Clinical Efficacy of TCM Multi-channel Intervention Plus Antagonist Regimen on Ovarian Function，TCM Syndromes and Natural Conception in Poor Ovarian Responders Undergoing IVF-ET / 中国实验方剂学杂志

ObjectiveTo objectively analyze the effects of traditional Chinese Medicine （TCM） multi-channel intervention on the ovarian function，TCM syndromes and natural conception of poor ovarian responders（kidney-Yin deficiency，liver depression and blood stasis pattern） who planned to receive another in vitro fertilization embryo transfer（IVF-ET）antagonist regimen. MethodThe 128 low-prognosis patients （kidney Yin deficiency，liver depression and blood stasis pattern） who attended the West China Second University Hospital， Sichuan University and the Hospital of Chengdu University of Traditional Chinese Medicine from August 2020 to February 2023 and met the inclusion criteria were selected，and then divided into the treatment group and the control group according to the random number table，with 64 patients in each group. The control group was treated with oral dehydroepiandrosterone（DHEA），while the treatment group was treated with multi-channel TCM（oral TCM decoction + auricular point sticking + Bushen Huoxue prescription through retention enema）. After 3 menstrual cycles，the relevant indicators for ovarian function evaluation，TCM syndrome scores and natural conception were collected from both groups. ResultCompared with the situation before treatment，the basal follicle stimulating hormone（bFSH），bFSH/basal luteinizing hormone（bLH），basal estradiol（bE2），antral follicle count（AFC），the number of oocytes obtained，the number of normal fertilization，the number of superior embryos and TCM syndrome scores in the treatment group were improved after treatment（P<0.05，P<0.01）. For the control group， the bFSH/bLH and TCM syndrome scores were increased after treatment（P<0.05）， while the bFSH，bFSH/bLH，bE2，AFC，the number of oocytes obtained，the number of normal fertilization，and the number of superior embryos showed no significant difference after treatment. Compared with the control group after treatment，bFSH，bFSH/bLH，bE2，AFC，the number of normal fertilization，the number of superior embryos and TCM syndrome scores in the treatment group were better （P<0.05，P<0.01），while there was no significant difference in the number of oocytes obtained. After treatment，there were 3 cases of natural conception in the treatment group，while there were no natural conception in the control group. ConclusionFor patients with poor ovarian response and kidney Yin deficiency，liver depression and blood stasis pattern，multi-channel intervention of TCM plus the antagonist regimen can reduce bFSH，bFSH/bLH values，improve the levels of bE2，increase AFC，the number of oocytes obtained，the number of normal fertilization and the number of superior embryos，improve ovarian function，menstruation and TCM syndromes，improve their quality of life，and even enable some patients to get pregnant naturally before re-progression and improve their pregnancy outcome.

Staged Treatment with Chinese Herbal Medicine in a Controlled Ovarian Hyperstimulation of In Vitro Fertilization-Embryo Transfer Programme / 中医杂志

It is believed that kidney deficiency is the fundamental pathogenesis while liver constraint and spleen deficiency， and disharmony of chong （thorough vessel， 冲脉）and ren （conception vessel， 任脉） is the key pathogenesis of infertility patients who adopted controlled ovarian hyperstimulation of in vitro fertilization-embryo transfer （IVF-ET） programme. Therefore， the method of tonifying the kidneys dominantly and treating the liver and spleen simultaneously is proposed， and Chinese herbal medicine is suggested to be used in adjuvant treatment of staged IVF-ET controlled ovrian hyperstimulation. In the regulation stage， modified Liuwei Dihuang Pill （六味地黄丸） can be used to tonify kidney and supplement essence， fortify spleen and nourish liver； in the ovulation promotion stage， modified Wenjing Decoction （温经汤） should be used to warm kidney and assist yang， dispel stasis and nourish blood； in the pre-transplantation endothelial preparation stage， modified Shenling Baizhu Powder （参苓白术散） is suggested to fortify spleen and replenish qi， invigorate blood and resolve stasis； after the transplantation stage， modified Shoutai Pill （寿胎丸） or Taiyuan Decoction （胎元饮） can be taken to fortify spleen and tonify kidney， benefit qi and nourish blood.

Embryo development is impaired by sperm mitochondrial-derived ROS

BACKGROUND: Basal energetic metabolism in sperm, particularly oxidative phosphorylation, is known to condition not only their oocyte fertilising ability, but also the subsequent embryo development. While the molecular pathways underlying these events still need to be elucidated, reactive oxygen species (ROS) could have a relevant role. We, therefore, aimed to describe the mechanisms through which mitochondrial activity can influence the first stages of embryo development. RESULTS: We first show that embryo development is tightly influenced by both intracellular ROS and mitochondrial activity. In addition, we depict that the inhibition of mitochondrial activity dramatically decreases intracellular ROS levels. Finally, we also demonstrate that the inhibition of mitochondrial respiration positively influences sperm DNA integrity, most likely because of the depletion of intracellular ROS formation. CONCLUSION: Collectively, the data presented in this work reveals that impairment of early embryo development may result from the accumulation of sperm DNA damage caused by mitochondrial-derived ROS.

