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1.
Medicine (Baltimore) ; 99(1): e18489, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895782

RESUMO

BACKGROUND: In a multitude of previous studies, Chlamydia trachomatis (CT) plays an important role in the occurrence of ectopic pregnancy (EP). However, the predictive value of CT infections in the occurrence of EP has not been estimated worldwide. We thus evaluated, by means of a meta-analysis, the current status of the association between CT infections with EP and the potential predictive value of CT infections in EP. METHODS: We evaluated studies performed between the database construction time and August 2018 published in PubMed, the Cochrane Library, EMBASE, and the Web of Science (SCI). The relationship between CT and EP was calculated based upon the predetermined entry criteria for control group selection and the original data. The related articles were analyzed using a random-effects model, and the heterogeneity of the studies was assessed using the I index. Data were analyzed with the STATA 12.0 software. RESULTS: Twenty-five studies that recruited 11960 patients were included in the present meta-analysis, and the relation of CT infections with EP were assessed. The association between CT infections and EP risk showed an odds ratio (OR) of 3.03, with a 95% confidence interval (CI) of 2.37 to 3.89. Our results showed that there was a statistically significant difference between the intervention and control groups. The prevalence of CT infections in EP was then calculated by a subgroup analysis: African (OR, 2.22; 95% CI, 1.14-4.31), European (OR, 3.16; 95% CI, 2.10-4.47), North American (OR, 3.07; 95% CI, 1.78-5.31), and Asian (OR, 3.39; 95% CI, 1.95-5.90). CONCLUSIONS: From the results of numerous studies conducted on different continents, this meta-analysis showed a clear association between EP and prior CT infections, that is, CT infections increase the risk of EP occurrence.


Assuntos
Infecções por Chlamydia/epidemiologia , Gravidez Ectópica/epidemiologia , Adulto , Chlamydia trachomatis , Feminino , Humanos , Razão de Chances , Gravidez , Gravidez Ectópica/etiologia , Prevalência , Fatores de Risco , Sensibilidade e Especificidade
2.
J Gynecol Obstet Hum Reprod ; : 101661, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31809957

RESUMO

BACKGROUND: The objective of this study was to explore the outcomes of using the progestin-primed ovarian stimulation (PPOS) protocol in aged infertile women. The patients recruited in the study had displayed a poor ovarian response (POR) in the first IVF/ICSI-ET cycles with the ultra-short gonadotropin-releasing hormone agonist (GnRH-a) protocols. MATERIALS AND METHODS: A self-controlled retrospective study was conducted to investigate the clinical outcomes of 117 aged infertile women who met the inclusion criteria. The patients were grouped into two; group B included patients who had displayed a poor ovarian response (POR) in the first IVF/ICSI-ET cycle with the ultra-short GnRH-a protocol. Group A was made up of patients who underwent the PPOS protocol in the second cycle. The study was done between January 2015 to May 2018 in the reproductive and genetic centre of integrated traditional and western medicine, Affiliated hospital of Shandong University of traditional Chinese medicine. Reproduction-related clinical outcomes in the two groups were compared. RESULTS: There were no statistically significant differences in the serum levels of LH, E2, and P on the trigger day between group A and group B (P>0.05). The number of follicles with a diameter > 14 mm was significantly higher in the PPOS protocol patients than in the ultra-short GnRH-a protocol group (4.83 ± 2.82 vs. 3.25 ± 2.53, P < 0.01). The duration and total dosage of gonadotropin of the PPOS protocol group were less than in the previous ultra-short GnRH-a protocol, although the statistical differences were not significant (P > 0.05). The number of eggs obtained in the PPOS group was significantly higher than that of the previous one (4.29 ± 3.11 vs. 2.76 ± 2.33, P < 0.05). The numbers of MII eggs, cleavage, 2 P N, transplantable embryos, and high quality embryos were higher in the PPOS protocol group than that in the ultra-short protocol group. However, the differences between the two groups in all the above parameters were not statistically significant (P > 0.05). The rate of high-quality embryos was significantly higher in the PPOS protocol group than in the ultra-short protocol group (38.61(100/259) vs. 32.02(65/203), P < 0.05). Although not statistically significant (P > 0.05), the abortion rate of the PPOS protocol group was higher than that of the ultra-short protocol group. The clinical pregnancy and live birth rates were significantly higher in the PPOS protocol group than in the ultra-short protocol group (p < 0.05). The clinical pregnancy rates in the PPOS protocol group and the ultra-short protocol group were 32.35 % and 25.53 % respectively while the live birth rates were 27.45 % and 21.28 % respectively. CONCLUSION: Compared with the ultra-short protocol, the PPOS protocol improves the number of follicles, the number of eggs, clinical pregnancy, and live birth rates in POR patients. The PPOS protocol could, therefore, provide a novel treatment strategy for inducing ovulation in POR patients.

