Recent progress of Bioinspired Hydrogel-based delivery system for endometrial repair.

Endometrial injury is the main fact leading to infertility. Current treatments of endometrial injury present many problems, such as unable to achieve desired effects due to low retention and the inherent potential risk of injury. Besides, it is important to the development of bioinspired material that can mimic the natural tissue and possess native tissue topography. Hydrogel is a kind of bioinspired superhydrophilic materials with unique characteristics, such as excellent biocompatibility, biodegradability, porosity, swelling, and cross-linkage. These unique physiochemical properties of bioinspired hydrogels enable their promising application as novel delivery platform and alternative therapies for endometrial injury. In this mini review, we summarize the recent advances in bioinispred hydrogel-based delivery system for endometrial repair, including as a post-operative physical barrier and therapeutic delivery system. In addition, present status, limitations, and future perspectives are also discussed.

Efficacy and Safety of the Bushen-Shugan Method in Pregnancy Outcomes in Patients with Recurrent Miscarriage Complicated by Anxiety and Depression: A Prospective Randomized Trial.

Objective: This study aimed to investigate the effect of the Bushen-Shugan (BSSG) method on pregnancy outcomes, serum D-dimer (D-D), platelet aggregation rate, homocysteine (Hcy) and antithrombin III (AT-III) in patients with recurrent miscarriage complicated by anxiety and depression. Methods: From December 2016 to December 2019, 100 patients with recurrent miscarriage combined with anxiety and depression were enrolled in our study, and a prospective randomized trial was carried out. Patients were randomly assigned to either the control group or the BSSG group via the random number table method. Traditional Chinese medicine (TCM) syndrome scores, laboratory indicators and psychological changes were compared in the 2 groups before and after treatment. Results: After treatment, the primary, secondary and total TCM syndrome scores in the 2 groups were lower, and the scores in the BSSG group were significantly lower than in the control group. The clinical curative effect in the BSSG group was significantly higher (92% vs 76%) than in the control group. The levels of ß-HCG, P, E2 and AT-III in the 2 groups were higher, while levels of D-D, platelet aggregation rate and Hcy were lower than before treatment. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were lower after treatment in both groups, and the scores in the BSSG group were significantly lower than in the control group. Conclusions: The BSSG method may be worthy of consideration because it improves pregnancy outcomes in patients with recurrent miscarriage complicated by anxiety and depression.

[Retrospective analysis on pregnancy outcomes and fat-related factors of treatment of endomorph PCOS infertility patients by acupuncture of 8 acupoints around umbilicus].

OBJECTIVE: To assess the therapeutic effect of acupuncture of eight acupoints around the umbilicus in improving the metabolic level and reproductive function in endomorph polycystic ovary syndrome (PCOS) infertile patients. METHODS: Retrospective analysis was performed on 96 cases of endomorph type PCOS infertility patients who were admitted to the clinic of the Reproductive Center of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from October 2015 to June 2018. Among them, fifty-six cases of the acupuncture group received treatment with acupuncture stimulation of eight acupoints (Shuifen ï¼»CV9ï¼½, Yinjiao ï¼»CV7ï¼½, Tianshu ï¼»ST25ï¼½, Wailing ï¼»ST26ï¼½, Huaroumen ï¼»ST24ï¼½, etc.) around the umbilicus, and 40 cases of the control group were treated by oral administration of Letrozole. Acupuncture was performed once every other day, and Letrozole (2.5 mg/day) given once daily for 5 days, if no pregnancy got, the treatment procedure was repeated once again next menstruation cycle, continuously for 3 months. The pregnancy outcomes including the pregnancy rate, persistent pregnancy rate, ovulation rate and the first trimester abortion rate, and the levels of fat-related factors including body mass index (BMI), waist-to-hip ratio (WHR), homeostasis model of insulin resistance (HOMA-IR=fasting insulin x fasting blood glucose /22.5), leptin(LEP) and adiponectin(APN) of the two groups were compared. The ovulation rate (number of effective ovulation cycles/ number of observation cycles) x 100%, the first trimester abortion rate (number of spontaneous abortion within 12 weeks÷pregnancy cases) X100% were calculated. The fasting blood samples were taken for assaying serum LEP and APN contents using ELISA, blood glucose level using hexokinase assay, and serum insulin by using chemiluminescent microparticle immunoassay, separately. RESULTS: After the treatment, the pregnancy rate and the level of APN were significantly higher (P<0.05), and the BMI, WHR, HOMA-IR and LEP levels were all obviously lower in the acupuncture group than in the control group (P<0.05). There were no significant differences between the two groups in the persistent pregnancy rate, abortion rate and ovulation rate (P>0.05). CONCLUSION: Acupuncture at the eight points around the umbilicus can raise the pregnancy rate in obese type PCOS patients, which may be related to its effects in up-regulating serum APN and lowering BMI, WHR, HOMA-IR, and serum LEP levels.

Efficacy and safety of Ding-Kun-Dan for female infertility patients with predicted poor ovarian response undergoing in vitro fertilization/intracytoplasmic sperm injection: study protocol for a randomized controlled trial.

BACKGROUND: Women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) who have a predicted poor ovarian response (POR) present a challenge for reproductive medicine specialists. Traditional Chinese medicine (TCM) is commonly used in China for such patients, in the belief that it will improve the ovarian response and ultimately increase pregnancy rates. However, there is a lack of high-quality evidence about the effect of TCM on improving ovarian response in such patients. The purpose of this study is to evaluate ongoing viable pregnancy rate at 12 weeks' gestation and related indicators of ovarian response in fertile women who have a predicted poor ovarian response having immediate versus delayed IVF/ICSI after 3 months of Ding-Kun-Dan (DKD) pre-treatment. METHODS/DESIGN: This study is a multicenter, randomized controlled, parallel-group, phase III, superiority clinical trial. Two hundred and seventy-eight eligible female infertility patients with POR will be included in the study and randomly allocated into an immediate treatment group and a DKD group in a 1:1 ratio. Both groups will receive IVF or ICSI as a standard treatment while in the DKD group, a commercially available Chinese medicine, DKD, will be administrated for 3 months before the IVF/ICSI cycle starts. The primary outcome of the study is the ongoing pregnancy rate at 12 weeks' gestation. The secondary outcomes include total gonadotropin dosage, duration of stimulation, estradiol (E2) and progesterone (P) levels on human chorionic gonadotropin (hCG) trigger day, cycle cancellation rate, number of oocytes retrieved, high-quality embryo rate, biochemical pregnancy rate, the change of serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and E2 levels and all side effects, safety outcomes, and any adverse events. The protocol was approved by the Ethics Committee of the First Teaching Hospital of Tianjin university of TCM (approval no. TYLL2017[K] 004). DISCUSSION: IVF/ICSI is increasingly used to treat couples desiring a baby. Many of these women will have poor ovarian function. In China, DKD is commonly used for these patients prior to undergoing IVF/ICSI. There is no effective treatment for poor ovarian response in Western medicine currently. It is important, therefore, to undertake this randomized control trial to determine whether DKD is effective or not. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR-IOR-17011697 . Registered on 19 June 2017.