Morpho-anatomy of in vitro germination and cryopreservation of the orchid Cattleya crispa (Orchidaceae Morfoanatomía de la germinación in vitro y criopreservación de la orquídea Cattleya crispa (Orchidaceae) / Morfoanatomía de la germinación in vitro y criopreservación de la orquídea Cattleya crispa (Orchidaceae)

Introduction: Cattleya crispa is an ornamental epiphytic orchid with geographic distribution restricted to the Brazilian Atlantic Forest. Due to predatory extractivism and human-induced habitat loss, this species appears on the Red List of Brazilian Flora. Objective: To characterize morpho-anatomical aspects regarding germination and post-seminal development from C. crispa seeds; as well as studying the effect of cryopreservation on these seeds. Methods: We used light microscopy and electron microscopy to describe the microstructure of a 100 ripe seeds. We evaluated seed viability, seed germination, survival rate and protocorm weight in cryopreserved and non-cryopreserved material, with four replicas per treatment using 20 mg of plant material. Results: The seeds are fusiform, whitish yellow with a length from 700 to 900 µm and a water content of 5 %. Germination began seven days after sowing, the formation of the globular protocorm at 30 days and the formation of the seedling occurred 150 days. The persistent seed coat can compress the protocorm and cause it to collapse. The cryopreserved seeds presented 87.15 % viability, 78.32 % germination, 8.48 % survival and protocorms with 104.27 mg five months after sowing. Data wasn't different to non-cryopreserved seeds. Conclusions: The cryocapability of the seeds shows that cryopreservation can be used for long-term conservation. The results of this work contribute to the overall biology of C. crispa and to the propagation and storage of genetic material for conservation purposes.

Introducción: Cattleya crispa es una orquídea epífita ornamental con distribución geográfica restringida a la Mata Atlántica brasileña. Debido al extractivismo depredador y a la pérdida de hábitat inducida por el hombre, esta especie aparece en la Lista Roja de la Flora Brasileña. Objetivo: Caracterizar aspectos morfoanatómicos de la germinación y desarrollo inicial de semillas de C. crispa; así como estudiar el efecto de la criopreservación de estas semillas. Métodos: Utilizamos microscopía óptica, microscopía electrónica de barrido y microscopía electrónica de transmisión para describir la microestructura en 100 semillas maduras. Evaluamos la viabilidad de la semilla, la germinación de la semilla, la tasa de supervivencia y el peso de los protocormos en el material criopreservado y no criopreservado, con cuatro réplicas por tratamiento de 20 mg de material vegetal. Resultados: Las semillas son fusiformes, amarillo blanquecinas, con una longitud de 700 a 900 µm y un contenido de agua del 5 %. La germinación comenzó siete días después de la siembra, la formación del protocormo globular a los 30 días y la formación de la plántula a los 150 días. La cubierta de semilla persistente puede comprimir el protocormo y provocar su colapso. Las semillas criopreservadas presentaron 87.15 % de viabilidad, 78.32 % de germinación, 8.48 % de supervivencia y protocormos con 104.27 mg a los cinco meses de la siembra. Los datos no fueron diferentes a las semillas no criopreservadas. Conclusiones: La capacidad criogénica de las semillas muestra que la crioconservación puede utilizarse para la conservación a largo plazo. Los resultados de este trabajo contribuyen a la biología general de C. crispa y a la propagación y almacenamiento de material genético con fines de conservación.

Development of the Goose Tongue Filiform Papillae: Could it be Tooth-Like Sense Organs? / Desarrollo de las Papilas Filiformes de la Lengua de Ganso: ¿Podrían ser Órganos Sensoriales Parecidos a los Dientes?

SUMMARY: The geese's tongue filiform papillae are particularly long, and exhibit the same morphology of a tooth, evoking the lingual teeth of several fishes. In adult animals, they contain numerous mechanical Herbst's corpuscles but no taste buds. In the embryo, they appear since stage 38 and acquire their definitive shape between stages 38 and 42. They express several proteins associated with mammalian tooth development (BMP4, β-catenin, SHH, PITX2, PAX9), also known to be linked to parrot's pseudoteeth and goose's denticulations development. Neurofilaments are early present in the papillae primordia, and appear particularly numerous in adult papillae. Our results suggest that these papillae constitute a mechanical organ with a « tooth shape » derived from ancestral odontodes, whose development is controlled by numerous genes involved in classical odontogenesis.

