[A randomized, single-blind, parallel-controlled and multicentre study: compare the efficacy and safety of domestic and imported human recombinant FSH in WHO group â ¡ anovulatory infertility].

OBJECTIVE: To evaluate the efficacy and safety of domestic human recombinant FSH(rhFSH)in women with anovulation of WHO group Ⅱ. METHODS: A randomized, blind, parallel-controlled, non-inferiority and multicenter study was performed. A total of 534 admitted to 13 hospitals from May 2008 to August 2009. There were 531 women with ovulatory disorder was included in the statistical analysis, were randomly divided into test group(domestic rhFSH, n=352)and control group(imported rhFSH, n=179). Percentage of cycle with mature follicle, ovulation rate, clinical pregnancy rate, multiple pregnancy rate, ovarian hyperstimulation syndrome(OHSS)and adverse events were observed. RESULTS: No statistical significant differences(P>0.05)were observed between the two groups in terms of the efficiency on mature follicle[91.8%(323/352)versus 88.8%(159/179)], ovulation rate[91.3%(295/323)verus 90.6%(144/159)], clinical pregnancy rate[19.2%(62/323)verus 18.2%(29/159)], the number of the follicles<14 mm, the level of serum LH and progesterone, the thickness of endometrium on the day of hCG administration. The number of follicle≥18 mm and 14 mm≤follicle<18 mm and the level of serum estradiol on the day of hCG in the test group were significantly higher than those in the control group(P<0.05). The number of days of rhFSH administration in the test group was significantly less than that in the control group[(9.8±2.2)versus(11.4± 0.6)days, P<0.05], the dosage of rhFSH was significantly lower than that in the control group[(879 ± 419)versus(1 043±663)U, P<0.05]. The multiple pregnancy rate in the test group was significantly higher than that in the control group[21%(13/62)versu 10%(3/29), P<0.05]. The incidence of OHSS and adverse events were similar between the two groups(P>0.05), and no other adverse events were observed in test group during treatment. CONCLUSION: Ovarian stimulation with domestic rhFSH is effective, safe and economical in women with anovulation of WHO group Ⅱ.

[Effects of 17 beta-estradiol on the release of nitric oxide from HUVEC].

OBJECTIVE: The protective mechanism of 17 beta-estradiol on blood vessels was investigated to provide evidences for clinical use of hormone replacement therapy in postmenopausal women. METHODS: To observe the effects of 17 beta-estradiol (17 beta-E2), testosterone (T), homocysteine (Hcy), 17 beta-E2 combined with T and 17 beta-E2 combined with Hcy on the production of nitric oxide (NO) released from cultured human umbilical endothelial cells (HUVEC) in vitro. RESULTS: Preincubation with 10(-9) mol/L 17 beta-E2 8-48 hours significantly enhanced the release of nitric oxide from HUVEC versus the control, but 10(-9) mol/L T had no effects within 48 hours. Pretreatment with 10(-9)-10(-7) mol/L testosterone for 24 hours had no effects on the release of NO from HUVEC versus the control, but 10(-6), 10(-5) mol/L T significantly reduced the release of NO from HUVEC. HUVEC were treated by 10(-9)-10(-5) mol/L 17 beta-E2 and 10(-9)-10(-5) mol/L T respectively for 24 hours. 10(-9), 10(-8) mol/L T had no effects on the beneficial effect of 17 beta-E2 with regard to the production of NO from HUVEC, while 10(-5) mol/L T greatly attenuated the beneficial effect of 17 beta-E2 with regard to the production of NO from HUVEC. Pretreatment with 10(-4)-10(-3) mol/L Hcy for 24 hours greatly inhibited the release of NO from HUVEC. If treated HUVEC with various concentrations of 17 beta-E2 (10(-9), 10(-7), 10(-5) mol/L) and Hcy for 24 hours simultaneously, 10(-9)-10(-7) mol/L 17 beta-E2 can partly eliminate the effects of Hcy on the released of NO from HUVEC. CONCLUSIONS: T can not enhance the release of NO from HUVECs. The effect of 17 beta-E2 combined with T on the release of NO depends on the concentration of both 17 beta-E2 and T. When 17 beta-E2 and T are in low dose, HUVEC can release more NO. Hcy can inhibit the release of NO from HUVEC, concomitant treatment with a low dose of 17 beta-E2 may eliminate the effects of Hcy on HUVEC.

[Differential diagnosis of endometrial abnormality by transvaginal sonography].

Transvaginal sonography examination was performed 450 times in 281 women to diagnose the endometrial abnormality by measuring the thickness of endometrium. There were 37 women with normal ovulatory cycles, 200 postmenopausal women with no vaginal bleeding, and 44 women with irregular vaginal bleeding. For ovulatory cycles, the mean of endometrial thickness was 7.8 +/- 2.1 mm (3-13 mm) in the follicular phase, 10.4 +/- 1.9 mm (8-13 mm) around ovulation and 10.4 +/- 2.3 mm (8-19 mm) in the luteal phase. The average thickness of endometrium for postmenopausal women without bleeding was 1.4 +/- 0.7 mm (1-5 mm). The measurement of the thickness of endometrium in women with irregular vaginal bleeding was also confirmed by histological analysis. Atrophy endometrium was diagnosed in 6 cases, the thickness of endometrium was 2.2 +/- 2.0 mm, hydrohystera was found in 8 women, thickness of endometrium was 14.5 +/- 6.1 mm, endometrial hyperplasia in 10 cases, thickness was 17.4 +/- 6.7 mm, endometrial polyps in 12 cases, thickness was 16.7 +/- 7.7 mm, and endometrial carcinoma in 8 cases, thickness was 24.4 +/- 11.9 mm. Generally, the normal thickness of endometrium for postmenopausal women should be less than 5.0 mm.

[Psychological aspects of infertile couples in China].

From March 1991 to February 1992, a psychological interview survey was performed among 652 women and 425 of their husbands who came to the Female Infertility Clinic in PUMC Hospital to seek consultation and treatment for their infertility. The results showed that more than 80 percent of the couples had been tolerating various psychological stresses caused by infertility. Disapproval was the most common feeling. The couples' emotion was influenced by each other. Emotional scores of husbands and wives were significantly positive correlated (P < 0.001). However, men are more capable to cope with this problem than women. Men's attitude to infertility is more positive and optimistic than women. There is no significant difference between women and men in their attitude to the treatment and forecasting of prognosis. Cultural background is a major factor associated with psychological stresses of infertile couples. Infertility has more severe impact on people living in rural areas as well as ones with lower level education. Infertility also affected couple's sexual and marital relationships. The relationship between women and their parents in-laws became worse among 8.6 percent of infertile women. About one-third of female participants thought the examination and the treatment for infertility also developed some emotional stresses and psychological burdens. Infertility may create various psychological stresses and influence the effect of treatment. Therefore, the management of infertility should not only include physical treatment but also understanding, sympathy and support, all above should not be neglected.