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Cadmium is one of the heavy metals with severe reproductive toxicity,whose half-life lasts 20 to 40 years.Cadmium could induce dysfunction of testis and epididymis for its significant accumulation in human testis,and the amount,motility parameters and morphology of sperm change abnormally.The adverse change could also extend to male offspring and cause the impairment of their reproductive system.There has been no clear mecha-nism of how cadmium induces dysfunction of male reproductive system,and treatment for the adverse influence on male reproductive system by cadmium has not yet been found.Therefore,this problem has been discussed in repro-ductive and environmental field for a long time.A number of previous investigations showed that cadmium could damage male fertility by followed pathways,including interfering with hormone secretion,inducing oxidative stress,activating inflammation and apoptosis,and causing energy metabolism disorder,etc.In order to enlighten new ideas for therapeutic targets of male reproductive function damage induced by cadmium,we systematically reviewed and summarized the findings of previous publications in this paper.
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Recurrent implantation failure(RIF)refers to the situation where couples facing infertility undergo multiple IVF-ET cycles and transfer multiple high-quality embryos,yet are unable to achieve embryo implantation or clinical pregnancy.The causes of RIF are multifaceted and can be influenced by many factors that may impact the outcome of IVF-ET assisted pregnancy.Despite this,there is ongoing debate regarding the definition of RIF,as well as the screening,diagnosis,and treatment approaches.This confusion largely stems from differences between current domestic and foreign guidelines and consensus.In order to provide clarity on this issue,this article aims to offer reference opinions on the standardized clinical diagnosis and treatment of RIF,based on recent research progress as well as both domestic and foreign guidelines and consensus.
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Abstract Objective To explore the expression levels and clinical value of FKBP10 in lung adenocarcinoma brain metastases. Design A retrospective single-institution cohort study. Patients The perioperative records of 71 patients with lung adenocarcinoma brain metastases who underwent surgical resection at the authors' institution between November 2012 and June 2019 were retrospectively analyzed. Methods The authors evaluated FKBP10 expression levels using immunohistochemistry in tissue arrays of these patients. Kaplan-Meier survival curves were constructed, and a Cox proportional hazards regression model was used to identify independent prognostic biomarkers. A public database was used to detect FKBP10 expression and its clinical value in primary lung adenocarcinoma. Results The authors found that the FKBP10 protein was selectively expressed in lung adenocarcinoma brain metastases. Survival analysis showed that FKBP10 expression (p = 0.02, HR = 2.472, 95% CI [1.156, 5.289]), target therapy (p < 0.01, HR = 0.186, 95% CI [0.073, 0.477]), and radiotherapy (p = 0.006, HR = 0.330, 95% CI [0.149, 0.731]) were independent prognostic factors for survival in lung adenocarcinoma patients with brain metastases. The authors also detected FKBP10 expression in primary lung adenocarcinoma using a public database, found that FKBP10 is also selectively expressed in primary lung adenocarcinoma, and affects the overall survival and disease-free survival of patients. Limitations The number of enrolled patients was relatively small and patients' treatment options varied. Conclusions A combination of surgical resection, adjuvant radiotherapy, and precise target therapy may benefit the survival of selected patients with lung adenocarcinoma brain metastases. FKBP10 is a novel biomarker for lung adenocarcinoma brain metastases, which is closely associated with survival time and may serve as a potential therapeutic target.
