Efficacy and safety of the combined oral contraceptive ethinylestradiol/drospirenone (Yasmin) in healthy Chinese women: a randomized, open-label, controlled, multicentre trial.

To evaluate and compare the contraceptive efficacy, bleeding pattern, side effects and other positive effects of a combined oral contraceptive (COC) containing drospirenone (DRSP) [Yasmin] with those of a COC containing desogestrel (DSG) in healthy Chinese women. This was a randomized, open-label, controlled, multicentre study of 768 healthy Chinese women requiring contraception. The subjects were randomized to ethinylestradiol (EE) 30 microg/DRSP 3 mg (n = 573) or EE 30 microg/ DSG 150 microg (n = 195), at a ratio of 3 : 1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment. Weight, height and body mass index were evaluated at each visit. The Menstrual Distress Questionnaire (MDQ) was administered at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). Baseline characteristics were similar between the two groups (p > 0.05). The Pearl Index (method failure) for EE/DRSP was 0.208 per 100 women-years, which was lower than that for EE/DSG (0.601 per 100 women-years). There were no significant differences between the treatment groups with regard to bleeding patterns. According to the MDQ subscale, improvements in water retention and increases in appetite during the intermenstrual period and in water retention and general well-being during the menstrual period in the EE/DRSP group (-0.297, -0.057, 0.033 and 0.150, respectively) were significantly improved compared with the EE/DSG group (-0.108, 0.023, 0.231 and -0.023, respectively) [all p < 0.05]. Other values that improved in both groups, particularly improvement in breast pain and tenderness and skin condition, were more evident in the EE/DRSP group (18.0%, 89/494; 12.6%, 62/494) than in the EE/DSG group (11.3%, 19/168; 5.4%, 9/168). Mean weight increased in the EE/DSG group (0.57 kg) while there was a significant decrease in mean weight (-0.28 kg) in the EE/DRSP group (p < 0.01). Both EE/DRSP and EE/DSG have good contraceptive efficacy and a comparable bleeding pattern. EE/DRSP had a more favourable effect on weight and premenstrual symptoms than EE/DSG.

Gene expression profiles of peri-implantation endometrium of high responders during controlled ovarian hyperstimulation / 上海第二医科大学学报

Objective To investigate the gene expression profiles of peri-implantation endometrium of high responders during controlled ovarian hyperstimulation. Methods High responders with cancelled embryo-transfer during controlled ovarian hyperstimulation (high responder group, n=4) and healthy fertile volunteers (control group, n=3) were performed endometrial biopsies during peri-implantation. Histologic changes of endometrium were observed by HE staining, genes of differential expression were screened with microarrays Affymetrix U133A 2.0 and identified by Real-time PCR. The biological process analysis was performed by online biological information analysis tool PANTHER. Results The ehdometrium was in mid-secretory phase in control group, while development delay was found in some glandular organs in endometrium of high responder group. Three hundred and sixty-four genes of differential expression were screened, among which 233 were up-regulated genes and 131 were down-regulated genes. OPN, PLA2G2, DPPIV, IGFBP5 and SSAT were identified as endometrial function-related genes, whose Real-time PCR findings were positively correlated to gene signal values detected by microarray(r=0.44, P<0.01). PANTHER analysis indicated that genes of differential expression participated in the biological processes of cytokine signal transduction and immunological regulation. Conclusion Ovarian high response affects the gene expression profiles of peri-implantation endometrium, which may be one of the causes of sub-optimal endometrial receptivity.

Factors in relation to repeated abortions among unmarried young people in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the factors related to repeated abortions among unmarried young people, and to standardize the services as informed choice counseling and post abortion, and to reduce the repeated abortion rate.</p><p><b>METHODS</b>A cross-sectional survey using anonymous questionnaire was conducted among unmarried young women who requested termination of early pregnancy in 10 hospitals in Shanghai.</p><p><b>RESULTS</b>2343 subjects responded to the questionnaires. Results showed that the repeated abortion rate was 38.5%, repeated abortion rate within 1 year was 23.5%, and the high risk factors of abortion accounted for 40.2% . Subjects who were older than 19, unemployed, with poor education background, cohabitating and boyfriends being elder were more likely to have repeated abortions (OR > 1). Subjects who did not change boyfriend or use no contraception were more likely to have repeated abortions 1 year after abortion (OR > 1).</p><p><b>CONCLUSION</b>No reliable contraception used after abortion seemed to be the main reason for repeated unwanted pregnancy. Being socially disadvantaged women such as unemployed or with poor education background, meanwhile cohabitating with boyfriends or boyfriends being elder etc. they should be viewed as the key population for intervention. Male involvement and reliable contraceptive methods use among young people should be emphasized as key steps for intervention. 1 year after abortion fell into the key period for intervention. Reinforcement on factors including: training for service providers to improve their skills, setting up standard technical process and monitoring systems to carry out the basic principle of 'Informed Choice', and widely launching post-coital contraception programs including emergency contraception, luteal phase contraception and menstrual induction should be stressed.</p>

Impact of body mass index on outcome of in vitro fertilization-embryo transfer in patients with polycystic ovarian syndrome / 上海第二医科大学学报

Objective To compare the clinical outcomes of in vitro fertilization-embryo transfer(IVF-ET) in polycystic ovary syndrome(PCOS) patients with different body mass index(BMI).MethodsEighty-seven PCOS patients who received IVF-ET were classified into four groups according to BMI: group A,BMI0.05).ConclusionThe doses of gonadotropins are increased in PCOS patients with increasing BMI.The number of usable embryo is significant decreased in PCOS patients with BMI≥25 kg/m2.