The ratio of positive endometrial cells in the peritoneal washings of post-hysteroscopy group was 51.2%(62/121),which was significantly higher than pre-hysteroscopy group,38.0%(46/121)(P0.05).Conclusions Hysteroseopic procedures may have a risk of disseminating the endometrial cells into peritoneal cavity.Under a certain uterine distention pressure,the rate of dissemination is correlated with hysteroscopie duration.