3.
Medicine (Baltimore) ; 98(38): e17329, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568019

RESUMO

Thus far, all clinical trials evaluating the efficacy of embryo transfer strategies have selectively delayed the first frozen embryo transfer (FET) by at least 1 menstrual cycle. Nevertheless, this approach, which is based solely on clinical experience, may create unnecessary psychological stress on infertile patients who are anxious to conceive as soon as possible. This study aimed to investigate whether the time interval between oocyte retrieval and subsequent FET affects reproductive outcomes.We implemented a large retrospective cohort study in a single assisted reproductive technology (ART) unit at a university-based hospital, including 1540 autologous FET cycles performed in freeze-all cycles. The beginning of the FET was classified as either 'cycle 1' (performing FET within the first menstrual cycle) or 'cycle ≥2' (performing FET after one or more menstrual cycles). Live birth rate (LBR) was the primary outcome of our study.The mean interval for 'cycle 1' and 'cycle ≥2' FETs was 25.72 ±â€Š5.10 days and 75.33 ±â€Š24.85 days, respectively (P < .001). The type of controlled ovarian hyperstimulation (COH) and endometrial preparation protocols differed significantly between groups (P = .008 and P = .004, respectively). However, FET groups were similar in many ways. Univariate analysis showed that there was no significant difference in LBR between the different cycles (33.1% after 'cycle 1' FET vs 34.2% after 'cycle ≥2' FET, P = .68). To evaluate whether LBR remained unchanged after adjustment for potential confounders, we performed multivariate logistic regression. FET timing had no significant impact on LBR in the first FET (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 0.80-1.39).In accordance with the present study, it might not be necessary for clinicians to wait more than 1 menstrual cycle before performing FET. This allows us to reduce otiose deferment in FET, without adversely affecting reproductive outcomes.


Assuntos
Fase de Clivagem do Zigoto , Criopreservação , Transferência Embrionária/métodos , Ciclo Menstrual , Adulto , Feminino , Humanos , Gravidez , Resultado da Gravidez , Técnicas de Reprodução Assistida , Estudos Retrospectivos
4.
Libyan J Med ; 14(1): 1652058, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31405338

RESUMO

Objective: To investigate the effect of the duration of gonadotropin releasing hormone agonist (GnRH-a) use on the outcome of in vitro fertilization and embryo transfer (IVF-ET) during the short-acting long-term hyperstimulation cycle. Methodology: Clinical data from 776 patients receiving controlled ovarian stimulation (COS) after short-term regimen downregulation were retrospectively analyzed. According to the duration of GnRH-a, the patients were divided into 3 groups: Group A, 14 days for GnRH-a; Group B, 15-17 days for GnRH-a; and Group C, >18 days for GnRH-a. The clinical data, treatment and clinical outcomes were compared among the groups. Results: There were no significant differences in fertilization rate, implantation rate, clinical pregnancy rate, abortion rate, ovarian hyperstimulation syndrome (OHSS) rate(P > 0.05). The total costs in group A were significantly less than those in group B and C(P < 0.001). The number of eggs and quality embryos generated in group A was significantly higher than that in groups B and C (P = 0.014, P = 0.005). Conclusions: In the short-acting GnRH agonist long protocol, satisfactory IVF-ET pregnancy outcome was obtained with the use of GnRH-a for 14 days under the premise of lowering the receptor-regulating standard. Excessive application of GnRH-a will affect the number of eggs and embryos and increase the cost of medical treatment.

5.
Mol Cell Endocrinol ; 498: 110548, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31434001

RESUMO

Connexin 43 (Cx43)-coupled gap junctions in granulosa cells play an important role in follicular development, oocyte maturation, and corpus luteum maintenance. Bone morphogenetic protein 6 (BMP6) is highly expressed in human oocytes and granulosa cells and is involved in the regulation of female reproduction. Currently, whether oocyte- and granulosa cell-derived BMP6 affects the expression of Cx43 and its related gap junction intercellular communication (GJIC) activity in human granulosa cells remains unknown. In this study, we demonstrate that BMP6 treatment significantly suppressed the expression of Cx43 in both primary and immortalized (SVOG) human granulosa-lutein cells. Using both pharmacological inhibitors and small interfering RNA-mediated knockdown approaches, we demonstrate that ALK2 and ALK3 BMP type I receptors are involved in BMP6-induced suppressive effects on Cx43 expression and GJIC activity in SVOG cells. Furthermore, these cellular activities are most likely mediated by the SMAD1/SMAD5-SMAD4-dependent signaling pathway. Notably, the ChIP analyses demonstrated that phosphorylated SMADs could bind to human Cx43 promoter. Our findings provide new insight into the molecular mechanisms by which an intrafollicular growth factor regulates cell-cell communication in human granulosa cells.