Las papilas filiformes de la lengua de los gansos son particularmente largas y exhiben la morfología de un diente, evocando los dientes linguales presentes en varios peces. En los animales adultos, contienen numerosos corpúsculos de Herbst mecánicos, aunque una ausencia de papilas gustativas. En el embrión, aparecen a partir del estadio 38 y adquieren su forma definitiva entre los estadios 38 y 42. Expresan varias proteínas asociadas al desarrollo dentario de los mamíferos (BMP4, β-catenina, SHH, PITX2, PAX9), también conocidas por estar asociadas al desarrollo de pseudodientes en el loro y denticulaciones en el ganso. Los neurofilamentos están presentes tempranamente en los primordios de las papilas y aparecen particularmente numerosos en las papilas adultas. Nuestros resultados sugieren que estas papilas constituyen un órgano mecánico con «forma de diente» derivado de odontoides ancestrales, cuyo desarrollo está controlado por numerosos genes implicados en la odontogénesis clásica.

Consideraciones éticas y científicas del inicio de la vida sobre el aborto eugenésico en enfermedades genéticas incapacitantes en Perú

El artículo expone conceptos actuales biológicos, así como algunos planteamientos filosóficos acerca del inicio de la vida, que se examinarán en relación con la necesidad del aborto eugenésico. Se presenta el concepto de "exdurantismo", en el que la combinación del nuevo genoma nuclear y mitocondrial hacen único al individuo; además, se concibe al complejo genómico como "integrador somático" que dirige el desarrollo embrionario, y se muestra la problemática en el caso de las violaciones que provocan embarazos, el aborto eugenésico en enfermedades genéticas incapacitantes o la utilización de embriones posterior a la fertilización in-vitro. Se plantea que la dignidad de la persona comienza desde la concepción. Frente a la detección de una enfermedad genética, grave o letal, se debe ofrecer soporte económico y social, de diagnóstico y tratamiento; además, desde la salud pública, una mayor inversión para plantear estrategias de tamizaje, diagnóstico, manejo e investigación.

The article presents current biological concepts, as well as some philosophical approaches to the beginning of life, which will be examined in relation to the need for eugenic abortion. The concept of "exdurantism" is presented, in which the combination of the new nuclear and mitochondrial genome makes the individual unique; furthermore, the genomic complex is conceived as a "somatic integrator" that directs embryonic development, and the problematic is shown in the case of rape that causes pregnancies, eugenic abortion in incapacitating genetic diseases or the use of embryos after in-vitro fertilization. The dignity of the person begins at conception. When a serious or lethal genetic disease is detected, economic and social support, diagnosis and treatment should be offered; in addition, public health should invest more in screening, diagnosis, management and research strategies.

O artigo apresenta conceitos biológicos atuais, bem como algumas abordagens filosóficas sobre o início da vida, que serão examinados em relação à necessidade do aborto eugênico. É apresentado o conceito de "exdurantismo", no qual a combinação do novo genoma nuclear e mitocondrial torna o indivíduo único; além disso, o complexo genômico é concebido como um "integrador somático" que dirige o desenvolvimento embrionário, e é mostrada a problemática no caso de estupro que resulta em gravidez, aborto eugênico em doenças geneticamente incapacitantes ou o uso de embriões após a fertilização in vitro. Argumenta-se que a dignidade da pessoa começa na concepção. Diante da detecção de uma doença genética, grave ou letal, devem ser oferecidos apoio econômico e social, diagnóstico e tratamento, bem como maior investimento em saúde pública em estratégias de triagem, diagnóstico, gestão e pesquisa.

Post-modern bioethical stresses destination of surplus embryos: Brazilian analysis and brief comparisons

The objective of the present study is to point out tensions of the theoretical/practical universe that Bioethics is facing in Brazil, in the search for a praxis for the destination of surplus embryos. We consider that Bioethics analyzes the implications of such practices in society and in relationships between individuals. Brief data from other countries were presented to compare the Brazilian situation progressively from the conceptual point of view and the adoption of measures. The research is a scoping review on the main points that have been hindering the progress of discussions on the subject and consequently the respective solution. The legal status of the embryo was described from several perspectives and theories, with the resulting proposals for the destination of surplus embryos in their positive and negative aspects. The tensions of Bioethics were presented in the context of post-modernity and the consequent social and moral plurality, together with the difficulties of identifying a secular bioethical morality. In the end, we conclude the possibility of proclaiming a consensus on the destination of surplus embryos based on secular morality, supported by the figure of the "moral strangers".