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Abstract Objectives Accurate prognosis assessment across the heterogeneous population of brain metastases is very important, which may facilitate clinical decision-making and appropriate stratification of future clinical trials. Previous studies have shown the L1 Cell Adhesion Molecule (L1CAM) is potentially involved in human malignancies of multiple different samples and unfavorable survival. However, no data of L1CAM are available for the brain metastases from lung adenocarcinoma, especially for the one with neurosurgical resection. Method The authors investigated the L1CAM expression in cranial metastatic lesions for patients with brain metastases from lung adenocarcinoma after neurosurgical resection using tissue microarrays that were obtained from the Department of Neurosurgery at the Cancer Hospital of the Chinese Academy of Medical Sciences. Furthermore, the relationship between L1CAM expression and clinic-pathological parameters, including overall survival time, was analyzed to assess the prognostic value of L1CAM. Results L1CAM high expression was found in 62.30% of brain metastases from lung adenocarcinoma and significantly correlated with brain metastasis number (p = 0.028) and Lung-molGPA score (p = 0.042). Moreover, L1CAM expression was an independent predictor of survival for brain metastases after neurosurgical resection in a multivariate analysis. Patients with L1CAM high expression had unfavorable overall survival time (p = 0.016). In addition, the multivariate analysis also showed age and extracranial transfer were also the independent prognostic factors for this type of patient with brain metastases. Conclusions A subset of brain metastases from lung adenocarcinoma aberrantly expresses L1CAM. L1CAM is a novel independent prognostic factor for brain metastasis from lung adenocarcinoma after neurosurgical resection.
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OBJECTIVE@#To explore the expression of CCN5 in endometriotic tissues and its impact on proliferation, migration and invasion of human endometrial stromal cells (HESCs).@*METHODS@#We collected ovarian endometriosis samples from 20 women receiving laparoscopic surgery and eutopic endometrium samples from 15 women undergoing IVF-ET for comparison of CCN5 expression. Cultured HESCs were transfected with a recombinant adenovirus Ad-CCN5 for CCN5 overexpression or with a CCN5-specific siRNA for knocking down CCN5 expression, and the changes of cell proliferation, migration and invasion were evaluated using CCK-8 assay, wound healing assay and Transwell chamber assay. RT-qPCR and Western blotting were used to examine the expression levels of epithelial-mesenchymal transition (EMT) markers including E-cadherin, N-cadherin, Snail-1 and vimentin in HESCs with CCN5 overexpression or knockdown.@*RESULTS@#CCN5 expression was significantly decreased in ovarian endometriosis tissues as compared with eutopic endometrium samples (P < 0.01). CCN5 overexpression obviously inhibited the proliferation, migration and invasion of HESCs, significantly increased the expression of E-cadherin and decreased the expressions of N-cadherin, Snail-1 and vimentin (P < 0.01). CCN5 knockdown significantly enhanced the proliferation, migration and invasion of HESCs and produced opposite effects on the expressions of E-cadherin, N-cadherin, Snail-1 and vimentin (P < 0.01).@*CONCLUSION@#CCN5 can regulate the proliferation, migration and invasion of HESCs and thus plays an important role in EMT of HESCs, suggesting the potential of CCN5 as a therapeutic target for endometriosis.
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Feminino , Humanos , Movimento Celular , Proliferação de Células , Endometriose/metabolismo , Endométrio/metabolismo , Células Epiteliais , Transição Epitelial-Mesenquimal , Células EstromaisRESUMO
Objective@#To learn the awareness of the Three Level Social-psychological Service in Zhejiang Province and its influencing factors, so as to provide the basis for promoting the construction of social-psychological service system.@*Methods@#The counties (cities, districts) in Zhejiang Province were divided into three levels: high, medium and low, according to economic development. The residents are selected by multistage stratified random sampling method. A questionnaire survey was conducted to collect the general information of residents and their awareness of the Three Level Social-psychological Service.The influencing factors for the awareness were analyzed by multivariate logistic regression model. @*Results @#Of 7 114 questionnaires sent out, 6 577 valid ones were recovered, with the response rate of 92.45%. The overall awareness rates of the Three Level Social-psychological Service and service sites was 63.02% and 59.91%, respectively. The multivariate logistic regression analysis showed that the age of 40-<50 years ( OR=1.376, 95%CI: 1.077-1.758 ), permanent residence ( OR=1.474, 95%CI: 1.319-1.647 ), being the national pilots ( OR=1.200, 95%CI: 1.079-1.334 ) and having the experience of seeking mental health services before 2018 (OR=1.323, 95%CI: 1.191-1.469) were the influencing factors for the awareness of the Three Level Social-psychological Service; under 50 years old ( OR: 0.610-0.768, 95%CI: 0.423-0.991 ), permanent residence ( OR=1.571, 95%CI: 1.407-1.755 ), being the national pilots ( OR=1.368, 95%CI: 1.232-1.519 ) and having the experience of seeking mental health services before 2018 ( OR=0.733, 95%CI: 0.661-0.812 ) were the influencing factors for the awareness of the Three Level Social-psychological Service sites. @*Conclusions@#It is necessary to improve the awareness of the Three Level Social-psychological Service among Zhejiang residents. Age, permanent residence, being the national pilots, seeking mental health service experience before 2018 are associated with the awareness of the Three Level Social-psychological Service.
