Clinical features and microsurgical reconstruction of congenital unilateral absence of the vas deferens with obstructive azoospermia: a tertiary care center experience / 亚洲男科学杂志(英文版)

Patients with congenital unilateral absence of the vas deferens (CUAVD) manifest diverse symptoms from normospermia to azoospermia. Treatment for CUAVD patients with obstructive azoospermia (OA) is complicated, and there is a lack of relevant reports. In this study, we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA. From December 2015 to December 2020, 33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital (Shanghai, China). Patient information, ultrasound findings, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated. Of 33 patients, 29 patients were retrospectively analyzed. Vasoepididymostomy (VE) or cross VE was performed in 12 patients, the patency rate was 41.7% (5/12), and natural pregnancy was achieved in one of the patients. The other 17 patients underwent testicular sperm extraction as the distal vas deferens (contralateral side) was obstructed. These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA, even with a relatively low rate of patency and natural pregnancy.

Comparison of mental health status of pregnant women with assisted reproductive technology and natural pregnancy / 中国实用护理杂志

Objective:To explore whether assisted reproductive technology (ART) can affect the mental health of pregnant women during pregnancy.Methods:Convenient sampling method was used to select 500 pregnant women who underwent prenatal examination in Dalian Women and Children′s Medical Group from July 2019 to July 2020, including 193 cases of ART pregnant women (observation group) and 307 cases of natural pregnant women (control group). PEM-D psychosomatic holistic diagnosis and treatment system combined with Symptom Checklist- 90 (SCL-90), 7- item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate and compare the mental health status between the two groups.Results:The total score of SCL-90 in the observation group was (154.34 ± 14.42), which was significantly higher than that in the control group (142.42 ± 14.39), the difference was statistically significant ( t=5.35, P<0.05). The scores of anxiety, depression and paranoia in the observation group were (2.17 ± 0.47), (2.15 ± 0.68), (1.78 ± 0.45), which were significantly higher than those in the control group (1.95 ± 0.52), (1.77 ± 0.55), (1.58 ± 0.39), the differences were statistically significant ( t=2.86, 3.88, 3.20, all P<0.015). The scores of GAD-7 and PHQ-9 in the observation group were (6.72 ± 2.44), (5.43 ± 2.54), which were significantly higher than those in the control group (5.76 ± 2.47), (3.74 ± 1.66), the differences were statistically significant ( t=2.52, 3.57, both P<0.05). There was no significant difference in PSQI scores between the two groups ( P>0.05). Conclusions:ART affects the mental health of pregnant women, especially increases the level of depression and anxiety. We should provide corresponding psychological support and help for these pregnant women to reduce their depression and anxiety level.

Theoretical and Clinical Studies of Integrated Traditional Chinese Medicine and Western Medicine for Infertile Women with Diminished Ovarian Reserve / 中国实验方剂学杂志

Infertility with diminished ovarian reserve(DOR) is a major problem in the field of reproductive health and it has attracted great attention worldwidely.Function deficiency of the kidney is one of the fundamental pathogenesis for DOR.Traditional Chinese medicines(TCMs) have a long history with rich experience for the treatment of infertility.Some TCMs are very effective in the treatment of kidney deficiency for infertility with DOR.The integrated TCMs and western medicine,and combination of disease differentiation and syndrome differentiation may help for diagnosis and treatment of infertility with DOR.We adopt the concept of unified treatment for special disease,and the methods and principle of treatment can be used.Therefore,we adopt the TCM concept of kidney-tonifying,blood-nourishing,liver-dispersing and spleen-invigorating.The TCMs kidney-tonifying formulae are added and subtracted.TCMs can regulate the reproductive function via multiple systems for simultaneous conditioning of follicular development and ovulation.At the same time,a hypothesis of " simultaneous conditioning of follicular development and ovulation" was proposed.Two-stage therapy with integrated TCMs and western medicine has been used,mainly for increasing the number of eggs,and improving follicle quality.The goal is to achieve simultaneous conditioning of follicular development and ovulation and ultimately for effective treatment of infertility with DOR.

Maternal and neonatal perinatal outcomes in pregnancies after in vitro fertilization and natural pregnancy: a systematic: a meta analysis / 重庆医学

Objective To systematically evaluate maternal perinatal complications and neonatal outcomes after in vitro fertili zation and embryo transplantation(IVF-ET).Methods The computer retrieval was performed on the databases of PubMed,Cochrane library,EMbase,CNKI,Wanfang and Chinese biomedical literature database.The articles on the comparison between IVF and natural pregnancy were included.The RevMan5.3 software was adopted to conduct the meta analysis.Results Twenty-three articles conforming to the requirements were included,including 1 312 651 cases,among them 113 044 cases were IVF and 1 199 607 cases were naturalpregnancy.IVF mother's age was larger than that of natural pregnancy,while the gestational weeks were smaller than those of natural pregnancy,the newborn birth weight was lighter than that of natural pregnancy(P＜0.05);the probability of pregnancy-induced hypertension (PIH),placenta previa,postpartum hemorrhage and gestational diabetes mellitus (GDM) occurrence in IVF mother were higher than that of natural pregnancy (P＜0.05);the rate of multiple and cesarean section in IVF mothers were higher than that of natural pregnancy (P＜0.05);the occurrence rates of small for gestational age(SGA),low birth weight infants,stillbirth and premature in IVF were higher than those of natural pregnancy (P＜0.05).Conclusion The maternal perinatal complications in IVF are higher than those of natural pregnancy,and the birth outcomes in IVF are worse than those of natural pregnancy.

A Case of Heterotopic Pregnancy Diagnosed after the Operation of Left Tubal Pregnancy / 대한주산의학회잡지

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.

A Case of Heterotopic Pregnancy Diagnosed after the Operation of Left Tubal Pregnancy / 대한주산의학회잡지

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.

A Case of Male Infertility, who Induced Natural Pregnancy with Treatment using Hochu-ekki-to and Keishi-bukuryo-gan After In Vitro Fertilization Failure / 日本東洋医学雑誌

The authors report a case of primary male infertility with Grade I varicocele that responded well to Kampo therapy. The duration of infertility was 8 years. During that time, the authors tried AIH (artificial insemination with husband's semen) 26 times and HIT (hysteroscopic insemination into tube) twice, but both these measures failed. IVF-ET (in vitro fertilization-embryo transter) was then attempted twice. In the first attempt, the authors succeeded in fertilization and cleavage of one of ten extracted eggs, but implantation failed to occur. In the second trial, none of the five eggs extracted were successfully fertilized. The authors then prescribed a combination of Hochuekki-to and Keishibukuryo-gan. Three months later, natural pregnancy occurred that resulted in the birth of a healthy boy by natural delivery. Although the authors have sometimes seen cases of natural pregnancy after the failure of IVF-ET, none of such cases suffered from reduced fertility. Male infertility is frequently involved with cases of decreased fertility. In such cases, success is rarely achieved with ordinary IVF-ET. For this reason, the science of microscopic fertilization is developing rapidly. There is currently no remedy for low fertility. In this type of situation, Kampo may help to improve fertility.