El objetivo del presente estudio es señalar las tensiones del universo teórico/práctico que la bioética enfrenta en Brasil, en la búsqueda de una praxis para el destino de los embriones sobrantes. Consideramos que la bioética analiza las implicaciones de tales prácticas en la sociedad y en las relaciones entre los individuos. Se presentaron breves datos de otros países para comparar progresivamente la situación brasileña desde el punto de vista conceptual y de la adopción de medidas. La investigación es una revisión del alcance de los principales puntos que han obstaculizado el avance de las discusiones sobre el tema y, en consecuencia, la respectiva solución. Se describió el estatuto jurídico del embrión desde diversas perspectivas y teorías, con las consiguientes propuestas para el destino de los embriones sobrantes en sus aspectos positivos y negativos. Se presentaron las tensiones de la bioética en el contexto de la posmodernidad y la consecuente pluralidad social y moral, junto con las dificultades de identificar una moral bioética laica. Al final, se concluye la posibilidad de proclamar un consenso sobre el destino de los embriones sobrantes basado en una moral laica, apoyada en la figura de los "extraños morales".

O objetivo do presente estudo é destacar as tensões do universo teórico/prático que a Bioética está enfrentando no Brasil, na busca de uma praxis para a destinação de embriões excedentes. Nós consideramos que a Bioética analisa as implicações de tais práticas na sociedade e nas relações entre indivíduos. Dados resumidos de outros países são apresentados para comparar a situação brasileira progressivamente de um ponto de vista conceitual para a adoção de medidas. A pesquisa é uma revisão de escopo sobre os pontos principais que vem atrapalhando o andamento das discussões sobre o assunto e consequentemente a solução respectiva. O status legal do embrião foi descrito a partir de diversas perspectivas e teorias, com as propostas resultantes para a destinação dos embriões excedentes em seus aspectos positivos e negativos. As tensões da Bioética foram apresentadas no contexto da pós-modernidade e a consequente pluralidade social e moral, juntamente com as dificuldades de identificar uma moralidade bioética secular. Ao final, nós concluímos pela possibilidade de proclamar um consenso sobre a destinação de embriões excedentes baseado na moralidade secular, apoiado pela figura dos "estranhos morais".

Cell-free DNA in Embryo Culture Media as Non-invasive Biomarker of the Quality of Embryo Cleavage

Background: The success of in vitro-fertilization (IVF) cycles is determined in large part by the quality of embryo cleavage, which in turn, is dependent on the quality of the embryo culture media (CM). Many factors can influence the quality of embryo CM, one of which is the levels of Cell Free Deoxyribonucleic acid (DNA). Understanding the association between Cell-free DNA levels in embryo CM and the quality of embryo cleavage could help improve the quality of IVF techniques. Methods: This prospective study was conducted with 96 spent CM from patients undergoing IVF cycle, in order to determine relationships of Cell-free DNA levels in embryo CM with embryo cleavage quality on day 3. After intracytoplasmic sperm injection (ICSI), 48 embryos were evaluated on day 3 of their development, according to their cell number. Day 2 and day 3 CM corresponding to each one of the embryos was analyzed, by quantitative PCR, for estimation of Cell-free DNA levels. Results: The results revealed a significant increase in Cell-free DNA levels on day 2 CM corresponding to 4 to 6 cell embryos compared to those corresponding to 7 to 8 cell embryos (p=0.04). As for day 3 CM, the results showed no significant difference between the Cell-Free DNA levels in CM of 7-8 and those of 4-6 cell embryos (p=0.4). Also, cell free DNA levels in embryo CM, were significantly higher on day 2 compared to day 3 for both 7-8 and 4-6 cell embryos (p=0.03; p=0.04). Conclusion: We conclude that cell-free DNA levels in CM might be associated with delayed embryo cleavage.

Is the length of time between endometrial scratching and embryo transfer important for pregnancy success? An observational study

SUMMARY OBJECTIVE: This study sought to evaluate the influence of time (early <90 days and late >90 days) and endometrial injury on pregnancy success. METHODS: This is a retrospective study in which all infertile women who underwent at least one in vitro fertilization cycle at Clinica Gera between 2010 and 2015 were considered for inclusion. We included patients with a normal ovarian reserve and regular menses at intervals of up to 30 days. A total of 315 patient files were reviewed, and the study group was composed of patients who faced fertility issues and had male-caused infertility or idiopathic infertility. Also, women with male or unknown cause of infertility who have performed endometrial biopsy and have undergone embryo transfer up to 180 days after this procedure between 2010 and 2015 were included. The patients were divided into two groups according to the interval between biopsy and embryo transfer: group 1 (early—an interval of <90 days) and group 2 (late—an interval of >90 days and up to 180 days). RESULTS: The results were superior for the group with an interval of less than 90 days relative to the group with an interval of more than 90 days (p<0.04). The pregnancy rates for group 1 and group 2 were 58.5% and 43.4%, respectively. The odds ratio for pregnancy success was 1.63 (95% confidence interval: 1.04 to 2.55). CONCLUSION: The early transfer of embryos (<90 days) may produce better results with a high rate of pregnancy. Further studies are necessary to identify the mechanism involved in this phenomenon.