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Hyperandrogenism is one of the major clinical characteristics of PCOS,which can be assessed either by biochemical determination of hyperan⁃drogenism or clinical manifestations of hyperan⁃drogenism to make diagnosis.Hyperandrogenism leads to ovulatory dysfunction and menstrual disorder by affecting follicular development,and causes hirsutism and acne as well;it is closely associated with the de⁃velopment of endometrial cancers,diabetes and car⁃diovascular diseases from the long-term perspective.Therefore,it is imperative to fully understand charac⁃teristics and management of PCOS-related hyperan⁃drogenism,which is an important part of the compre⁃hensive therapy for PCOS.
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OBJECTIVE: To explore the incidence and embryo factors of blighted ovum in twin pregnancies achieved by assisted reproductive technology(ART)under controlling for maternal factors by vanishing twin.METHODS: A retrospective analysis was conducted in 610 cases of twin pregnancies achieved by IVF/ICSI twin transfer,who were treated in Nanfang Hospital of Southern Medical University from Jan. 2012 to Jan. 2018,including 474 twin live-birth pregnancies and 136 blighted ovum with singleton live-birth pregnancies. The clinical data of the 2 groups were analyzed for comparisons of the maternal factors,including maternal age,paternal age,BMI,AFC,bFSH/bLH and so on,and embryonic factors,like methods of fertilization,embryo types,proportion of high-quality embryos on DAY3 and so on.RESULTS: There was statistical difference in the serum β-hCG and rate of blastocyst transfer betweeen the two groups(P0.05). Also methods of fertilization,proportion of high-quality embryos on DAY3 and FET cycles were not statistically different between 2 groups.Multifactor Logistic regression analysis showed that blastocyst transfer was the risk factor of blighted ovum(OR=19.386,P<0.05),and β-hCG level was the protective factor(OR=0.290,P<0.05).CONCLUSION: Studying blighted ovum with singleton live birth pregnancies,a kind of vanishing twin syndrome,can control blighted ovum-related maternal factors. Blastocyst transfer may increase the risk of blighted ovum,and low β-hCG level is the predictor of the incidence of blighted ovum.
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<p><b>OBJECTIVE</b>To compare the expression of pinopodes, the marker of endometrial receptivity, during the implantation window in Kunming mice stimulated with two different doses of raloxifene (RAL).</p><p><b>METHODS</b>Forty-eight 8-week-old female Kunming mice were randomly divided into 4 groups (n=12), namely saline group, clomiphene citrate (CC, 18 mg/kg) group, RAL (33 mg/kg) group and RAL (44 mg/kg group). In each group, the mice received intragastric administration of 1 mL of normal saline containing CC or RAL at the specified doses or saline only as indicated for ovulation induction, once daily for 2 days. The mice received then injection with 5 IU human chorionic gonadotropin (HCG) and mated and on day 4.5 of gestation, the pregnant mice were sacrificed for examination of the uterus with scanning electron microscopy.</p><p><b>RESULTS</b>Abundant and well developed pinopodes were observed in the endometrium of the mice in the 2 RAL groups and in the saline control group. The mice in CC group showed obviously reduced endometrial pinopodes with poor development.</p><p><b>CONCLUSIONS</b>RAL at two different doses does not obviously affect the expression of pinopodes in the uterine epithelium of mice, suggesting the safety of RAL at these two doses for ovulation induction without causing adverse effects on endometrial receptivity.</p>
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Objective To compare the effectivenessbetween the use of computer simulationin the teaching of abdomen diagnosis skills and the traditional teaching mode by conducting the real-time assessment and after-school questionnaire survey. Method Weselected 308 undergraduates with 165 (4 classes) majoring in clinical medicine and 143 (4 classes) majoring in medical laboratory in Kunming Medical Universityas the research object. Students were randomly divided into two groups and taught using demonstration method. One group practiced abdominal examination on other students while the other group adopted computer simulation.Both groups were giventests of practical skills and anonymous open-ended questionnaires after class.Results The average score of computer simulation group was higher than the other group. The questionnaire survey showed that computer simulation was suitable for repeatable exercises and easy to review after class (P<0.05).Conclusion In thediagnostic practice of abdominal examination,teaching assisted with computer simulation showing an outstanding performance should be combined and promoted with the traditional teaching.