7.
Sci Rep ; 9(1): 10873, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31350457

RESUMO

The complexity of follicular fluid metabolome presents a significant challenge for qualitative and quantitative metabolite profiling, and for discovering the comprehensive biomarkers. In order to address this challenge, a novel SWATHtoMRM metabolomics method was used for providing broad coverage and excellent quantitative capability to discover the human follicular fluid metabolites related to recurrent spontaneous abortion (RSA) after in vitro fertilization and embryo transfer, and to evaluate their relationship with pregnancy outcome. The follicular fluid samples from the spontaneous abortion group (n = 22) and the control group (n = 22) were analyzed using ultra-performance liquid chromatography high-resolution mass spectrometry. A novel, high-coverage, targeted metabolomics method (SWATH to MRM) and a targeted metabolomics method were used to find and validate the differential metabolites between the two groups. A total of 18 follicular fluid metabolites, including amino acids, cholesterol, vitamins, fatty acids, cholic acid, lysophosphatidylcholine and other metabolites, were identified. In the RSA group, 8 metabolites, namely dehydroepiandrosterone, lysoPC(16:0), lysoPC(18:2), lysoPC(18:1), lysoPC(18:0), lysoPC(20:5), lysoPC(20:4), and lysoPC(20:3), were up-regulated, and 10 metabolites, namely phenylalanine, linoleate, oleic acid, docosahexaenoic acid, lithocholic acid, 25-hydroxyvitamin D3, hydroxycholesterol, 13-hydroxy-alpha-tocopherol, leucine, and tryptophan, were down-regulated. These differential metabolites related to RSA may provide a possible diagnostic basis and therapeutic target for RSA, as well as a scientific basis for elucidating the mechanism of RSA.

8.
Medicine (Baltimore) ; 98(27): e16213, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277129

RESUMO

RATIONALE: The borderline form of empty follicle syndrome (EFS) is a phenomenon where only a few mature or immature oocytes are retrieved despite adequate response to controlled ovarian hyperstimulation (COH). It is a rare phenomenon with an unclear underlying mechanism, and there is currently no effective treatment. PATIENT CONCERNS: The patient received 3 assisted reproductive technology cycles, and although her follicular development and estrogen levels were normal during COH, the outcome with respect to the oocytes obtained was unsatisfactory. DIAGNOSES: Borderline form of EFS. INTERVENTIONS: In the context of undergoing GnRH-antagonist protocol, we implemented a double-trigger with human chorionic gonadotropin (hCG) after 6 hours of gonadotropin-releasing hormone agonist (GnRH-a) administration. OUTCOMES: Eleven oocytes were obtained (M I × 3, M II × 8), which underwent in vitro fertilization (IVF). After 18 hours, 7 oocytes showed normal fertilization, with 2 embryos formed 72 hours later (embryo rating, 6C II × 1, 9C II × 1); the embryos were then frozen. LESSONS: Oocyte maturation and ovulation are time-dependent processes, and that different patients require different lengths/intervals of time for treatment. Therefore, the borderline form of EFS, in general, may be treatable, and our novel trigger method provides a new treatment option for such patients in the future.


Assuntos
Gonadotropina Coriônica/farmacologia , Fármacos para a Fertilidade Feminina/farmacologia , Hormônio Liberador de Gonadotropina/agonistas , Síndrome de Hiperestimulação Ovariana/terapia , Indução da Ovulação/métodos , Adulto , Feminino , Fertilização In Vitro , Humanos , Recuperação de Oócitos , Gravidez , Substâncias para o Controle da Reprodução/farmacologia
9.
Chin J Integr Med ; 25(4): 252-258, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31236889

