The application of frozen-thawed blastocyst transfer in patients with diminished ovarian reserve / 医学研究生学报

Objective The embryonic development is usually observed for 5-6 days during the process of embryo culture in most embryonic laboratories.The article aimed to explore the application of D 6+D7 frozen-thawed blastocyst transfer in patients with di -minished ovarian reserve(DOR). Methods Retrospective analysis was conducted on 285 patients with DOR who were treated with in-vitro fertilization and embryo transfer (IVF-ET) in our center from 2015 to 2017.Frozen embryos were harvested from the natural cycle , mini-stimulation protocol, ovulation induction during the luteal phase , followed by frozen-thawed embryo transfer with a total of 442 cycles. The frozen embryos were divided into cleavage embryo group and blas -tocyst group according to different life stages , and comparison was made in general data and pregnancy outcome between the two groups .The blastocyst transfer group was subdivided into Day 5 group and Day6+Day7 group followed by the comparison of different pregnancy outcome between the two groups . Results Patients with DOR were treated with frozen-thawed blastocyst transfer with 291 cycles in cleavage embryo group and 151 cycles in blastocyst group.The implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of blastocyst group were significantly higher than those of cleavage embryo group ( 44.62％ vs 22.46％, 50.33％ vs 33.33％, 37.75％ vs 21.65％, P<0.05) and the abortion rate of blastocyst group was significantly lower than that of cleavage embryo group (35.05％ vs 25％, P<0.05).As to the frozen blastocyst transplantation cycle , the number of D5 blastocysts was 69, and D6+D7 blastocyst was 76. The embryo planting rate, clinical pregnancy rate, continued pregnancy rate and abortion rate of D 6+D7 group were higher than those of D5 group(39.74％ vs 50％, 44.93％ vs 55.26％, 34.78％ vs 39.47％, 22.58％ vs 28.57％), but the difference was of no statistical significance(P>0.05). Conclusion In patients with DOR, the transplanted blastocyst can significantly improve the pregnancy out -come, increase the clinical pregnancy rate and reduce the abortion rate .The embryo planting rate and clinical pregnancy rate of the transplanted D6+D7 blastocyst were higher than those of D 5 blastocyst, but the difference was not statistically significant .The abortion rate was also increased.Therefore, when the number of embryos is limited, patients with DOR may consider transplanting D 6+D7 high-quality blastocysts in order to get a certain clinical pregnancy rate .

Value of sperm acrosin activity detection in selecting the method of assisted reproduction for patients with unexplained infertility / 中华男科学杂志

Objective@#To investigate the clinical significance of sperm acrosin activity detection in selecting the method of assisted reproduction for patients with unexplained infertility (UI).@*METHODS@#This retrospective study included 49 UI couples treated by IVFET (49 cycles) after three failures in intrauterine insemination (IUI) and another 95 couples with uterine tube obstruction (UTO) treated by IVF (131 cycles). We analyzed the laboratory data, clinical outcomes and sperm acrosin activity in the two groups of patients. According to the level of sperm acrosin activity of the males, we further divided the UI patients into two subgroups, a 0.05). The sperm acrosin activity was remarkably lower in the UI than in the UTO patients (36.03 vs 61.98 IU/106, P < 0.01), and so was the fertilization rate in the < 36 IU/106 than in the ≥36 IU/106 sperm subgroup (47.7% vs 80.3%, P < 0.01).@*CONCLUSIONS@#The low fertilization rate caused by decreased sperm acrosin activity may be the main cause of infertility and the potential factor of UI. When sperm acrosin activity is < 36 IU/106 sperm, IVF plus shortterm fertilization by remedial ICSI should be preferred to IUI.

Melatonin regulates ovarian function: an update / 中华男科学杂志

Melatonin (N-acetyl-5-methoxytryptamine, MT) is a hormone synthesized and secreted by the pineal gland. Recent studies show that melatonin plays an essential role in the pathogenesis of many reproductive processes. High-concentration melatonin exists in human preovulatory follicular fluid and melatonin receptors are present in ovarian granulosa cells, which indicates the direct effects of melatonin on ovarian function. Reactive oxygen species are involved in a number of reproductive events, including folliculogenesis, follicular atresia, ovulation, oocyte maturation, and corpus luteum formation. Melatonin and its metabolites, as powerful antioxidants and free radical scavengers, can potentially inhibit premature ovarian failure. Literature published in recent years shows the essential roles of melatonin in improving human ovarian function and oocyte quality as well as in the management of infertility. Researches on the action mechanisms of melatonin may provide a theoretical basis for the prevention and treatment of some clinical diseases.

Inhibiting effect of letrozole combined with curcumin on xenografted endometrial carcinoma growth in nude mice / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Letrozole is an aromatase inhibitor that is used in the treatment of estrogen-sensitive tumors such as endometrial carcinoma, however, its therapeutic effect is still to be further improved. It is reported that curcumin has antitumor capability and can enhance the sensitivity of tumor cells to anticancer agents. This study was to investigate the inhibitory effect of letrozole combination with curcumin on the implanted endometrial tumor growth.</p><p><b>METHODS</b>Nude mice were implanted with endometrial carcinoma RL-952 cells. All tumor-bearing mice were randomly divided into 5 groups: control(without treatment), Let(1) (letrozole, 1 microg/d), Let(10) (letrozole, 10 microg/d), Cur [ curcumin, 300 mg/kg.d)], and Let + Cur group [10microg/d letrozole + 50mg/ (kg.d) curcumin]. The tumor growth was monitored. Tumor cells apoptosis was detected in both control and treated groups. The expressions of bcl-2 mRNA and bcl-2 protein were detected using RT-PCR and Western blot, respectively.</p><p><b>RESULTS</b>Fifty mice were successfully implanted with the endometrial tumor. Treatment with letrozole markedly inhibited tumor growth; the inhibitory effect was further enhanced by the combination of letrozole and curcumin. The inhibitory rates in Let (1), Let (10), the Cur, and the Let + Cur groups were 15.95%, 22.49%, 21.57%, and 35.89%, respectively. Treatment with curcumin inhibited the expression of bcl-2 in tumor cells at the mRNA and protein levels. The apoptosis rates in the control group and the four experimental groups mentioned above were 16.97%, 32.90%, 35.80%, 34.16%, and 47.24%, respectively. Tumor cells apoptosis were observed in mice treated with either letrozole or curcumin; however, combination of letrozole and curcumin further enhanced the inhibitory rate in tumor growth.</p><p><b>CONCLUSIONS</b>Treatment with letrozole or curcumin could inhibit the xenografted endometrial tumor growth by inducing apoptosis in tumor cells. Combination of letrozole and curcumin further enhanced the inhibitory effect of tumor growth.</p>