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Objective To analyze the expression of the placenta Grb10 from women conceived by transferred thawed blastocyst,and to evaluate the security of blastocysts vitrification.Methods A cross-sectional study was performed in the Department of Obstetrics and Gynecology of Fujian Provincial Maternity and Children's Hospital from January 2012 to May 2014,50 women conceived by transferring thawing blastocyst and 50 natural pregnancy control women were enrolled in this study.The expression of Grb10 protein was detected by immunohistochemistry and Western blot,and the expression of Grb10 mRNA was detected by Realtime PCR method.Results Comparison of two cases of gestational age,gestational age,fetal sex,fetal body weight,body length,head circumference,abdominal circumference,there were no significant differences(P>0.05),comparison of placental area,placental weight,the difference was statistically significant(P<0.05).Real-time PCR and Western blot results showed that,there was no significant difference in the expression of Grb10 mRNA and protein between the two groups(P>0.05).Conclusion Blastocysts vitrification may increase the area and quality of delivery of placenta,however,there was no significant change in the expression of Grb10 in placenta.
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<p><b>OBJECTIVE</b>To evaluate the impact of GOLPH3 expression in cumulus granulosa cells on the outcomes of intracytoplasmic sperm injection (ICSI).</p><p><b>METHODS</b>A total of 119 women receiving ICSI due to male infertility at our center between April, 2012 and June, 2014 were enrolled in the study. Cumulus granulosa cells were collected from the women for detection of GOLPH3 expressions using immunocytochemistry, Western blotting, and real-time PCR. GOLPH3 expression rate was compared between women with and without clinical pregnancy following ICSI, and the associations of GOLPH3 expression with the laboratory indicators of ICSI outcomes were assessed.</p><p><b>RESULTS</b>Immunocytochemistry showed that GOLPH3 expression was located mainly in in the plasma of the cumulus granulosa cells. The rate and intensity of GOLPH3 expression in the cumulus granulosa cells differed significantly between women with and without clinical pregnancy following ICSI (P<0.05). GOLPH3 expression was found to positively correlate with the numbers of punctured follicles, grade III oocyte cumulus complex, ICSI oocytes, fertilized oocytes, cleavage, high quality embryos, blastocysts, high quality blastocysts, and frozen embryos (all P<0.01). The results of RTPCR and Western blotting revealed significant differences in GOLPH3 expressions at both the mRNA and protein levels in the cumulus granulosa cells between the pregnant and non-pregnant groups after ICSI (t=14.560, P=0.000). Western blot analysis revealed significant difference of GOLPH3 protein expression in cumulus granulosa cells between women with and without clinical pregnancy following ICSI.</p><p><b>CONCLUSION</b>GOLPH3 expression in the cumulus granulosa cells plays an important role in the development of oocytes and promotion of conception to affect the outcomes of ICSI.</p>
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The presence of RNA has been confirmed in mature human sperm and plays an important role in altering the early events of embryos. Increasing evidence indicates that the expression of small non-coding RNAs can be changed by environmental exposures such as the structure of paternal diet and the status of stress. As the carriers of paternal information and epigenetic markers, small non-coding RNAs can alter the development of early embryos and offspring and mediate transgenerational transmission, which offers a new target for the studies of the epigenetics of sperm. Sperm piRNA, microRNA and tRNA, which are widely present in male germ cells, can mediate transgenerational transmission via related regulation mechanisms. This review introduces some new findings about the transgenerational epigenetics concerning the three small non-coding RNAs in sperm and offers a novel insight into male reproduction.