Effect and Mechanisms of Kaiyu Zhongyutang on Insulin Resistance， Glucose and Lipid Metabolism， Psychological State， and Embryo Outcome in Infertile Patients with PCOS Due to Liver Depression and Kidney Deficiency / 中国实验方剂学杂志

ObjectiveTo explore the effects and mechanisms of Kaiyu Zhongyutang on insulin resistance， glucose and lipid metabolism， psychological state， and embryo outcome in the infertile patients with polycystic ovary syndrome （PCOS） due to liver depression and kidney deficiency. MethodThe 126 infertile patients with PCOS due to liver depression and kidney deficiency who underwent in vitro fertilization-embryo transfer （IVF-ET） in the Department of Reproduction of the affiliated hospital of Nanjing university of Chinese medicine were randomly assigned into the observation （Kaiyu Zhongyutang + metformin） and control （metformin） groups. The two groups were compared in terms of traditional Chinese medicine （TCM） syndrome scores， body mass index （BMI）， glucose and lipid metabolism， homeostasis model assessment-insulin resistance （HOMA-IR）， interleukin （IL）-6， IL-8， C-reactive protein （CRP）， self-rating depression scale （SDS） score， self-rating anxiety scale （SAS） score， and clinical and laboratory scores of IVF after treatment. Result① After treatment， the observation group showed decreased scores of primary and secondary TCM syndromes and total TCM syndrome score （P < 0.05）， and the control group presented decreased scores of irritability and depression and total TCM syndrome score （P<0.05）. Compared with the control group， the observation group demonstrated reduced primary and secondary syndrome scores and total score after treatment （P<0.05）. ② After treatment， both groups showed decreased BMI， lowered levels of fasting insulin （FINS）， fasting plasma glucose （FPG）， cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， and HOMA-IR （P<0.05）， and elevated high-density lipoprotein （HDL） level （P<0.05）. Moreover， the observation group had lower BMI， FINS， FPG， TC， TG， LDL， and HOMA-IR and higher HDL than the control group （P<0.05）. ③ The treatment in both groups lowered the levels of IL-6， IL-8， and CRP and decreased SDS and SAS scores （P<0.05）. Moreover， the declines in the observation group were more obvious than those in the control group （P<0.05）. ④ Correlation analysis before treatment， IL-6， IL-8， and CRP had positive correlations with BMI， HOMA-IR， TC， TG， LDL， SDS， and SAS （P<0.05） and a negative correlation with HDL （P<0.05）. ⑤ The observation group showed reduced gonadotropin （Gn） using days and total Gn dose and higher two-pronuclear （2PN） fertilized oocytes， 2PN cleavage rate， normal fertilization rate， D3 transferable embryo number， D3 high-quality embryo number， high-quality embryo rate， and blastocyst formation rate than the control group （P<0.05）. ConclusionKaiyu Zhongyutang can treat PCOS patients by improving the emotional and reproductive functions and alleviating insulin resistance and glucose and lipid metabolism disorders. Moreover， it can reduce the Gn dose and Gn using days in the IVF process， improve the quality and maturity of eggs， increase the egg fertilization rate， enhance the potential of embryo development， and increase the rate of blastocyst formation by inhibiting inflammation.

Application and consideration of metabolomics detection in embryo culture medium in the noninvasive screening of embryos / 中华检验医学杂志

In vitro fertilization (IVF) is the most successful and efficient approach to infertility treatment. Choosing the appropriate embryos for transfer significantly decreases the pregnancy failure rate and improves IVF results. Invasive procedure to acquire embryo DNA has a significant limitation. The differences of metabolites, nucleic acids, proteins and other components in embryo medium can help to screen embryos with potential development to improve implantation rate and pregnancy rate, reduce abortion rate and avoid the transfer of aneuploid embryos and the transmission of mutated genes to offspring. The metabolomics screening of high developmental potential embryos with embryo culture medium can assess the developmental potential of embryos comprehensively, objectively and noninvasiveness, which is crucial for improving the pregnancy rate of single embryo transfer.