RESUMO

OBJECTIVE: To observe the effects of electroacupuncture (EA) on reproductive outcomes in women with Shen (Kidndy) deficiency syndrome after in vitro fertilization-embryo transfer (IVF-ET), and explore the underlying molecular mechanism. METHODS: Sixty-six infertile patients with Shen deficiency syndrome undergoing IVF-ET were divided into EA or control groups according to a random table, 33 cases in each group. Before undergoing IVF, patients in the EA and control groups received EA therapy and placebo needle puncture, respectively, for 3 menstrual cycles. Shen deficiency syndrome scores were assessed. Other outcome measures included the number of retrieved oocytes and fertilization, high-quality embryo and clinical pregnancy rates. Follicular fluid was collected on the day of oocyte retrieval, and granulosa cell expression of phosphatidylinositide 3-kinases (PI3K), serine-threonine kinase (Akt) and forkhead box O3 (Foxo3a) mRNA were measured by reverse transcribed and quantitative real-time polymerase chain reaction. RESULTS: Syndrome scores for pre- versus post-treatments decreased significantly (16.53±1.75 to 8.67±1.61) in the EA group (P<0.05), but showed no significant change in the control group (17.18±1.58 to 14.74±1.58). A significant difference in score change was found between the EA and control groups (P<0.05). High-quality embryo and clinical pregnancy rates were both increased in the EA group compared with the control group [69.15% (195/282) vs. 60.27% (176/292) and 66.67% (22/33) vs. 42.42% (14/33), respectively, P<0.05]. The fertilization rate was equivalent in EA and control groups. No difference was found in the number of retrieved oocytes between the two groups. Granulosa cell expression levels of PI3K and Akt mRNA were significantly increased in the EA group compared with the control group, while the expression of Foxo3a was reduced (all P<0.05). CONCLUSIONS: For infertile patients with Shen deficiency syndrome undergoing IVF, EA for tonifying Shen as an adjunct treatment may alleviate clinical symptoms and improve the high-quality embryo rate. The EA-induced mechanism may involve regulation of PI3K/Akt/Foxo3a expression in granulosa cells to improve the developmental microenvironment of oocytes and inhibit granulosa cell apoptosis, possibly contributing to the improved clinical pregnancy rate (Registration No. ChiCTR 1800016217).


Assuntos
Eletroacupuntura , Transferência Embrionária , Fertilização In Vitro , Proteína Forkhead Box O3/metabolismo , Células da Granulosa/metabolismo , Rim/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Adulto , Feminino , Proteína Forkhead Box O3/genética , Humanos , Fosfatidilinositol 3-Quinases/genética , Gravidez , Taxa de Gravidez , Proteínas Proto-Oncogênicas c-akt/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Síndrome
10.
Reprod Biol Endocrinol ; 17(1): 45, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31186025

RESUMO

BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex disorder associated with multiple metabolic disturbance, including defective glucose metabolism and insulin resistance. The altered metabolites caused by the related metabolic disturbance may affect ovarian follicles, which can be reflected in follicular fluid composition. The aim of this study is to investigate follicular fluid metabolic profiles in women with PCOS using an advanced sequential window acquisition of all theoretical fragment-ion spectra (SWATH) mass spectrometry. MATERIALS AND METHODS: Nineteen women with PCOS and twenty-one healthy controls undergoing IVF/ET were recruited, and their follicular fluid samples were collected for metabolomic study. Follicular fluid metabolic profiles, including steroid hormones, free fatty acids, bioactive lipids, and amino acids were analyzed using the principal component analysis (PCA) and partial least squares to latent structure-discriminant analysis (PLS-DA) model. RESULTS: Levels of free fatty acids, 3-hydroxynonanoyl carnitine and eicosapentaenoic acid were significantly increased (P < 0.05), whereas those of bioactive lipids, lysophosphatidylcholines (LysoPC) (16:0), phytosphingosine, LysoPC (14:0) and LysoPC (18:0) were significantly decreased in women with PCOS (P < 0.05). Additionally, levels of steroid hormone deoxycorticosterone and two amino acids, phenylalanine and leucine were higher in the PCOS patients (P < 0.05). CONCLUSION: Women with PCOS display unique metabolic profiles in their follicular fluid, and this data may provide us with important biochemical information and metabolic signatures that enable a better understanding of the pathogenesis of PCOS.


Assuntos
Biomarcadores/análise , Líquido Folicular/química , Espectrometria de Massas/métodos , Metabolômica/métodos , Folículo Ovariano/química , Síndrome do Ovário Policístico/diagnóstico , Adulto , Aminoácidos/análise , Ácidos Graxos não Esterificados/análise , Feminino , Humanos , Análise dos Mínimos Quadrados , Lipídeos/análise , Síndrome do Ovário Policístico/metabolismo , Análise de Componente Principal
11.
Libyan J Med ; 14(1): 1597327, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30935302

RESUMO

Many undergoing in vitro fertilization-embryo transfer (IVF-ET) procedures treatments have been tried for older infertile patients, but still can not reverse the aging effect on oocyte, and infertility treatment is expensive, even for people in developed countries. The study aimed to compare outcomes following the application of luteal phase ovulation induction (LPOI) and ultra-short gonadotropin-releasing hormone agonist (GnRH-a) protocols in patients aged more than 40 years undergoing IVF-ET and to examine the effectiveness and feasibility of LPOI. A total of 266 IVF-ET cycles in 155 patients aged 40 years and over were retrospectively analyzed. Of these patients, 105 underwent the ultra-short GnRH-a protocol (GnRH-a group) and 50 underwent LPOI (LPOI group). Various clinical outcomes were compared between these two groups using either t-tests or the chi-square test. The study showed patients in the LPOI group required a higher dosage of human menopausal gonadotropin and a lower dosage of recombinant follicle stimulating hormone than those in the GnRH-a group. Furthermore, though the total dosage of gonadotropin was higher in the LPOI, its cost was lower. Finally, fertilization rates were higher and high-quality embryo rates were lower in the LPOI group, and the live birth rate of LPOI group is higher than (GnRH-a group) . These between-group differences were all significant (P < 0.05). Compared with the ultra-short GnRH-a protocol, LPOI may enable higher 2-pronuclear embryo fertilization rates and lower gonadotropin costs to be achieved, indicating that LPOI might be an ideal choice for older patients undergoing IVF-ET.