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Spermatogenesis is a complex developmental process in which a diploid progenitor germ cell transforms into highly specialized spermatozoa. During spermatogenesis, membrane remodeling takes place, and cell membrane permeability and liquidity undergo phase-specific changes, which are all associated with the alteration of membrane lipids. Lipids are important components of the germ cell membrane, whose volume and ratio fluctuate in different phases of spermatogenesis. Abnormal lipid metabolism can cause spermatogenic dysfunction and consequently male infertility. Germ cell membrane lipids are mainly composed of cholesterol, phospholipids and glycolipids, which play critical roles in cell adhesion and signal transduction during spermatogenesis. An insight into the correlation of membrane lipids with spermatogenesis helps us to better understand the mechanisms of spermatogenesis and provide new approaches to the diagnosis and treatment of male infertility.
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Humanos , Masculino , Adesão Celular , Membrana Celular , Química , Colesterol , Química , Glicolipídeos , Química , Infertilidade Masculina , Lipídeos de Membrana , Química , Fosfolipídeos , Química , Transdução de Sinais , Espermatogênese , Espermatozoides , Biologia CelularRESUMO
<p><b>OBJECTIVE</b>To investigate the effect of prostaglandins E2 (PGE2) in enhancing vascular endothelial growth factor (VEGF) expression in a rat macrophage cell line and the effect of the media from PGE2-inuced rat macrophages on angiogenetic ability of human umbilical vein endothelial cells (HUVECs) in vitro.</p><p><b>METHODS</b>Western blotting and qPCR were employed to investigate the expressions of VEGF protein and mRNAs in rat macrophage cell line NR8383 stimulated by PGE2 in the presence or absence of EP2 receptor inhibitor (AH6809) and EP4 receptor inhibitor (AH23848). Conditioned supernatants were obtained from different NR8383 subsets to stimulate HUVECs, and the tube formation ability and migration of the HUVECs were assessed with Transwell assay.</p><p><b>RESULTS</b>PGE2 stimulation significantly enhanced the expression of VEGF protein and mRNAs in NR8383 cells in a dose-dependent manner. The supernatants from NR8383 cells stimulated by PGE2 significantly enhanced tube formation ability of HUVECs (P<0.05) and promoted the cell migration. Such effects of PGE2 were blocked by the application of AH6809 and AH23848.</p><p><b>CONCLUSION</b>PGE2 can dose-dependently increase VEGF expression in NR8383 cells, and the supernatants derived from PGE2-stimulated NR8383 cells can induce HUVEC migration and accelerate the growth of tube like structures. PGE2 are essential to corpus luteum formation by stimulating macrophages to induce angiogenesis through EP2/EP4.</p>
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Animais , Humanos , Ratos , Linhagem Celular , Movimento Celular , Células Cultivadas , Meios de Cultivo Condicionados , Farmacologia , Dinoprostona , Farmacologia , Células Endoteliais da Veia Umbilical Humana , Biologia Celular , Macrófagos , Química , Neovascularização Patológica , RNA Mensageiro , Receptores de Prostaglandina E Subtipo EP2 , Metabolismo , Receptores de Prostaglandina E Subtipo EP4 , Metabolismo , Fator A de Crescimento do Endotélio Vascular , Xantonas , FarmacologiaRESUMO
<p><b>OBJECTIVE</b>To investigate the role of endometrial macrophages in embryo implantation and in regulating the expression of vascular endothelial growth factor A (VEGFA) in mouse endometrium during the peri-implantation period.</p><p><b>METHOD</b>At D3.5 (D0.5 defined as the morning when a vaginal plug was observed), pregnant mice were divided randomly into experimental group, control group and blank group. In the experimental group, the mice were subjected to intrauterine injection of clodronate liposomes on the left side of uterus to eliminate the macrophages, and PBS liposomes on the right side. PBS liposomes and PBS were administered in the control and blank groups, respectively. The uterine tissues were collected on D5.5 and stained with trypan blue to show the implantation sites. Flow cytometry was performed to examine the percentage of F4/80(+) CD11b(+) macrophages macrophages in the uterus. F4/80(+) macrophage population within the endometrium and ovary and changes in VEGFA expression at the implantation and non-implantation sites were examined using immunohistochemistry.