Effect of follicular size on clinical outcomes of frozen-thawed embryo transfer induced by hCG on ovulation in natural cycles / 中华妇产科杂志

Objective:To investigate the effect of follicular size on the clinical outcomes of frozen-thawed embryo transfer induced by human chorionic gonadotropin (hCG) of natural cycles on ovulation.Methods:Clinical data of 427 cycles of frozen-thawed single blastocyst transfer in Nanjing Drum Tower Hospital from January 2016 to December 2019 were retrospectively analyzed. The patients were divided into 15-16 mm group (15≤diameter≤16 mm, n=66), 16-17 mm group (16<diameter≤17 mm, n=101), 17-18 mm group (17<diameter≤18 mm, n=125), 18-20 mm group (18<diameter≤20 mm, n=109),>20 mm group (diameter>20 mm, n=26), according to the maximum follicle diameter on the induction day of hCG ovulation induction. The estradiol and luteinizing hormone (LH) levels, and clinical pregnancy rate, abortion rate and live birth rate were compared in five groups. Results:There were statistically significant differences in estradiol and LH levels among the five groups on the day of hCG induction (all P<0.05). Estradiol levels in 15-16 mm group to >20 mm group gradually increased on the day of hCG induction, and estradiol level in 15-16 mm group was significantly lower than those in 17-18 mm group, 18-20 mm group and >20 mm group (median: 1 002.3 vs 1 103.3 vs 1 171.2 vs 1 539.0 pmol/L), with statistical significances ( P=0.034, P<0.001, P=0.002). On the day of hCG induction, LH levels in 15-16 mm group to >20 mm group showed a decreasing trend, and LH level in 15-16 mm group was significantly higher than those in 17-18 mm group and >20 mm group (median: 37.73 vs 28.24 vs 24.11 U/L), with statistically significant differences ( P=0.007, P=0.006). There were no significant differences in clinical pregnancy rate, abortion rate and live birth rate in 15-16 mm group to >20 mm group (all P>0.05). Conclusion:In the natural cycle protocol of hCG induced ovulation, the small follicle group could achieve similar clinical outcomes compared with normal sized follicles in the single blastocyst transfer of frozen-thawed embryos.

Analysis of reproductive outcomes in the first IVF-ET cycle after laparoscopic treatment in patients with endometriosis / 中华妇产科杂志

Objective:To explore the effect of endometriosis (EM) on reproductive outcomes of young patient with EM after laparoscopic treatment in the first in vitro fertilization-embryo transfer (IVF-ET) cycle.Methods:The clinical data and reproductive outcomes of 394 infertile patients with EM after laparoscopic treatment (EM group) and 3 242 infertile patients caused by gamete transport disorder (control group) in the first IVF-ET cycle were collected in Chongqing Health Center for Women and Children from January 2016 to June 2021. The information included baseline characteristics, oocyte retrieval, embryo development, clinical pregnancy, miscarriage, and live birth. Propensity score matching (PSM) method was used to perform 1∶2 matching between EM group and control group. The impact of EM on reproductive outcomes was analyzed in the retrospective observational study.Results:In the initial data, compared with control group, the number of two pronucleus (2PN) zygotes (9.7±4.8 vs 9.0±4.4), the number of transferable embryos (6.2±3.6 vs 5.5±3.4) and the rate of transferable embryos (64.0% vs 60.8%) on the third day were significantly lower in EM group, and the differences were statistically significant (all P<0.05). After PSM was performed, there were 394 and 787 cases in EM group and control group, respectively. Compared with control group, the number of 2PN zygotes (9.7±4.9 vs 9.0±4.4), the 2PN fertility rate (77.1% vs 75.3%), the number of transferable embryos on the third day (6.2±3.6 vs 5.5±3.4), the transferable embryos rate on the third day (63.8% vs 60.8%) were significantly lower in EM group, and the differences were statically significant (all P<0.05). The study did not find the effect of EM on embryo implantation rate, pregnancy rate, early miscarriage rate, live birth rate and preterm birth rate (all P>0.05). Conclusions:EM might interfere with the development of oocytes and embryos. Obtaining top-quality embryos may be an effective way to improve the prognosis of patients with EM after laparoscopic treatment.

Determination of endometrial receptivity by three-dimensional power ultrasound for evaluation of pregnancy outcome after in vitro fertilization and embryo transfer / 中国基层医药

