Effectiveness of growth hormone in promoting endometrial growth in patients with endometrial dysplasia in frozen embryo transfer.

This study was designed to investigate the effect of growth hormone (GH) in promoting endometrial thickness, blood flow, and pregnancy outcome in patients with thin endometrium for frozen embryo transfer. Thirty-eight patients were recruited in the reproductive center of Jingzhou Hospital affiliated to Yangtze University who cancelled fresh embryo transfer due to thin endometrium and planned to undergo frozen-thawed embryo transfer (FET) from May 2019 to May 2020. The patients were randomly divided into the GH injection group (19 cases, endometrium preparation with hormone replacement therapy (HRT) and GH by subcutaneous injection) and the control group (19 cases, endometrium preparation with HRT). Both groups were similar in socio-demographic characteristics. After treatment, the thickness and volume of endometrium in the HRT & GH group were significantly increased (p < 0.05), and the growth rate was significantly higher than that in the control group (p < 0.05). The proportion of type A & B endometrium increased from 78.9% to 94.7% in the HRT & GH group. Moreover, the proportion of type Ⅰ and Ⅱ of endometrial blood perfusion in the HRT & GH group significantly increased compared with that before treatment. The human chorionic gonadotropin (hCG) positive rate (47.4 vs. 42.1%) and clinical pregnancy rate (36.8% vs. 31.6%) were slightly higher in the HRT&GH group than that in the control group. In conclusion, for patients with thin endometrium, HRT combined with subcutaneous injection of GH can increase the thickness and volume of the endometrium, improving the blood perfusion of the endometrium. This may play a positive role in improving endometrial receptivity and pregnancy outcome.

Melatonin and its emerging physiological role in reproduction: A review and update.

Melatonin is a neuroendocrine hormone secreted by the pineal gland. The secretion of melatonin follows a circadian rhythm controlled by the suprachiasmatic nucleus, and its secretion is synchronized with the changes in light and dark periods in nature, with the highest secretion level at night. Melatonin is a critical hormone that coordinates external light stimulation and cellular responses of the body. It transmits information about the environmental light cycle, including the circadian and seasonal rhythms, to the relevant tissues and organs in the body, which, along with changes in its secretion level, ensures that its regulated functional activities are adapted in response to changes in the outside environment. Melatonin takes beneficial actions mainly through the interaction with specific membrane-bound receptors, termed MT1 and MT2. Melatonin also acts as a scavenger of free radicals via non-receptor-mediated mechanism. For more than half of acentury melatonin has been associated with vertebrate reproduction, especially in the context of seasonal breeding. Though modern humans show little remaining reproductive seasonality, the relationships between melatonin and human reproduction continue to attract extensive attention. Melatonin plays important roles in improving mitochondrial function, reducing the damage of free radicals, inducing oocyte maturation, increasing fertilization rate and promoting embryonic development, which improves the outcomes of in vitro fertilization and embryo transfer. The present article reviews the progress that has been made in our evolving understanding of the physiological role of melatonin in reproduction and its potential clinical applications in reproductive medicine.

Emerging progress on diagnosis and treatment of female genital tuberculosis.

Female genital tuberculosis (FGTB) is an infection caused by Mycobacterium tuberculosis and usually occurs secondary to pulmonary tuberculosis (TB) through the blood circulation, lymph circulation, or direct spreading from abdominal TB. FGTB is an uncommon type of TB that can destroy genital organs, and lead to menstrual disorders and infertility. The diagnosis of FGTB is often made by detection of acid-fast bacilli under microscopy, culture with endometrial biopsy, or histopathological examination of epithelioid granuloma on a biopsy. A multidrug anti-TB regimen is the major management of FGTB, including rifampicin, isoniazid, pyrazinamide, and ethambutol, while surgery is proposed in more deteriorated cases. However, the conception rate in infertile women with FGTB is still low, even after multidrug anti-TB therapy. Additionally, the risk of complications, such as ectopic pregnancy or miscarriage, remains high. In this review, we summarize the characteristics of FGTB, present current epidemiological data, and focus on its early diagnosis and effective management.