</p><p><b>RESULTS</b>Endometrial F4/80(+) CD11b(+) macrophages macrophages were significantly reduced by 74% following intrauterine injection of clodronate liposomes (P<0.05). The number of macrophages in the ovaries showed no significant difference among the 3 groups. In the experimental group, the left side of the uterine showed imcomplete cavity closure with a lower number of implantation site than the right side (2.20∓1.81 vs 5.10∓1.91, P<0.05). VEGFA expression at the implantation site were significantly decreased in the endometrium on the left side with macrophage suppression as compared with that on the right side (P<0.05).</p><p><b>CONCLUSION</b>Endometrial macrophages appear to modulate uterine receptivity by regulating the expression of VEGFA to affect embryo implantation, suggesting the important role of macrophages in embryo implantation.</p>
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Animais , Feminino , Camundongos , Gravidez , Implantação do Embrião , Endométrio , Fisiologia , Imuno-Histoquímica , Macrófagos , Biologia Celular , Ovário , Biologia Celular , Distribuição Aleatória , Útero , Biologia Celular , Fator A de Crescimento do Endotélio Vascular , FisiologiaRESUMO
<p><b>OBJECTIVE</b>To evaluate the impact of sperm midpiece morphology observed under high-power microscope on embryo development following intracytoplasmic morphologically selected sperm injection.</p><p><b>METHODS</b>Morphologically normal sperms from 57 patients undergoing intracytoplasmic sperm injection (ICSI) for male-factor infertility were selected microscopically (magnification of ×200 or 400) and subjected to motile sperm organellar morphology examination (MSOME) at high magnification of ×6000. According to the morphology of sperm medpiece, the sperms were divided into 3 groups, namely group A with a/b of 1-1.2, group B with a/b≥1.5, and group C with irregular morphology. The sperms in the 3 groups were intracytoplasmically injected in oocytes and the outcomes of the embryos were compared.</p><p><b>RESULTS</b>Groups A, B, and C showed significant differences in the rate of ET-D3 top quality embryo (79.7% vs 55.6 % vs 33.3%) and implantation rate (43.2% vs 11.1% vs 0%), but not in the fertilization rate (73.3% vs 80.4% vs 63.5%), blastocyst formation rate (23.2% vs 22.2% vs 9.09%), cryopreservation rate (29.2% vs 25.0 % vs 13.0%), or D3 top quality embryo rate (35.3% vs 37.8% vs 18.8%).</p><p><b>CONCLUSIONS</b>In ICSI cycle, selecting morphologically normal sperms for intracytoplasic injection can increase the normal fertilization rate and top quality embryo rate on the transfer day and improve the implantation rate of the embryo.</p>
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Feminino , Humanos , Masculino , Criopreservação , Implantação do Embrião , Desenvolvimento Embrionário , Fertilização , Infertilidade Masculina , Oócitos , Análise do Sêmen , Injeções de Esperma Intracitoplásmicas , Peça Intermédia do Espermatozoide , FisiologiaRESUMO
<p><b>OBJECTIVE</b>To investigate the associations of occupational, educational and residential factors with the outcomes of in vitro fertilization -embryo transfer (IVF-ET).</p><p><b>METHODS</b>A retrospective analysis was conducted among 3998 patients undergoing the first treatment with IVF-ET and 3064 perinatal infants in our center between January, 2010 and June, 2014. The relation of the patients' occupation, educational background, and residence registry with IVF-ET outcomes was analyzed.</p><p><b>RESULTS</b>The risk of abortion in the first trimester was significantly higher in female patients engaged in agriculture (OR=4.319, P=0.047). Occupation and educational background of the patients and their spouse were related with the incidence of ectopic pregnancy following IVF-ET. The total incidence rate of perinatal birth defects was 2.1% in this cohort, and was the highest in Shenzhen (5.5%) but this difference was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>The patients' occupation and educational background are related with the outcomes of IVF-ET, suggesting the importance of health education and prenatal examination.</p>
