ABSTRACT
Twenty eight polycystic ovarian syndrome (PCOS) patients complicated with insulin resistance, whose testosterone and luteinizing hormone levels were normal, received metformin treatment (500 mg b.i.d) for 3 months.Blood anti-Müllerian hormone (AMH) levels, endocrine and metabolic parameters were measured before and after treatment.The mean levels of AMH were not significantly changed after 3 months of treatment [(8.4±3.2) vs.(8.5±3.2) μg/L, P=0.148].However, the BMI[(27.6±4.1) vs.(29.3±4.4)kg/m2], fast glucose[(5.32±0.47) vs.(5.55±0.71)mmol/L], fast insulin [(93.3±17.8) vs.(147.7±44.1)pmol/L] and homeostasis model assessment of insulin resistance (HOMA-IR) (3.17±0.71 vs.5.27±1.85) were significantly decreased after treatment (all P<0.05).The results indicate that metformin treatment may not significantly affect serum AMH levels, although it can improve the insulin resistance and reduce the BMI value in PCOS patients.
ABSTRACT
Objective To investigate the effect of gonadotropin-releasing hormone analogue(GnRH-a) on pregnancy outcome in patients with endometriosis infertility after laparoscopic surgery.Methods Two hundred and twenty two patients treated with laparoscopic surgery for endometriosis infertility in Jiaxing Maternal and Child Health Care Hospital between January 2010 and December 2012 were enrolled and 184 patients completed the study.Patients were randomly assigned to two groups:110 patients in GnRH-a group received long-acting GnRH-a (3.75 mg injection every 28 d for 3 times) before trying to conceive,74 patients in control group were directly trying to conceive for 1 to 36 months.According to endometriosis fertility index (EFI),patients were further subgrouped:GnRH-a group 1 (EFI scores =6-10,n =83),GnRH-a group 2 (EFI scores =0-5,n =27),control group 1 (EFI scores =6-10,n =55) and control group 2 (EFI scores =0-5,n =19).The cumulative pregnancy rate (CPR) and abortion rate were compared among groups and subgroups.Results The patients were followed up for 1 to 36 months after trying to conceive,with a median follow-up time of 14 months.The total CPR was 62％ (114/184),the median time for gestation was 11 months.Within the first 6 months after operation,the CPR in GnRH-a group and its subgroups were lower than those in corresponding control groups,with significant difference between GnRH-a group and control group [9％ (10/110) vs.32％ (24/74),x2 =16.00,P ＜0.01],GnRH-a group 1 and control group 1 [8％ (7/83) vs.38％ (21/55),x2 =18.10,P ＜0.01].Within 12 months,24 months and 36 months,the CPR in GnRH-a group and its subgroups were all higher than those in corresponding control groups [66％ (55/83) vs.49％ (27/55),x2 =4.05,P ＜ 0.05].The pregnant rate within 12 months in GnRH-a group was 88％ (63/72),which was not significantly different to that in control group [76％ (32/42),x2 =2.44,P ＞ 0.05].Kaplan-Meier analysis showed that there were no significant difference in CPR between GnRH-a group and control group,GnRH-a group 1 and control group 1,GnRH-a group 2 and control group 2 (all P ＞ 0.05).The median time for gestation in GnRH-a group and its subgroups were shorter than those in corresponding control group.The median time for gestation in GnRH-a group was 10 (95％ CI:8.2-11.8) months and that in control group was 17 (95％ CI:1l.8-22.1) months.The abortion rate in GnRH-a group and control group was 11％ (7/72) and 26％ (11/42),respectively (x2 =4.34,P ＜ 0.05).Conclusion Administration of GnRH-a for 3 cycles can improve postoperative pregnancy rate within 1 year and reduce the abortion rate for endometriosis infertile patients after laparoscopic surgery especially for these with strong fertility.
ABSTRACT
Objective To investigate the relative risk factors for early abortion among singleton pregnancies after assisted reproductive technology (ART) treatment. Methods A retrospective analysis was performed on 1636 singleton pregnancies, including 196 early abortion cases and 1195pregnancies with live birth after exclusion of those lost cases during follow-up, or complicated with uterine deformity, or oocyte receptor, or late abortion, or incomplete medical record, following in vitro fertilization(IVF)/ intracytoplasmic sperm injection (ICSI) treatment and the risk factors of early abortion were investigated. The early abortion rate was also compared between fresh IVF/ICSI group and frozen embryo transfer (FET) group (n=386). Results Multivariate Logistic regression analysis indicated that elder women (OR= 1. 143,95%CI: 1. 096-1. 196) and patients with polycystic ovarian syndrome (OR = 4. 309,95 % CI : 2. 564-7.243) were risk factors of spontaneous early abortion,and high mean score of transferred embryos (MSTE) (OR = 0. 808, 95% CI: 0. 717-0. 912) and endometrial triple-lined pattern on the day of human chorionic gonadotropin (hCG) administration (OR=0. 431, 95% CI: 0. 243-0.764)were protective factors. Significant difference were found in the maternal age [(32.22±4. 10) yrs vs (30.28±3. 66) yrs],the duration of infertility [(5. 90±4.26) yrs vs (5.20 ± 3. 32) yrs], basal serum follicle-stimulating hormone (FSH) level [(6. 35 ±2.30) mIU/ml vs (5.95±2.12) mIU/ml], number of transferred embryos (2. 31±0. 51) vs (2. 18±0.49), serum estradiol level on the day of hCG administration [(2467. 1 ± 1588. 8) pg/ml vs (2934. 5 ±1785.2) pg/ml] and MSTE (7.03 ±1.35 vs 7.74 ± 1.25) between the abortion group and livebirth group (all P＜0. 05). The spontaneous abortion rate was higher in the FET group than in the fresh embryo transfer group [17. 36%(67/386) vs 13.02% (213/1636), χ2 =4. 296, P=0. 023].Conclusions Women at elder age, or with long duration of infertility, high basal FSH level,polycystic ovarian syndrome, low MSTE, non-triple-lined pattern of endometrium on the day of hCG administration are at risk of spontaneous early abortion in pregnancies after ART. The rate of spontaneous abortion is higher in FET group than in fresh IVF/ICSI group.
ABSTRACT
0.05), but each gene expression level was higher in schizophrenic or siblings than in normal controls(P0.05), and the correlation between the gene expression levels of IL-1? and TNF-? were significant in all groups(r=0.847 or 0.942, P