Objective:To investigate the clinical value of endometrial receptivity determination by transvaginal three-dimensional power ultrasound in the prediction of pregnancy outcome after in vitro fertilization and embryo transfer. Methods:A total of 220 infertile patients who underwent in vitro fertilization and embryo transfer in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2018 to July 2021 were included in this study. Before in vitro fertilization and embryo transfer, all patients were tested for endometrial receptivity by transvaginal two-dimensional and three-dimensional power ultrasound. Pregnancy outcomes were followed up. Anatomical indexes (endometrial thickness, endometrial volume, and endometrial morphology) and endometrial blood flow indexes [endometrial blood flow type, pulsation index, resistance index (RI), ratio of peak systolic velocity to end-diastolic velocity (S/D), vascularization index (Vl), blood flow index (FI) and vascular blood flow index (VFI)] were compared between different pregnancy outcomes. Results:There were no significant differences in endometrial thickness, endometrial volume, and endometrial morphology between successful pregnancy and failed pregnancy groups ( t or χ2 = 0.23-0.54, P = 0.523-0.890). There was no significant difference in endometrial blood flow typing between successful pregnancy and failed pregnancy groups ( χ2 = 0.217, P = 0.897). PI, RI, and S/D in the successful pregnancy group were (2.46 ± 0.29), (1.07 ± 0.21), and (0.57 ± 0.10), respectively, which were significantly lower than (2.71 ± 0.34), (1.35 ± 0.24), and (0.66 ± 0.11) in the failed pregnancy group ( t = 4.51, 5.27, 3.43, all P < 0.001). VI, FI, and VFI values in the successful pregnancy group were (23.04 ± 2.95), (32.26 ± 3.17), and (6.59 ± 0.94) respectively, which were significantly higher than (16.85 ± 2.17), (28.42 ± 3.04), and (4.88 ± 0.86) in the failed pregnancy group ( t = 10.94, 6.25, 8.37; all P < 0.001). Conclusion:Endometrial blood flow parameters such as PI, RI, S/D, VI, FI, and VFI determined by transvaginal three-dimensional power ultrasound have a certain predictive value for pregnancy outcomes after in vitro fertilization and embryo transfer. They can be used as sensitive indexes for evaluating endometrial receptivity.

Application progress of mobile health in nursing of patients with infertility / 中国实用护理杂志

This article firstly reviews the current application status of mobile health based on social networking media, mobile health applications, wearable devices in infertility patients′nursing. Then, this paper analyzes the application effects of mobile health in the five aspects of treatment process management, health education, medication management, lifestyle management and psychological care for infertility patients based on the literature. The existing problems are analyzed and prospected on this basis, in order to provide a reference for the application of mobile health to infertility patients′nursing in China.

Autophagy Regulated by Chinese Medicine Monomers in Embryo Implantation： A Review / 中国实验方剂学杂志

Embryo implantation is one of the most critical steps in the reproductive process. The failure of embryo implantation to continue development is one of the important reasons leading to infertility. The success of embryo implantation depends on the high receptivity of endometrium and the embryo with implantation ability. Autophagy is a process in which cytoplasm， organelles， and inclusions are absorbed by double-membrane vesicles and transported to lysosomes for degradation and recycling， which is a way to maintain the homeostasis. A large amount of evidence have shown that autophagy plays an important role in all aspects of embryo implantation. Based on this， this paper explored the relationship between autophagy and endometrial receptivity and embryo implantation ability. According to the latest research progress， this paper combed 5 mechanisms （promotion of decidualization of endometrial stromal cells， promotion of apoptosis， regulation of hormone levels， coordination of inflammation， and promotion of ovulation） of 14 kinds of Chinese medicine monomers， including emodin， catalpol， paeoniflorin， resveratrol， folic acid， zearalenone， curcumin， wogonin， quercetin， chrysin， berberine， apigenin， phisetine， and kaempferol， in regulating different links of autophagy intervention in embryo implantation. This paper is expected to provide references and ideas for future Chinese medicine monomers to improve the success rate of embryo implantation.

Impairment of superovulation on the establishment of pregnancy in mice / 解剖学报

Objective To explore whether superovulation impairs the process of pregnancy establishment in mice by changing the intrauterine environment. Methods The implantation and pregnancy of superovulated and normal mice were compared. The superovulated mice were subjected to unilateral tubal ligation on day 0. 5 and blastocysts were transplanted to the other uterine horn on day 2. 5. The number of implantation sites of bilateral uterine horn was compared. The differences between preimplantation uteri of superovulated and normal pseudopregnancy mice were compared by tissue sections and high-throughput sequencing. Bioinformatics analysis was performed on the differentially expressed genes in two groups. Results Compared with the control group, the pregnancy rate of mice in the superovulation group decreased significantly. The number of implantation sites in the superovulation group was higher than the control. There was no significant difference in the pregnancy rate of the uterine horn between the control side and the transplanted side of the superovulated mice. The endometrium was thinned and the number of glands was reduced in superovulated pseudopregnancy mice. The gene expression patterns of preimplantation uterus in superovulation pseudopregnancy and normal pseudopregnancy mice were different. There were 1097 significantly differentially expressed genes, including 752 up-regulated genes and 345 down-regulated genes. Bioinformatics analysis showed that differentially expressed genes are mainly involved in biological processes, such as decidualization, response to progesterone, positive regulation of angiogenesis. They were mainly enriched in FoxO signaling pathway, cell cycle pathway and steroid biosynthesis pathway. Conclusion Superovulation impaired the process of establishing pregnancy and altered the gene expression patterns of biomarker of uterine receptivity in mice.

