The effect of adenomyosis on IVF after long or ultra-long GnRH agonist treatment.

RESEARCH QUESTION: Does adenomyosis affect IVF independent of decreased ovarian reserve, and what are the characteristics and IVF outcome of the ultra-long gonadotrophin-releasing hormone (GnRH) agonist protocol in adenomyosis? DESIGN: Observational cohort study of three groups of patients undergoing first cycle of IVF treatment with normal ovarian reserve: (A) 362 patients with adenomyosis using the ultra-long GnRH agonist protocol; (B) 127 patients with adenomyosis using the long GnRH agonist protocol; (C) 3471 patients with tubal infertility using the long GnRH agonist protocol. RESULTS: Compared with groups B and C, the number of oocytes retrieved in group A decreased, and the gonadotrophin dosage and duration in group A were higher (P < 0.001). In long GnRH agonist treatment, clinical pregnancy rate (OR 0.492, 95% CI 0.327 to 0.742, P < 0.001), implantation rate (OR 0.527, 95% CI 0.350 to 0.794, P = 0.002) and live birth rate (OR 0.442, 95% CI 0.291 to 0.673, P < 0.001) decreased and miscarriage rate (OR 3.078, 95% CI 1.593 to 5.948, P < 0.001) increased in adenomyosis patients compared with tubal infertility. For adenomyosis patients, clinical pregnancy rate (OR 1.925, 95% CI 1.137 to 3.250, P = 0.015), implantation rate (OR 1.694, 95% CI 1.006 to 2.854, P = 0.047) and live birth rate (OR 1.704, 95% CI 1.012 to 2.859, P = 0.044) increased in the ultra-long GnRH agonist treatment compared with long GnRH agonist treatments. CONCLUSION: Adenomyosis could negatively affect IVF outcomes independent of ovarian reserve after long GnRH agonist protocol. Patients with adenomyosis following the ultra-long GnRH agonist protocol could have a better pregnancy outcome than those following the long GnRH agonist protocol.

Decreased Endometrial IL-10 Impairs Endometrial Receptivity by Downregulating HOXA10 Expression in Women with Adenomyosis.

OBJECTIVE: The aim of this study was to investigate the potential role of IL-10 in regulating the receptivity marker HOXA10 in the endometrium of women with adenomyosis. METHODS: The expression levels of IL-10, HOXA-10, STAT3, and p-STAT3 in the endometrium of women with adenomyosis and controls were examined by means of western blotting and immunohistochemistry. The expression of the HOXA10 protein in Ishikawa cells treated with rIL-10 was examined by western blotting. The attachment rate of BeWo cell spheroids to Ishikawa cells treated with rIL-10 was expressed as a percentage of the total number of spheroids. RESULTS: The expression levels of HOXA10 and IL-10 in the adenomyosis group were significantly lower than those in the control group, and there was a positive correlation between HOXA10 and IL-10 protein levels in all the women examined. rIL-10 increased HOXA10 expression in a concentration- and time-dependent manner by inducing the phosphorylation of STAT3 in Ishikawa cells. Treatment with rIL-10 promoted the attachment of BeWo spheroids to Ishikawa cells, which was reversed by the inhibition of STAT3 phosphorylation. The expression of p-STAT3 in the adenomyosis group was significantly lower than that in the control group, and there was a positive correlation between IL-10 and p-STAT3 protein levels in all the women examined. CONCLUSIONS: Both IL-10 and HOXA10 levels in the endometrium are significantly reduced in women with adenomyosis compared with those in control women. The phosphorylation of STAT3 has been proven to be a critical mediator between IL-10 and HOXA10, which may play critical roles in embryo implantation.

The effect of first trimester subchorionic hematoma on pregnancy outcomes in patients underwent IVF/ICSI treatment.

OBJECTIVE: The aim of this retrospective cohort study was to assess the effect of subchorionic hematoma (SCH) on pregnancy outcomes in IVF/ICSI patients. METHODS: We retrospectively analyzed 1097 pregnancies achieved by in vitro fertilization and embryo transfer (IVF-ET) or frozen-thawed embryo transfers (FETs) between January 2013 and June 2013 at the IVF center of Nanjing Drum Tower Hospital. The prevalence of SCH was 12.1% in this group (133/1097). We compared the pregnancy outcomes between the SCH group and non-SCH group, while the risk factors for SCH were also evaluated. RESULTS: There was no significant difference between SCH group and non-SCH group with regard to patients' age, spouse's age, endometrial thickness, miscarriage rate (5.6% versus 6.2%, p > 0.05), second trimester fetus loss rate (5.6% versus 7.7%, p > 0.05) or live birth rate (89.5% versus 86.1%, p > 0.05). While the birth weight in singleton pregnancy in SCH group was significant lower (3207.8 ± 595.7 g versus 3349.2 ± 59.7 g, p = 0.03). SCH was more common in fresh embryo transfer patients than that in FET patients (16.6% versus 5.1%, p < 0.01), fresh embryo transfer was a high risk for SCH with OR 3.67, 95% CI: 2.28-5.90. CONCLUSION: We concluded that SCH was associated with lower birth weight in singleton pregnancy, but SCH did not increase pregnancy loss rate in IVF/ICSI patients, and fresh embryo transfer may contribute to SCH onset.

Scientific Collaboration in Chinese Nursing Research: A Social Network Analysis Study.

Collaboration has become very important in research and in technological progress. Coauthorship networks in different fields have been intensively studied as an important type of collaboration in recent years. Yet there are few published reports about collaboration in the field of nursing. This article aimed to reveal the status and identify the key features of collaboration in the field of nursing in China. Using data from the top 10 nursing journals in China from 2003 to 2013, we constructed a nursing scientific coauthorship network using social network analysis. We found that coauthorship was a common phenomenon in the Chinese nursing field. A coauthorship network with 228 subnetworks formed by 1428 nodes was constructed. The network was relatively loose, and most subnetworks were of small scales. Scholars from Shanghai and from military medical system were at the center of the Chinese nursing scientific coauthorship network. We identified the authors' positions and influences according to the research output and centralities of each author. We also analyzed the microstructure and the evolution over time of the maximum subnetwork.

[Expression of cyclooxygenase-2 in the testes and epididymides of adult male rats].

OBJECTIVE: To investigate the expression of cyclooxygenase-2 (cox-2) in the testes and epididymides of adult male rats and its significance. METHODS: Immunohistochemical staining was used to detect the expression and localization of cox-2 in the testicle and epididymal tissues of 40 adult male SD rats. RESULTS: Strong cox-2 immunoreactivity was detected in the epididymides and testes of the rats. In the caput epididymides, cox-2 expressed mainly in the epithelial nuclei and partly in the cytoplasm. Cox-2 was also found positive in the testis nuclei and cytoplasm. CONCLUSION: Immunohistochemical staining is a fairly sensitive method for detecting cox-2 expression in the testes and epididymides of adult male rats.