Assuntos
Transferência Embrionária/métodos , Fertilização In Vitro , Hormônio Liberador de Gonadotropina/agonistas , Fase Luteal/fisiologia , Indução da Ovulação/métodos , Adulto , Fatores Etários , Feminino , Humanos , Idade Materna , Estudos Retrospectivos
12.
Acupunct Med ; 37(1): 33-39, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30864824

RESUMO

OBJECTIVE: To evaluate the effect of transcutaneous electrical acupuncture stimulation (TEAS) on pregnancy outcomes in patients with recurrent implantation failure (RIF) undergoing in vitro fertilisation (IVF). METHODS: A total of 122 women with RIF undergoing fresh embryo transfer cycle IVF were randomly allocated to a TEAS or mock TEAS (MTEAS) group. Gonadotrophin therapy using a long protocol was provided in both groups. TEAS consisted of 30 min of stimulation (9-25 mA, 2 Hz) at SP6, CV3, CV4 and Zigong from day 5 of the ovarian stimulation cycle once every other day until the day of embryo transfer. The patients in the control group received MTEAS. Implantation, clinical pregnancy and live birth rates were compared. RESULTS: In the TEAS group, the implantation rate, clinical pregnancy rate and live birth rate (24.3%, 32.8% and 27.9%, respectively) were significantly higher than in the MTEAS group (12.1%, 16.4% and 13.1%, respectively). CONCLUSIONS: TEAS significantly improves the clinical outcomes of subsequent IVF cycles among women who have experienced RIF. TRIAL REGISTRATION NUMBER: ChiCTR-TRC-14004730.


Assuntos
Eletroacupuntura , Infertilidade Feminina/terapia , Pontos de Acupuntura , Adulto , Implantação do Embrião , Transferência Embrionária , Feminino , Fertilização In Vitro , Humanos , Infertilidade Feminina/fisiopatologia , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Estudos Prospectivos , Resultado do Tratamento
13.
Hum Reprod Update ; 25(2): 224-242, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30608586

RESUMO

BACKGROUND: Neurotrophins [nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4)] and glial cell line-derived neurotrophic factor (GDNF) are soluble polypeptide growth factors that are widely recognized for their roles in promoting cell growth, survival and differentiation in several classes of neurons. Outside the nervous system, neurotrophin (NT) and GDNF signaling events have substantial roles in various non-neural tissues, including the ovary. OBJECTIVE AND RATIONALE: The molecular mechanisms that promote and regulate follicular development and oocyte maturation have been extensively investigated. However, most information has been obtained from animal models. Even though the fundamental process is highly similar across species, the paracrine regulation of ovarian function in humans remains poorly characterized. Therefore, this review aims to summarize the expression and functional roles of NTs and GDNF in human ovarian biology and disorders, and to describe and propose the development of novel strategies for diagnosing, treating and preventing related abnormalities. SEARCH METHODS: Relevant literature in the English language from 1990 to 2018 describing the role of NTs and GDNF in mammalian ovarian biology and phenotypes was comprehensively selected using PubMed, MEDLINE and Google Scholar. OUTCOMES: Studies have shown that the neurotrophins NGF, BDNF, NT-3 and NT-4 as well as GDNF and their functional receptors are expressed in the human ovary. Recently, gathered experimental data suggest putative roles for NT and GDNF signaling in the direct control of ovarian function, including follicle assembly, activation of the primordial follicles, follicular growth and development, oocyte maturation, steroidogenesis, ovulation and corpus luteum formation. Additionally, crosstalk occurs between these ovarian regulators and the endocrine signaling system. Dysregulation of the NT system may negatively affect ovarian function, leading to reproductive pathology (decreased ovarian reserve, polycystic ovary syndrome and endometriosis), female infertility and even epithelial ovarian cancers. WIDER IMPLICATIONS: A comprehensive understanding of the expression, actions and underlying molecular mechanisms of the NT/GDNF system in the human ovary is essential for novel approaches to therapeutic and diagnostic interventions in ovarian diseases and to develop more safe, effective methods of inducing ovulation in ART in the treatment of female infertility.

