Abdominal ectopic pregnancy following a frozen embryo transfer cycle: a case report.

BACKGROUND: Abdominal ectopic pregnancy (AEP) is a rare form of ectopic pregnancy. As the number of in-vitro fertilization (IVF) procedures continues to increase, the incidence of AEP will also rise. However, the rarity and atypical presentation of AEP make early diagnosis challenging. CASE PRESENTATION: Herein, we report an AEP following frozen-thawed embryo transfer (FET) in an artificial cycle. The patient was misdiagnosed with implantation failure when the serum human chorionic gonadotropin (hCG) level was detected as 2.59mIU/ml at fourteenth day after embryo transfer. Therefore, she was suggested to stop luteal phase support. However, a ruptured AEP was developed 33 days following embryo transfer, which was diagnosed by laparoscopic surgery. CONCLUSIONS: The case highlighted the delayed serum ß-hCG and massive intraperitoneal hemorrhage may be clues to make early diagnosis of AEP. Clinicians must attach great importance to close monitoring and bear in mind the possibility of abdominal pregnancy.

[Pregnancy outcome of frozen-thawed embryo transfers in different endometrial progesterone preparation time].

OBJECTIVE: To investigate the pregnancy outcome of frozen-thawed embryos transfer in different endometrial progesterone preparation time. METHODS: From January to December 2012, pregnant outcome of 1 103 frozen-thawed embryo transfer cycles using artificial periodic endometrial preparation were studied retrospectively in Reproductive Medical Center of Henan Provincial People's Hospital. It was divided into 4 groups: group 3-3 (n = 543, 3 days after endometrial progesterone preparation and transfer D3 embryo), group 4-3(n = 330, 4 days after endometrial progesterone preparation and transfer D3 embryo), group 5-5 (n = 150, 5 days after endometrial progesterone preparation and transfer D5 blastula), group 6-5 (n = 80, 6 days after endometrial progesterone preparation and transfer D5 blastula). The rate of implantation, pregnancy, ectopic pregnancy, multiple pregnancy, and first trimester abortion were compared among those groups. RESULTS: (1) With the different endometrial progesterone preparation methods and transfer D3 embryos, implantation rate [group 3-3:39.9% (429/1 074); group 4-3:44.1% (286/648)], pregnancy rate [group 3-3:56.0% (304/543); group 4-3:59.4% (196/330)], ectopic pregnancy rate [group 3-3:3.3% (10/304); group 4-3:2.6% (5/196)], multiple pregnancy rate[group 3-3: 38.5% (117/304) ; group 4-3: 43.4% (85/196)]and early abortion rate [group 3-3: 13.5% (41/304); group 4-3:13.3% (26/196)] had no significant differences between group 3-3 and group 4-3 (all P > 0.05). (2) With the different endometrial progesterone preparation methods and transfer D5 blastocysts, implantation rate [group 5-5:64.7% (191/295) ; group 6-5:69.4% (100/144)], pregnancy rate [group 5-5:80.7% (121/150) ; group 6-5:78.8% (63/80)], ectopic pregnancy rate [group 5-5:2.5% (3/121); group 6-5:0], multiple pregnancy rate[group 5-5:55.4% (67/121); group 6-5: 46.3% (37/80)] and early abortion rate [group 5-5: 5.8% (7/121); group 6-5:7.9% (5/63)]. However, there were no significantly differences between group 5-5 and group 6-5(all P > 0.05). CONCLUSIONS: The two different progesterone transformed endometrial methods can obtain satisfactory clinical outcome with D3 embryo or D5 blastocysts transfor. It is convenient to clinical and laboratory work arrangements.

Supplementation with low concentrations of melatonin improves nuclear maturation of human oocytes in vitro.

PURPOSE: Studies in bovine and porcine have indicated that melatonin (MT) could induce meiotic maturation of immature oocytes in vitro. The object of the current study was to investigate if MT could ameliorate human oocytes maturation during rescue in vitro maturation (IVM). METHODS: Two hundred seventy eight germinal vesicle (GV) oocytes and 451 (MI) metaphase I oocytes were vitrified, thawed and then matured in vitro. All the oocytes were randomly allocated into six groups in which the oocytes were cultured in medium supplemented with different concentrations of MT (0, 10(-2), 1, 10(2), 10(4), 10(6) nM) and nuclear maturation was evaluated at 6 h, 12 h, 18 h, 24 h and 48 h of culture. RESULTS: The optimal MT concentration for both GV and MI oocytes was 1 nM. At 24 h of culture, nuclear maturation rate of MI oocytes cultured in 1 nM MT medium was significantly higher than other groups (P < 0.05); Nuclear maturation rate of GV oocytes cultured in 1 nM MT medium was also significantly higher than the control group (P < 0.05). On the other hand, decreased nuclear maturation rate was observed in the high MT concentration group (10(6) nM). CONCLUSIONS: The current study demonstrated that low concentration of exogenous MT could ameliorate nuclear maturation of human oocyte during rescue IVM, while high concentration of MT presented negative effects.

LncRNA NEAT1 affects endometrial receptivity by regulating HOXA10 promoter activity.

In vitro fertilization and embryo transfer (IVF-ET) is one of the effective methods to treat female infertility. Poor endometrial receptivity (ER) is an important factor leading to embryo implantation dysfunction, which can reduce pregnancy rate of IVF-ET. The mice model with embryo implantation dysfunction in vivo and attachment model of trophoblast (JAR) spheroids in vitro were constructed. The levels of lncRNA NEAT1, HOXA10, CTCF and markers of ER were detected. The cell proliferation was measured. The interaction between lncRNA NEAT1 and CTCF, HOXA10 promoter and CTCF were confirmed. LncRNA NEAT1 and HOXA10 levels in infertile patients and mice model with embryo implantation dysfunction were increased. In vitro experiments showed that down-regulation of lncRNA NEAT1 improved EECs proliferation and ER marker expressions. LncRNA NEAT1 could bind to CTCF, and CTCF could bind to HOXA10 promoter and down-regulate HOXA10 gene expression by regulating histone modification level. The lncRNA NEAT1/CTCF/HOXA10 signaling pathway regulated EECs proliferation and ER establishment in vitro and in vivo. Our study suggested that lncRNA NEAT1 could up-regulate HOXA10 promoter activity and its expression by combining with CTCF, thus improving EECs proliferation and ER establishment, and ultimately facilitating embryo implantation.