Expectant management of heterotopic cesarean scar pregnancy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Heterotopic cesarean scar pregnancy (HCSP) is a very rare but life-threatening entity and there is no optimal management strategy. Here we report a successfully managed case of HCSP with expectant treatment in a tertiary referral hospital.</p><p><b>METHODS</b>A woman with HCSP after in vitro fertilization-embryo transfer opted for expectant treatment after five days of mild bleeding and ultrasound demonstrated cardiac activity disappearance of the scar pregnancy at 8(+4) weeks of gestation.</p><p><b>RESULTS</b>The patient had mild to moderate bleeding during close monitoring. Three days later, speculum examination revealed the gestational mass was partly protruding at the os of the cervix and it was removed with forceps without massive hemorrhage. A healthy male baby was delivered by cesarean section at gestational age of 36(+4) weeks.</p><p><b>CONCLUSIONS</b>The expectant method might be an alternative option for a HCSP with loss of cardiac activity of the scar pregnancy, when applied under supportive management and with available emergency surgery facilities.</p>

Outcome of in vitro fertilization-embryo transfer in treatment of polycystic ovarian syndrome / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the outcome of in vitro fertilization embryo transfer (IVF-ET) in treatment of polycystic ovarian syndrome (PCOS) with infertility.</p><p><b>METHODS</b>A retrospective analysis was performed from 52 patients with PCOS (PCOS group) and 408 cases with tubal infertility (control group). Both groups underwent IVF-ET treatment from 2001 to 2004. The duration of stimulation, amps of gammaFSH, the level of serum E2, P on the day of HCG injection, the number of oocytes retrieved, the rates of fertilization, cleavage, implantation and pregnancy, the incidence of ovarian hyperstimulation syndrome (OHSS) and cancelled rate of ET were compared between the two groups.</p><p><b>RESULT</b>The duration of stimulation and amps of gammaFSH were not significantly different between the two groups. The concentration of serum E2, P on the day of HCG injection, the numbers of oocytes retrieved and cleavaged embryos were significantly higher in PCOS group (P <0.01, <0.05). Fertilization rate was significantly lower in PCOS group (P <0.01). The implantation, pregnancy and miscarriage rates per ET were not statistically significant. The OHSS rates and cancelled rates of ET were higher in PCOS group (P <0.01).</p><p><b>CONCLUSION</b>Women with PCOS have a lower fertilization rate compared with those with tubal-factor fertility during IVF-ET. However, more oocytes are recovered and the preimplanted embryo has a normal chance of implantation leading to similar pregnancy rates. The OHSS rates and cancelled rates of ET are higher in PCOS because of a greater number of oocytes developed and a higher level of E2.</p>

Relationship between serum resistin level and preeclampsia / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the alteration of serum resistin levels in normal pregnancy and preeclampsia.</p><p><b>METHODS</b>Blood samples were take from 28 normal non-pregnant women, 27 women in the 1st, 26 in the 2nd and 26 in the 3rd trimester of normal pregnancy and 25 women with preeclampsia. Serum resistin concentration was determined using ELISA method.</p><p><b>RESULT</b>Serum levels of resistin were not significantly different among non-pregnancy, the 1st and the 2nd trimester of pregnancy (P>0.05 for all). Serum resistin level was significantly elevated in the 3rd trimester of pregnancy as compared with non-pregnancy (P<0.01), the 1st (P<0.001) and the 2nd trimester of pregnancy (P<0.001). Serum resistin level was significantly lower in preeclampsia than in the 3rd trimester of normal pregnancy (P<0.001), but was comparable to that of non-pregnancy, the 1st and the 2nd trimester of pregnancy (P>0.05 for all).</p><p><b>CONCLUSION</b>The decrease of serum resistin level in the preeclampsia may provide insight into the pathogenesis of the disease.</p>

Impact of leptin levels on outcome of in vitro fertilization-embryo transfer / 浙江大学学报·医学版

OBJECTIVE: To investigate the impact of ovarian stimulation on leptin levels and their effect on in vitro fertilization-embryo transfer (IVF-ET). METHODS: In 39 women who underwent IVF-ET, serum and follicular fluid leptin and E(2) levels were measured by enzyme-linked immunosorbent assay and radioimmunoassay. Blood samples were collected just prior to FSH and HCG injection and follicles puncture. Follicular fluid was collected at the time of oocyte retrieval. RESULTS: The serum leptin levels before HCG administration (26.1+/-2.3)&mgr;g/L were significantly higher than before FSH administration (9.3+/-1.0)&mgr;g/L and oocyte retrieval (15.8+/-2.3)&mgr;g/L(P<0.001). On the day of oocyte retrieval, there was no significant difference between the serum leptin(15.8+/-2.3)&mgr;g/L.and the follicular fluid leptin (18.5+/-2.2)&mgr;g/L. Serum and follicular leptin levels in successful pregnancies were significantly lower(P<0.05) than in women with failed conception. CONCLUSION: It could indicate that high leptin levels may interfere with the developing of dominant follicles.