14.
J Pak Med Assoc ; 68(12): 1769-1781, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30504940

RESUMO

OBJECTIVE: To assess the difference in the metabolomics profiles of follicular fluid between older and younger reproductive-aged women. METHODS: The retrospective study was conducted at the Centre of Reproduction and Genetics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China and comprised patient data related to the period between July and October 2015. Follicular fluid was obtained from male-factor infertility women aged 28-35 years as the younger group A, and those aged 35-42 years as the older group B. The subjects were undergoing in vitro fertilization / intracytoplasmic sperm injection and were retrospectively analysed by ultra-performance liquid chromatography-high-resolution mass spectrometry. The fragments were structurally identified using debris' information obtained from fragmented ion scans to identify the different compounds. RESULTS: Of the 55 cases studied, 28(51%) were in group A with a mean age of 29.57 ± 2.92 years, and 27(49%) were in group B with a mean age of 39.19±2.95 years. Compared with the group A, four types of compounds, hormones, licithin, lysophospholipids, and protein degradation fragments, were expressed significantly differentially in group B (p<0.05 each). Nicotine glucuronide and phosphatidylcholine were found only in Group B follicular fluid. CONCLUSIONS: The components of follicular fluid and relative contents were found changed with ageing.


Assuntos
Envelhecimento/metabolismo , Líquido Folicular , Metaboloma/fisiologia , Metabolômica/métodos , Reprodução/fisiologia , Adulto , Biomarcadores/análise , Biomarcadores/metabolismo , Feminino , Fertilização In Vitro , Líquido Folicular/química , Líquido Folicular/metabolismo , Humanos , Infertilidade Feminina/metabolismo , Análise dos Mínimos Quadrados , Estudos Retrospectivos
15.
Pharmazie ; 73(6): 318-323, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29880083

RESUMO

AIM OF THE STUDY: Sequential window acquisition of all theoretical fragment-ion spectra (SWATHTM), a powerful high-resolution mass spectrometric data independent acquisition technique, was used to identify differences that relate certain metabolites to endometriosis (EMT) in follicular fluid collected from EMT patients and a control group. METHODS: A case-control study was conducted to analyze the EMT-related metabolites and the IVF clinical data of 33 subjects. Subjects were divided between the observation group (17 cases, infertility due to EMT) and the control group (16 cases, infertility due to male factor, such as obstructive azoospermia). RESULTS: Analysis revealed three metabolites including phytosphingosine, LysoPC(18:2(9Z,12Z)) and LysoPC(18:0), which were closely related to infertility associated withEMT. In the EMT group, LysoPC(18:2(9Z,12Z)) and LysoPC(18:0) were upregulated, while phytosphingosine was downregulated. CONCLUSIONS: This study employed, for the first time, the SWATHTM data acquisition mode for the metabolomics study of human follicular fluid in patients with EMT. The differential metabolite profiles of follicular fluid were identified and mapped. These differential metabolites are involved in cell proliferation and apoptosis, energy metabolism, inflammatory responses and angiogenesis. The differential metabolite profile may be a new tool for early noninvasive assessment of the developmental potential of oocytes in patients with EMT.


Assuntos
Endometriose/metabolismo , Líquido Folicular/metabolismo , Espectrometria de Massas/métodos , Metabolômica/métodos , Adulto , Estudos de Casos e Controles , Endometriose/complicações , Feminino , Fertilização In Vitro/métodos , Humanos , Infertilidade/etiologia , Infertilidade/metabolismo , Lisofosfatidilcolinas/metabolismo , Masculino , Esfingosina/análogos & derivados , Esfingosina/metabolismo
16.
Biomed Res Int ; 2018: 1780391, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29951527

RESUMO

Objective: We reveal the relationship between progesterone level in follicular fluid and oocyte quality based on sequential window acquisition of all theoretical fragment-ion spectra (SWATH™), a powerful high-resolution mass spectrometric data independent acquisition technique. Method: Follicular fluid samples were collected from 22 subjects (the level of progesterone > 1.5 ng/mL) of progesterone group, as well as from 22 subjects (the level of progesterone < 1.5 ng/mL) of control group, and analyzed using UPLC-Q-TOF. All methods were performed in accordance with ISO 9001:2008. Novel SWATH acquisition mode on an ultra-high performance liquid chromatography coupled with hybrid triple quadrupole time-of-flight mass spectrometry (with resolving power 20,000-40,000) was investigated for the analysis of human follicular fluid. The principal component variable grouping detects intersample variable correlation and groups variables with similar profiles which simplifies interpretation and highlights related ions and fragments. It can also extract product ion spectra from the data collected by fragmenting a wide precursor ion window. Results: Follicular fluid from the two groups differed with respect to five metabolites. Follicular fluid from the progesterone group contained elevated levels of 8-hydroxyguanosine and 4-hydroxynonenal and reduced levels of ATP, estradiol, and L-carnitine. The increased progesterone level on the day of HCG injection could negatively impact oocyte quality, thus reducing the pregnancy rate of IVF patients.