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Feminino , Humanos , Lactente , Gravidez , Aborto Espontâneo , Escolaridade , Transferência Embrionária , Fertilização in vitro , Incidência , Ocupações , Resultado da Gravidez , Gravidez Ectópica , Características de Residência , Estudos RetrospectivosRESUMO
<p><b>OBJECTIVE</b>To test whether intracytoplasmic injection of morphologically selected spermatozoa (IMSI) from patients with male factor infertility can improve the clinical and embryo development outcomes of intracytoplasmic sperm injection-embryo transfer (ICSI-ET).</p><p><b>METHODS</b>We performed IMSI for 82 couples diagnosed with obstructive azoospermia at high magnification (×6600) and traditional ICSI for another 91 couples using testicular sperms. We also performed IMSI for 44 couples with teratozoospermia at high magnification (×6600) and traditional ICSI for 71 patients using ejaculated sperms. The clinical and embryo development outcomes were compared between the cycles.</p><p><b>RESULTS</b>For obstructive azoospermia, IMSI and ICSI showed no significant difference in the rates of cleavage (95.5% vs 96.7%), D3 top quality embryos (28.2% vs 29.2%), implantation (26.4% vs 32.3%), pregnancy (47.3% vs 50%), blastocyst formation (54.3% vs 54.6%), or abortion (14% vs 7.3%) (P>0.05), but a significantly higher normal fertilization rate was achieved in IMSI group (84.3% vs 77%, P<0.05). For teratozoospermia, the 2 techniques resulted in no significant differences in the rates of cleavage (96.2% vs 95.2%), D3 top quality embryo (27.6% vs 27.1%), implantation (28.2% vs 30.7%), pregnancy (43.7% vs 43.2%), or abortion (9.7% vs 10.5%) (P>0.05), but the normal fertilization rate (68% vs 75.5%) and the blastocyst formation rate (54.6% vs 67.9% ) were significantly higher in IMSI group (P<0.05).</p><p><b>CONCLUSION</b>IMSI can improve the normal fertilization rates in couples with male factor infertility (including obstructive azoospermia and teratozoospermia) and increase blastocyst formation rate in cases of azoospermia.</p>
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Feminino , Humanos , Masculino , Gravidez , Implantação do Embrião , Transferência Embrionária , Desenvolvimento Embrionário , Fertilização , Infertilidade Masculina , Terapêutica , Injeções de Esperma Intracitoplásmicas , Espermatozoides , Biologia Celular , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To investigate the value of serum beta-human chorionic gonadotropin (β-HCG) on days 9 (d9) and 11 (d11) after fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET) in predicting the pregnancy outcomes.</p><p><b>METHODS</b>A total of 227 fresh ET and FET cycles performed at the Center of Reproductive Medicine, Qingyuan People's Hospital between Dec, 2012 and Feb, 2014 were analyzed. The data of serum β-HCG levels on d9 and d11 after fresh ET and FET cycles and the pregnancy outcomes were reviewed, and the ROC curve was constructed to determine the optimal cut-off level of serum β-HCG level for predicting pregnancy outcomes.</p><p><b>RESULTS</b>According to pregnancy outcomes, the cycles were divided into non-pregnancy group (group A), biochemical pregnancy group (group B), and clinical pregnancy group (group C). Significant differences were found between the mean serum β-HCG levels measured on d9 and d11 in all the 3 groups (P<0.01). The cycles in group C were further divided into 5 subgroups with single pregnancy (C1), twin pregnancy (C2), early abortion (C3), ectopic pregnancy (C4), or intrauterine pregnancy complicated with ectopic pregnancy group (C5), and all the 5 subgroups showed significant differences in β-HCG measurements between d9 and d11 (P<0.01). On d9 after ET and FET, the optimal cut-off level of serum β-HCG was 49.05 IU/L for predicting for clinical pregnancy, and was 105.15 IU/L for predicting twin pregnancy; the two corresponding cut-off levels of serum β-HCG on d11 was 51.2 IU/L and 241.75 IU/L, respectively.</p><p><b>CONCLUSION</b>The absolute serum β-HCG level on d9 and d11 after fresh ET and FET allows an accurate diagnosis of pregnancy and helps in the prediction of the pregnancy outcomes.</p>