Clinical efficacy of acupuncture combined with Chinese herbal medication for recurrent implantation failure infertility of kidney deficiency and blood stasis and its effects on serum p38MAPK and JAK/STAT protein expression / 中国针灸

OBJECTIVES@#To observe the effects of acupuncture combined with Chinese herbal medication on pregnancy outcomes in patients with recurrent implantation failure (RIF) infertility of kidney deficiency and blood stasis, and to explore its effects on the protein expression of serum p38MAPK and JAK/STAT.@*METHODS@#Sixty-two patients with RIF infertility of kidney deficiency and blood stasis who were scheduled for artificial cycle frozen-thawed embryo transfer were randomly divided into an observation group (31 cases, 4 cases dropped out) and a control group (31 cases, 3 cases were eliminated). The patients in the control group were treated with conventional artificial cycle frozen-thawed embryo transfer. On the basis of the control group, the patients in the observation group were treated with acupuncture combined with Chinese herbal medication. Acupuncture was applied at Baihui (GV 20), Guanyuan (CV 4) and bilateral Neiguan (PC 6), Zigong (EX-CA 1), Guilai (ST 29), Zusanli (ST 36), Taichong (LR 3), Shenshu (BL 23), Ciliao (BL 32), with each session lasting for 30 minutes, once every other day. Chinese herbal medication was administered to Bushen Huoxue (tonifing the kidney and activating blood circulation) decoction, with one dose per day, starting from the 3rd to 5th day of the menstrual cycle and continuing until 1 day before embryo transfer. Clinical pregnancy rate, embryo implantation rate, live birth rate, and biochemical pregnancy rate were compared between the two groups. TCM symptom score, platelet count (PLT), and plasma D-dimer level were assessed before treatment and 1 day before embryo transfer. Western blot method was used to detect the expression of serum P38MAPK, JAK, and STAT proteins before treatment and 1 day before embryo transfer.@*RESULTS@#In the observation group, the clinical pregnancy rate, embryo implantation rate, and live birth rate were higher (P<0.05), while the biochemical pregnancy rate was lower (P<0.05) than those in the control group. One day before embryo transfer, both groups showed a decrease in TCM symptom scores, PLT, and plasma D-dimer levels compared to those before treatment (P<0.05), and the observation group had lower TCM symptom scores and plasma D-dimer levels than the control group (P<0.05). One day before embryo transfer, the expression levels of serum p38MAPK, JAK, and STAT proteins in both groups were lower than those before treatment (P<0.05), and the observation group had lower serum p38MAPK protein expression than the control group (P<0.05).@*CONCLUSIONS@#Acupuncture combined with Chinese herbal medication can improve the clinical pregnancy rate, embryo implantation rate, live birth rate, and reduce the biochemical pregnancy rate in RIF infertility patients of kidney deficiency and blood stasis. Its mechanism of action may be related to down-regulating plasma D-dimer level and protein expression of serum p38MAPK.

Acupuncture for in vitro fertilization-embryo transfer: an overview of systematic reviews / 中国针灸

OBJECTIVES@#To evaluate the report quality, methodological quality and evidence quality of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture for in vitro fertilization-embryo transfer (IVF-ET).@*METHODS@#The SRs/MAs of acupuncture for IVF-ET were searched electronically from databases of CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, from inception of each database to September 27th, 2022. Two reviewers independently screened the literature and extracted the data. Using PRISMA statement, the AMSTAR 2 scale and the GRADE system, the report quality, methodological quality and evidence quality of the included SRs/MAs were assessed.@*RESULTS@#A total of 28 SRs/MAs were included, with PRISMA scores ranging from 8.5 points to 27 points. The problems of report quality focused on protocol and registration, retrieval, risk of bias in studies, additional analysis, limitations and funding. The methodological quality of included studies was generally low, reflecting on items 2, 3, 7, 10, 12 and 16. A total of 85 outcome indexes were included in the GRADE system for evidence grade evaluation. Most of the evidences were low or very low in quality. The reasons for the downgrade were related to study limitations, inconsistency, imprecision and publication bias.@*CONCLUSIONS@#Acupuncture therapy improves the outcomes of IVF-ET, but the methodological quality and evidence quality of related SRs/MAs are low. It is recommended to conduct more high-quality studies in the future to provide more reliable evidences.

Effects of paternal age on pregnancy outcomes in frozen-thaw embryo transfer cycles / 现代泌尿外科杂志

【Objective】 To observe the effects of paternal age on the pregnancy outcomes in frozen embryo transfer (FET) cycles. 【Methods】 The clinical data of two groups after propensity score matching (PSM) were retrospectively analyzed, including 738 cycles in the 0.05). The clinical pregnancy rate (52.2%vs. 67.2%) and live birth rate (41.1% vs. 57.2%) decreased in the 40-60 year group compared with those in the 0.05). 【Conclusion】 Advanced paternal age decreases clinical pregnancy rate and live birth rate.