Assuntos
Líquido Folicular/metabolismo , Metabolômica , Oócitos , Progesterona/sangue , Cromatografia Líquida de Alta Pressão , Estradiol , Feminino , Fertilização In Vitro , Humanos , Gravidez
17.
Chin J Integr Med ; 20(7): 503-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24715425

RESUMO

OBJECTIVE: To observe the effects of Liuwei Dihuang Granule ([symbols; see text], LDG) for tonifying Kidney (Shen) on the outcomes of in vitro fertilization pre-embryo transfer (IVF-ET) of infertility women with Kidney-yin deficiency syndrome and to explore its mechanism by detecting the proteome expression in the follicular fluid. METHODS: Sixty-six infertility patients of Kidney-yin deficiency syndrome who would undergo IVF-ET, were randomly assigned to a treatment group and a control group according to a random number table, 33 cases in each group. Another 33 cases of non-Kidney-yin deficiency syndrome was taken as a syndrome-control group. Besides Western routine therapy, LDG was given 3 menstrual cycles before IVF to the treatment group, and a placebo granule to the control and syndrome-control groups. The scores of Kidney-yin deficiency symptoms (sore waist and knees, dry vagina, dysphoria with feverish sensation in the chest, palms and soles, etc.) were assessed, the number of retrieved oocytes, rates of high quality oocytes and embryos, fertility rate and clinical pregnancy rate were recorded, and the follicular fluid was collected on the day when the ovum was picked up, the differential protein expression was detected using two-dimensional gel electrophoresis, and then, matrix assisted laser desorption ionization time-of flight mass spectrometry (MALDI-TOF-MS) was applied to identify the proteins. RESULTS: The syndrome score in the treatment group decreased significantly from 16.09±2.58 to 8.67±2.13, while it changed insignificantly in the control group, with a significant difference in the lowering score between the two groups (P<0.05); the high quality rates of oocytes and embryos and clinical pregnancy rate were all superior in the treatment group to the control group (82.29% vs 78.08%, 76.76% vs 68.79%, 63.64% vs 36.36%, all P<0.05). The protein expression map from the follicular fluid showed that compared with the control group, 33 differential protein expressions were found in the syndrome-control group, among which 18 were down-regulated, and 15 up-regulated; in the treatment group 28 differential protein expressions were found, among which 15 were down-regulated, and 13 up-regulated. Through MALDI-TOF-MS, 14 proteins were identified (P<0.05). CONCLUSIONS: For the infertility patients undergoing IVF, LDG could alleviate clinical symptoms, improve rates of high quality oocytes and embryos, so as to raise clinical pregnancy rate. The mechanism may be through regulating proteome expression in the follicular fluid to improve the developmental microenvironment for oocytes which would lead to a successful embryo implantation.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fertilização In Vitro/métodos , Infertilidade Feminina/terapia , Resultado da Gravidez , Proteômica/métodos , Deficiência da Energia Yin/terapia , Adulto , Transferência Embrionária , Feminino , Líquido Folicular/metabolismo , Saúde Holística , Humanos , Infertilidade Feminina/metabolismo , Rim/metabolismo , Oócitos/citologia , Oócitos/metabolismo , Síndrome de Hiperestimulação Ovariana/metabolismo , Placebos , Gravidez , Deficiência da Energia Yin/metabolismo
18.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 34(11): 1306-9, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25566619

RESUMO

OBJECTIVE: To observe the effect of Yougui Formula Granule (YFG) on ovarian granulosa cells gene expression profiles in in vitro fertilization-embryo transfer (IVF-ET) patients of Shen yang deficiency syndrome (SYDS) from the viewpoint of genomics. METHODS: Totally 72 infertility patients undergoing IVF-ET were randomly assigned to the treatment group and the control group according to random digit table, 36 in each group. Patients in the treatment group took YFG combined gonadotropin (Gn), while those in the control group took placebos combined Gn. All medication lasted for 3 menstrual cycles before IVF. With high-throughput gene sequencing technology, gene expression profiles of ovarian granulosa cells in the two groups were analyzed to explore the difference by gene ontology (GO) enrichment analysis and kyoto encyclopedia of genes and genomes (KEGG) pathway analysis. RESULTS: Ovarian granulosa cell gene expression profiles from the follicular fluid showed, when compared with the control group, 391 differential genes were found in the syndrome-control group, 153 down-regulated and 238 upregulated. Enrichment of differentially expressed cellular location and molecular function of genes involved cell proliferation and apoptosis associated cyclin, protein ubiquitination, construction of microtubules and microfilament, mitochondrial function and energy-related factors, regulatory factors for hormone synthesis. Participated pathways involved energy metabolism pathway and transforming growth factor-ß (TGF-ß) signaling pathway. CONCLUSIONS: There existed significant difference in gene expression profiles of ovarian granulosa cells between the treatment group and the control group. Differentially expressed genes involved in biological processes correlates with Shen yang deficiency induced proliferation of germ cells, confused apoptosis, and hindered process during which mitochondria produced energy.


