Cardiovascular dysfunction in offspring of ovarian-hyperstimulated women and effects of estradiol and progesterone: a retrospective cohort study and proteomics analysis.

CONTEXT: The cardiovascular dysfunction in children born with assisted reproductive technologies has been of great concern. However, the association of ovarian hyperstimulation syndrome (OHSS), a complication of assisted reproductive technologies, with worse cardiovascular functions and underlying mechanism remains unknown. OBJECTIVES: The objective of the study was to assess the cardiovascular functions of children born to mothers with OHSS and investigate the underlying regulator(s). DESIGN AND SETTING: This was a retrospective cohort recruited in a university hospital. PARTICIPANTS AND METHODS: We assessed the cardiovascular functions by Doppler echography in 42 children born to OHSS women, 34 children of mothers with non-OHSS in vitro fertilization, and 48 spontaneously conceived (SC) children (mean age ∼ 4.5 y). Groups were matched for gestational age at delivery and birth weight. An isobaric tag for relative and absolute quantitation-labeled proteomics analysis was performed with another set of umbilical arteries from OHSS and SC pregnancies (n = 3 for both groups). RESULTS: Children of OHSS mothers showed a significantly decreased mitral ratio of early to late mitral peak velocities, reduced systolic and diastolic diameters of common carotid arteries, and impaired flow-mediated dilation compared with non-OHSS in vitro fertilization and SC children. Intima-media thickness and arterial stiffness indices were similar in the three groups. In the proteomics study, 1640 proteins were identified from OHSS and SC umbilical arteries, and 40 differentially expressed proteins were selected for further analysis. Estradiol and progesterone were identified as activated upstream regulators. CONCLUSIONS: Children born to ovarian-hyperstimulated women displayed cardiovascular dysfunctions. The underlying mechanisms may involve the effects of supraphysiological estradiol and progesterone levels.

[Influence of Xianglingwan on dysmenorrhea and serum CA125 in treating patients with endometriosis].

OBJECTIVE: To observe the influence of Xianglingwan on dysmenorrhea and serum CA125 in treating patients with endometriosis. METHOD: A total of 54 patients with endometriosis and without medical complications were random selected. Xianglingwan was administered from the fifth day of the menstrual cycle for 3 weeks every month as a therapeutic course, and three months for a therapeutic period. Pelvic type B ultrasonograph and blood CA125 were detected before and after treatment. Visual analogue scale was admitted to evaluate the dysmenorrhea. RESULT: The serum CA125 reduced obviously after therapy. There was a significant difference between them (P < 0.01). The symptom of dysmenorrhea also reduced obviously after treatment. There was a significant difference between them (P < 0.05). CONCLUSION: Xianglingwan can treat edometriosis effectively, and has less adverse reactions, it can also reduce the symptom of dysmenorrheal and the serum CA125.

[Role of three-dimensional transvaginal sonography in evaluation of the depth of myometrial invasion of endometrial carcinoma].

OBJECTIVE: To investigate the value of three-dimensional transvaginal sonography (3-DTVS) in diagnosing depth of myometrial invasion (MI) and analyze factors that may influence 3-DTVS diagnosis. METHODS: Fifty-three patients with endometrial carcinoma proven by histological diagnosis postoperatively in Women's Hospital, Zhejiang University from 2002 to 2003 were included in the study. All patients underwent primary surgery and 2-DTVS and 3-DTVS examinations within 7 days before operation. The diagnosis of the depth of MI was made by multiplanar mode reconstruction and volume measurement based on 3-DTVS. Clinical-pathological parameters were simultaneously recorded. RESULTS: Eighteen patients were deep MI, 31 superficial MI and 4 no myometrial involvement. The sensitivity, specificity, positive and negative predictive values of 3-DTVS and 2-DTVS in detecting superficial MI were 92%, 100%, 100%, 67%; and 44%, 100%, 100%, 21%, respectively. The sensitivity, specificity, positive and negative predictive values of 3-DTVS and 2-DTVS in detecting deep MI were 72%, 86%, 72%, 86% and 75%, 84%, 67%, 89%, respectively. There was significant difference between 3-DTVS and 2-DTVS in detecting superficial MI (chi(2) = 13.2011, P = 0.005), but no significant difference in detecting deep MI (chi(2) = 0.0000, P > 0.05). The median tumor volume of deep and superficial MI was 1.12 cm(3) (Q(25 - 75) = 1.12 - 4.49) and 9.16 cm(3) (Q(25 - 75) = 3.35 - 23.12) respectively. There was a significant difference between the two groups (z = -3.72, P = 0.000). Among all the parameters involved in the study there was no significant factor influencing 3-DTVS diagnosis. CONCLUSIONS: Three-DTVS is superior to 2-DTVS in detecting superficial MI, but not in deep MI. The measurement of tumor volume with 3-DTVS could be used as an objective parameter for detecting deep MI.