Effect of different ovulation induction regimens for polycystic ovary syndrome / 中国医师杂志

Objective:To explore effects of controlled ovarian stimulation (COS) protocols on pregnancy outcomes for patients with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods:A total of 1 032 patients with PCOS who underwent IVF-ET from September 1, 2016 to July 31, 2020 in the Reproductive Center of Hunan Provincial Maternal and Child Health Care Hospital were retrospectively analyzed. The patients were divided into modified long regimen group (group A, 126 cases), luteal phase long regimen group (group B, 185 cases), antagonist regimen group (group C, 344 cases), and progestin primed ovarian stimulation (PPOS) group(group D, 377 cases) according to different ovulation stimulation regimens. The ovulation promotion status [days of gonadotropin (Gn), total amount of Gn, estradiol (E 2) level on the day of human chorionic gonadotropin (HCG) injection, number of retrieved eggs, number of mature eggs (MII eggs), number of normal fertilized embryos (2PN), number of high-quality embryos] and the first frozen embryo transfer pregnancy status (clinical pregnancy rate, implantation rate, early abortion rate) were compared among the patients in each group. Results:(1) There was no significant difference in general clinical data between the four groups (all P>0.05). (2) The number of Gn days in group D was significantly less than that in groups A, B and C, and the total number of Gn was significantly less than that in groups A, B and C (all P<0.05); The E 2 level of patients in group C and group D on the day of hCG injection was significantly lower than that of group A and group B (all P<0.05); The number of eggs obtained and MII eggs in group C and group D were significantly lower than those in group A and group B (all P<0.05); The number of high-quality embryos and 2PN in group D were significantly different from those in group A, group B and group C (all P<0.05). (3) The clinical pregnancy rates of the first frozen embryo transfer after whole embryo cryopreservation in group A, group B, group C and group D were 54.72%(29/53), 56.79%(46/81), 52.56%(82/156) and 54.32%(195/359), respectively, with no significant difference among the four groups (all P>0.05). There was no significant difference in embryo implantation rate and early abortion rate among the four groups (all P>0.05). Conclusions:The modified long regimen, luteal phase long regimen, antagonist regimen and PPOS regimen can achieve better pregnancy outcomes in patients with PCOS. Among them, PPOS regimen can reduce the amount and time of Gn, and frozen embryo transfer does not affect the pregnancy outcome of patients. It can be used as one of the priority recommended strategies for PCOS patients who plan to undergo frozen embryo transfer.

Effect of adjuvant growth hormone during luteal phase on in-vitro fertilization-embryo transfer outcome / 中国医师杂志

Objective:To investigate the effect of growth hormone (GH) supplementation during luteal phase one cycle before ovulation induction in patients undergoing in vitro fertilization-embryo transfer (IVF-ET).Methods:IVF-ET pregnancy-assisted patients who underwent long-term Gonadotropin Releasing Hormone-agonist (GnRH-a) protocol from January 1, 2019 to June 30, 2020 were collected from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital. Among them, 106 patients (GH group) were added with GH during luteal phase one cycle before ovulation induction, and 212 patients (control group) were not added with GH. Ovulation induction and pregnancy outcome were compared between the two groups.Results:(1) There was no statistically significant difference in primary infertility/secondary infertility rate, infertility years, age, and transplant cancellation cycle rate between the two groups (all P>0.05). (2) There were no significant differences in the number of oocytes obtained, MII oocytes, two pronucleus (2PN) oocytes, high-quality embryos and average number of transplanted embryos between GH group and control group (all P>0.05). The total amount of Gn in control group and GH group was (2 109.75±555.75)IU and (1 863±610.52)IU, respectively, with statistically significant difference ( P<0.05). (3) The embryo implantation rate of the control group and GH group was 43.73%(129/295) and 60.42%(87/144), respectively, with statistically significant difference ( P<0.05). The clinical pregnancy rates of the control group and GH group were 58.79%(107/182) and 71.91%(64/89), the difference was statistically significant ( P<0.05). The spontaneous abortion rate of early pregnancy in control group (4.67%, 5/107) was slightly higher than that in GH group (3.12%, 2/64), but there was no significant statistical difference ( P>0.05). Conclusions:For patients with normal ovarian response, adding small dose of growth hormone during luteal stage one cycle before controlled hyperovulation can improve the embryo implantation rate and clinical pregnancy rate, and reduce the amount of Gn, which is beneficial to patients.

Application of bipolar coagulation hemostasis in laparoscopic ovarian endometriosis cyst stripping / 中国基层医药

Objective To investigate the effect of bipolar coagulation hemostasis on ovarian function in patients with laparoscopic ovarian endometriosis cyst stripping.Methods From January 2015 to February 2016, 88 cases of ovarian endometriosis cyst were selected by using the random number table method.They were randomly divided into observation group and control group,44 cases in each group.The observation group was treated with bipolar coagulation hemostasis,and the control group was treated with endoscopic suturing.The luteinizing hormone(LH), follicle stimulating hormone(FSH),estradiol(E2 ),sinus follicle number(FO )and ovarian stroma systolic blood flow velocity peak preoperation,postoperation and postoperative 6 months were detected.Results The E2 levels in the observation group postoperation and postoperative 6 months were (190.03 ±30.88 )pmol/L and (179.82 ± 29.94)pmol/L,which were significantly lower than those in the control group [(230.04 ±32.22 )pmol/L and (232.49 ±28.41)pmol/L,t =5.947,9.465,all P 0.05).Conclusion The application of different hemostatic methods in laparoscopic ovarian endometriosis cyst stripping have effect on ovarian reserve function,but bipolar coagulation and hemostasis can significantly decrease ovarian reserve function,and it should be used as little as possible during the operation.

Expressions of ASPP2, iASPP and p53 in cervical cancinoma and the significance / 中南大学学报(医学版)

OBJECTIVE@#To explore the role of apoptosis stimulating proteins of p53 2 (ASPP2) and inhibitory member of the ASPP family (iASPP) in the occurrence of cervical cancer and the relation between these two proteins and p53.@*METHODS@#We used immunohistochemical method to detect the expression of ASPP2, iASPP, p53 in 51 patients with early cervical cancer tissue, 53 patients with cervical intraepithelial neoplasia (CIN) II-III, 48 patients with CIN I and 45 patients with normal cervical tissue. The relation among ASPP2, iASPP and p53 was analyzed.@*RESULTS@#When p53 was negative, the positive expression rate of ASPP2 in the cervical cancer group, the CIN II-III group, the CIN I group and the normal cervix group was gradually increased. There was significant difference between the CIN II-III group or the cervical cancer group and the normal cervix (P0.05). The positive expression rate of iASPP in the 4 groups gradually reduced, and the difference was significant difference between the cervical cancer group or the CIN II-III group and the normal cervix group (P0.05).@*CONCLUSION@#ASPP2 and iASPP may play an important role in the occurrence of early stage of cervical cancer by regulating the ability of wild type p53 in induction of apoptosis. ASPP2 and iASPP gene might be a potential molecular target for cervical carcinoma.

Primary ovarian carcinoid clinically manifested by intractable constipation: a case report / 南方医科大学学报

Ovarian carcinoid tumor is a very rare, low-grade malignant tumor, and most of the patients have no typical clinical symptoms. Some patients seek medical attention for pelvic masses often found incidentally, and about one-third of the patients may present with carcinoid syndrome. We report a case of ovarian carcinoid tumor clinically manifested by intractable constipation, which is a rare condition in these patients.