Assuntos
Medicamentos de Ervas Chinesas/farmacologia , Fertilização In Vitro , Medicamentos de Ervas Chinesas/uso terapêutico , Transferência Embrionária , Feminino , Líquido Folicular , Expressão Gênica/efeitos dos fármacos , Gonadotropinas , Células da Granulosa , Humanos , Síndrome , Transcriptoma , Deficiência da Energia Yang
19.
Afr J Tradit Complement Altern Med ; 10(6): 563-7, 2013 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-24311889

RESUMO

The objective of this paper was to investigate the characteristics and general rules of domestic safflower injection causing allergic shock, to retrieve the medical journals published domestically, and to make statistical analysis on the cases of allergic shock caused by safflower injection. Results showed that the incidence of allergic shock caused by safflower injection in patients above 40 years old was high: females were more than males. It occurred within 30 min after medication, and no patient died after emergency treatment. The study concluded that allergic shock caused by safflower injection is related to many factors, and clinical care personnel should pay more attention to it.


Assuntos
Anafilaxia/induzido quimicamente , Carthamus tinctorius , Flores , Extratos Vegetais/efeitos adversos , Adulto , Distribuição por Idade , Idoso , Anafilaxia/epidemiologia , Feminino , Humanos , Infusões Intravenosas , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
20.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 32(8): 1023-7, 2012 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-23173245

RESUMO

OBJECTIVE: To assess the effects of acupuncture combined Chinese materia medica for tonifying shen and soothing gan (CMMTSSG) on the anxiety and depression of patients with in vitro fertilization and embryo transplantation (IVF-ET), and to observe the treatment outcomes. METHODS: Totally 97 IVF-ET patients were randomly assigned to two groups, the acupuncture combined CMMTSSG (group A, 51 cases) and the Western medicine treatment group (group B, 46 cases). The long protocol of IVF-ET in a mid luteal phase was performed in all patients. Patients in group A received acupuncture and CMMTSSG (erzhi tiangui granule and xiaoyao granule) during the process of ovarian hyperstimulation, while those in group B only received the routines of IVF-ET. The improvement of Shen deficiency Gan depression syndrome (SDGDS) between after and before treatment were observed in the two groups. The changes of self-rating anxiety scale (SAS) and Beck depression inventory (BDI) score were observed. The endometrial thickness, typing, and endometrial blood flow resistance index (RI) on the day of injecting HCG, the number of retrieved oocytes, the rate of high quality oocytes, the fertilization rate, the rate of high quality embryos, and the clinical pregnancy rate were respectively compared between the two groups. RESULTS: The scores of SDGDS, SAS, and BDI were improved more obviously in group A than in group B, showing statistical difference (P < 0.01). There was no statistical difference in the endometrial thickness on the day of injecting HCG between the two groups (P > 0.05). The proportion of type A endometrium was 74.5% (38/51 cases) in group A and 45.7% (21/46 cases) in group B, showing statistical difference between the two groups (P < 0.01). The RI was significantly lower in group A (0.48 +/- 0.03) than in group B on the day of injecting HCG (0.52 +/- 0.06, P < 0.01). There was no statistical difference in the number of retrieved oocytes and the fertilization rate between the two groups (P > 0.05). The rate of high quality oocyte, the rate of high quality embryos, and the clinical pregnancy rate were all improved more significantly in group A than in group B, showing statistical difference between the two groups (P < 0.05). CONCLUSIONS: Acupuncture combined CM-MTSSG could obviously alleviate unfavorable emotions as anxiety and depression in patients with IVF-ET, effectively improve the treatment outcomes. Its effects might be correlated with lowering the excitability of the sympathetic nervous system, elevating the quality of oocytes, and improving the endometrial receptivity.


Assuntos
Terapia por Acupuntura , Ansiedade/terapia , Depressão/terapia , Medicamentos de Ervas Chinesas/uso terapêutico , Transferência Embrionária/psicologia , Fertilização In Vitro/psicologia , Adulto , Feminino , Humanos , Gravidez , Taxa de Gravidez , Resultado do Tratamento
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